Decisions, decisions! Today a person selecting a wheelchair faces many: Do I want or need a manual chair or a powered wheelchair? If I decide I need a powered wheel-chair, what kind of chair do I want? What special features might I need or want? How much speed do I need from my chair? What other factors should I consider in deciding which chair is best for me? This ABLEDATA Fact Sheet is designed to explore the special considerations in powered wheelchair selection and the various options available to meet the needs of powered chair users.
Until 1993, there were two basic styles of powered wheelchairs on the market: The traditional style and the platform-model powered chair. The traditional-style chair, the most common design in use today, is similar in appearance to a standard everyday wheelchair and is reinforced to tolerate the extra weight of a power and control system. These chairs usually are powered by a battery attached behind or underneath the seat of the wheelchair. The platform-model powered chair consists of a seating platform located atop a power base. A variation on the power base concept is a chair that includes built-in lifts to allow the user to raise and lower the seating platform. In 1993, a round-based powered chair called the Hoveround emerged on the market, effectively creating a new classification of powered chair. Another fairly recent innovation in the powered mobility aid market is the 3- or 4-wheeled scooter. For users with good upper body and arm strength and the ability to sit for extended periods, scooters may be a somewhat less expensive alternative to a powered wheelchair (for a detailed discussion of scooters and their features, see the ABLEDATA Fact Sheet on Scooters).
A powered wheelchair must be selected carefully in order to ensure it not only meets the needs of the individual who will use it but also represents good value for the money being invested in it. A 1993 report prepared by the Rehabilitation Engineering Center at the National Rehabilitation Hospital entitled Evaluating Powered Wheelchairs suggests that the powered wheelchair selection process include evaluation of the individual's physical status, functional capabilities, and usage requirements. Physical considerations include posture, strength, sensation, visual acuity and perception, and the ability to learn how to use the wheelchair safely. A functional evaluation should include actual use of the wheelchair in everyday settings; an evaluation of the individual's ability to get in and out of the wheelchair; and the ability to perform needed activities from the wheelchair.
While the person's physical capabilities and functional capacity clearly are important factors to consider, it also is essential that the wheelchair selected "fits" the individual's lifestyle. For example, if it is to be used both in the home and at work (or school) both environments must be architecturally accessible. If the person cannot get into the bathroom using a particular wheelchair, that chair is not a practical alternative for that individual. Transportation to and from various settings also is an important consideration: Is a van available to transport the individual in the chair, or is it necessary for the chair to fold or disassemble in order to be carried in an automobile trunk?
Another important consideration, and one that has not received much attention until recently, is personal style. Because powered wheelchairs generally are used by people with severe disabilities, function has traditionally been stressed over style. However, consumer demand for improved appearance of powered wheelchairs has led to an effort on the part of manufacturers to develop aesthetically appealing powered wheelchairs, some in a selection of colors, and most with more streamlined designs.
Basic powered wheelchair components have many similarities to those found on manual chairs. However, others such as controllers, batteries, and drive systems are unique to powered wheelchairs.
Frames
Many traditional-style models utilize the traditional cross-brace frame which
allows the chair to be folded or collapsed for storage and transport once the
batteries have been removed. Other traditional models and some power base chairs
disassemble for transport. A number of chairs, however, are designed to be transported
while carrying the user; consequently, they do not fold or disassemble.
One of the biggest breakthroughs in wheelchair technology has been the development of new, lighter-weight materials for wheelchair frames and some of these materials are now being used for powered wheelchairs. Traditional-style chairs now have frames made of steel, cold-rolled steel, tubular steel, chrome-moly, and aluminum. Power base chairs may have aluminum, stainless steel, cold-rolled steel, flat steel, tubular steel, or steel frames. The type of material used to construct the frame affects the weight of the frame, and therefore the overall weight of the wheelchair. The type of frame material also can affect the wheelchair's overall strength. While some of the materials used may result in powered chairs being relatively lighter weight than they have been in the past, it should be noted that powered chairs are still considerably heavier than manual wheelchairs, with weights ranging from 85 pounds to more than 300 pounds.
Upholstery
Upholstery for wheelchairs must withstand daily use in all kinds of
weather. Consequently, manufacturers provide a variety of options to users,
ranging from cloth to new synthetic fabrics to leather. Many manufacturers
also offer a selection of upholstery colors, ranging from black to neon, to
allow for individual selection and differing tastes among consumers.
Seating System
Seating systems are sold separately from the wheelchairs themselves,
as seating must be chosen on an individual basis. It is important when selecting
a wheelchair or a seating system to ensure that the two components are compatible.
Power base chairs, because of their more modular construction, frequently feature
customized chair-style seating systems.
Brakes
Most powered chairs utilize a dynamic braking system in which the motor
and brakes work together to slow and stop the chair when the joystick or other
controller is released, and which automatically engages the brakes when the
power is off or when the chair is not being powered in a forward or reverse
motion with the controller. Traditional-style chairs frequently also have "parking
brakes" (wheel locks) similar to those found on manual chairs which are
available in several different designs and can be mounted at various heights
to maximize convenience for the user.
Wheels/Tires
Traditional-style chairs generally use the standard four-wheel configuration,
with two large wheels at the back and two smaller ones (casters) at the front.
The standard tire used for the rear wheels on most wheelchairs is a pneumatic
tire, for which the standard sizes are 20 or 24 inches. Smaller and larger sizes,
however, also are used as are solid and semi-pneumatic tires. Casters, too,
vary in size (generally ranging from six to eight inches in diameter, although
smaller sizes are also used) and composition (pneumatic, solid rubber, plastic,
or a combination of these). Power base chairs typically use four wheels of the
same size, usually 8 to 10 inches in diameter. These chairs may have pneumatic,
semi-pneumatic, or solid tires.
