This document discusses the key components and considerations for wheelchair design and use. It explains that wheelchairs come in different sizes for adults, children, and infants. The frame can be rigid or folding, and the tires, wheels, brakes, and other parts are selected based on indoor or outdoor use and the individual's needs. Proper fit is important for comfort and to prevent secondary disabilities. Patients should be trained on basic wheelchair skills. Regular maintenance and occasional overhauls are also recommended. Wheelchairs may be modified to facilitate transfers, positioning, self-propulsion, and transportation.

1. BY
DR MOHD SHOEB PT

2.  A wheelchair is not just a chair with wheels,
it is a second home to the patient, since he
spend so much time in it.
 The patient’s wheechair should be designed
for comfort and ease of manipulation.
 Wheelchair differ in design and consruction
based on the needs of individuals and their
disabilities.

3.  Wheelchair come in three size : adult, child
and tiny tot.
 Since many of the disabled individuals live out
of wheechairs it is important to prescribe the
most comfortable one for a patient in the given
circumstances.

5.  FRAMES :- Frames are either rigid or folding.
The types of frames affects maneuverability
of the chair. A rigid frame in one solid piece
is lighter and used more for sports and other
rugged acivities. A folding frame is heavier
and requires more effort to maneuver but is
more convenient for storage in the home and
for placing into the car while travelling since
it occupies much less space.

6.  TYRES :- The selection of tyres depends on
the use of the chair. Tyres made with solid,
hard polyurethane and are designed for
indoor use, allowing for easy handling on
smooth surfaces. If used outdoor these tyre
offer no shock absorption.
Air filled tyres provide for shock absorption
and a smooth ride, particularly outdoor on
uneven or rough terrain. These tyre require
more effort to handle.

7.  WHEELS :- Two types of wheels are available
solid magnesium and with spokes.
Solid magnesium wheels never lose their
shape. Spoked wheels are lighter and
therefore easy to handle. The disadvantages
of spoked wheels is that the spokes are easily
broken and cause wheel to lose it shape.
They must be tightened frequently.
Wheel sizes may vary depending on the size
and weight of the user.

8.  WHEEL LOCKS :- prevents the chair from
rolling and can assist in slowing and stopping
the momentum of the chair. They are mounted
either in high or low position.
 CASTERS :- there are two caster in front of
the wheel. They are different from wheel in
that they can revolve in all direction and allow
for better front end handling on smoth
surfaces. These are pneumatic, semi-
pneumatic or solid. Casters may also have
locks.

9.  PUSH RIM (HAND RIMS) :- The type of push rim
depends on the user’s grip. There are basically
three types :
1. Standard metal rim
2. Friction rim
3. Rims with projection

10. Standard metal rim are used when grip is not a
problem. Friction rim are standard rim with friction
tape or surgical tubing to provide additional grip on
the rim surface. Projection rim are used by people
with limited reach and grip. Spacing between the
push rim and the tyre is adjusted to suit the user’s
hand size.

11.  FOOTRESTS :- footrest maintain the feet in
neutral and prevent deformities like equinus.
They are either fixed or movable. Swing away
footrest are more convenient but increase the
length of the chair, which affect turning. Heel
loops or leg straps can be added to the foot
plate.

12.  TILT BARS :- It project from the back frame,
usually 2-3 inches above the floor, used by
individual who is pushing the wheelchair. By
placing the foot on tilt bar and pushing down
with the foot, the person can tilt the
wheelchair back, allowing the caster to rise
off the surface, thus enabling them to clear
objects.

13.  BACKREST :- High wheelchair back provide
trunk support and are ideal for a high level
quadriplegic. Low chair back provide great
freedom for movement and preferred for low
level spinal cord lesion. Many wheelchair have
their backrest detachable, permitting a back
transfer.

14.  ARMRESTS :- Removable armrest are
convenient, provide support and make
transferring easy. It can be fixed or
adjustable in height and provide desired arm
support. However they restrict movement
during propulsion.

15.  FOLDABILITY :- many wheelchairs are
lightweight, foldable and modular, which
makes it convenier to transport in buses,
train and car. The seat in such wheelchair are
usually canvas.
 CUSHION :- Used to achieve the most
comfortable and supportive position possible
and make all the difference in development
of secondary disability like pressure sore. It
can be customized for postural control and
pressure relief. Seat cushion may be air
filled, gel inserted or contour foam.

16.  HEAD REST :- it is prescribed for those who
have no head control and have primitive
neck reflex. It is also detachable.
 CLOTHES GUARD :- this prevent loose fiting
clothes from getting entangled in the
wheels.

17. The patient is taught basic movement within the
wheelchair.
1. To manipulate the brakes.
2. To remove the armrest.
3. To pickup objects from the floor.
4. To reach down the foot rest.
5. To lift buttock forward in the chair.
6. To perform a wheelie.
7. To turn the chair.
8. To use the chair on sloping ground.
9. To push on the flat surface.

18.  The wheelchair should be cleaned regularly.
Mild soapy water and wax should be used on
the painted surfaces.
 Oil may be used for all movable parts, except
bearing for lubrication.
 Nuts, and bolts which tend to loosen over
time, must be tightened.

19.  The wheels should run parallel in a straight
line.
 Tyre pressure should be checked. Low
pressure will damage rims and make the
chair more difficult to propel.
 Once every six months wheelchair should
have a complete overhaul particularly if used
otdoors.

20. There are five justification for modifying specific
wheelchair parts and presenting new models :-
1. To facilitate transfer
2. To facilitate proper positioning
3. To overcome architectural barriers
4. To allow self propulsion
5. To permit transportation of objects in the
wheelchair.
6. To allow its own transportation.