Footrests
A variety of footrest assemblies are available on both types of wheelchairs.
They may be a rigid single unit, 90 degree-90 degree platforms, folding, flip-up,
detachable, adjustable length, hemi- height, or have a combination of features.
Armrests
Armrests also come in several styles or with a combination of features.
They may be full- or desk-length, or wraparound, and they may be fixed, removable,
pivoting, and/or adjustable height.
Controls
Powered chairs generally include as a standard feature a manually controlled
joystick to regulate the chair's speed and direction. However, most manufacturers
offer customized control options to accommodate the varied abilities of the
user, including sip-n-puff systems, head and chin switches, push-button controls,
trackballs, and tillers. Many chairs also have programmable control features
which allow the user or a dealer to adjust or set the chair's speed and control
limits as the user's abilities change. There are also manufacturers who do not
make wheelchairs, but who offer specialized control systems for powered wheelchairs,
including voice-activated controls. When purchasing controls and switches from
a source other than the chair's manufacturer, it is essential to determine that
the selected control is compatible with the chair.
Drive System
The drive system refers to the means by which power is delivered to
the chair's wheels. Standard drive systems include gear drive, direct drive,
and belt drive. The type of drive system affects the power available to propel
the chair and the amount and type of maintenance the chair requires.
Batteries
Batteries are a determining factor in the range and power of a powered
chair. Generally, the larger the chair's batteries, the greater the power and
the longer the chair's range between charges. Many chairs require two rechargeable
12-volt batteries. Most wheelchairs utilize U1, group 22 or 24 batteries, although
other batteries are also used. More manufacturers are designing chairs around
the group 24 battery because it affords a longer range. The type of battery
required is also an important consideration in terms of safety, maintenance,
and transport. Powered chairs may utilize lead acid, gel cell, or sealed wet
batteries. Gel cell batteries require the least maintenance and have less danger
of leaking than do the other battery types. Gel cell batteries are also required
by a number of airlines when transporting powered chairs.
When purchasing a powered wheelchair, the user also should consider whether batteries and the battery charger are included with the chair or whether they are extra-cost items. Another consideration is the range or distance a chair can travel between charges. Although factors such as the user's weight, additional powered features, speed, and the type of terrain on which the chair is used will effect the range, a maximum distance can be determined; that may be as few as 7 miles or as many as 40 miles. It is important that the chair's performance meet the user's needs and expectations.
Special Powered Features
Powered chairs may offer specialized powered features to meet the user's
needs, either as customization or options on a standard chair or as a chair
designed specifically for a particular purpose. Among the available features
are elevating and lowering seats, and reclining and/or tilt-in-space seats.
Specialized chairs have the capacity to raise the user to a standing position,
to negotiate stairs, or to be used as a lift or in transferring.
The Hoveround, as mentioned above, is a powered mobility aid that emerged on the market in 1993 and has effectively created a new class of powered chair. Its configuration is similar to that of a power base chair, but it also possesses features and options more frequently found on scooters. The unique features of the Hoveround include its round power base, which allows for an extremely tight turning radius, effectively allowing the user to "turn on a dime," and its one steerable rear wheel.
The American National Standards Institute (ANSI) recently approved a complete set of 18 standards for wheelchairs. These standards provide for standard methods of disclosing information and standard testing methods to measure a chair's strength, "tip-ability," turning radius, and other important criteria. The standards were developed by a committee that included rehabilitation engineers, manufacturers, consumers, and therapists from RESNA, a professional association that promotes the use of assistive technology by people with disabilities. The standards themselves are highly technical documents. However, summary documents are available from RESNA, 1700 North Moore Street, Suite 1540, Arlington, VA 22209; (703) 524-6686. Also available from RESNA is the complete set of standards for $180, or individual standards for $15 each.
Until recently, it has been difficult to find comparative product information about wheelchairs. While organizations like Consumers Union regularly test and report upon consumer products that are directed toward the general marketplace, little comparative testing has been done on products for small market items such as powered wheelchairs. Consequently, a wheelchair purchaser has been dependent upon anecdotal reports from other wheelchair purchasers or upon the experience of individuals who have prescribed a number of different wheelchairs over a period of time. In recent years, however, a concerted effort has been made to develop useful comparative information about wheelchairs.
The Rehabilitation Engineering Center at the National Rehabilitation Hospital (NRH) conducted a comprehensive comparative study of ten powered wheelchairs, using the ANSI/RESNA wheelchair standards test methods. Included in this study were wheelchairs from the following manufacturers: Damaco; Everest & Jennings International; Fortress Scientific; Invacare Corporation; Permobil Inc.; Redman Inc.; and 21st Century Scientific Inc. This is one of the first studies conducted in which standardized test methods have been used to compare performance and safety factors of powered wheelchairs. While the ten chairs tested represent only a fraction of the total number of powered wheelchairs available on the market, the results of this study, as well as the explanatory information included with the description of each test, make this an essential resource for powered wheelchair selection criteria. Copies of the study are available from NARIC, 800/346-2742.
Paraplegia News conducted a survey of powered wheelchairs in its April 1993 issue, where specific characteristics of wheelchairs were compared using the ANSI/RESNA standards. The article provides comparative product information on more than thirty powered wheelchairs currently on the market. Back issues of the magazine sometimes are available; so are reprints of specific articles. Readers who are interested in receiving a copy of this publication should call Paralyzed Veterans of America (PVA) Publications for availability. Their telephone number is 602/224-0500.
Homecare Magazine and TeamRehab Reports also publish an annual "Wheelchair Focus" that provides similar comparative information. It is published once a year (also in the spring) and can be ordered through Miramar Publishing at 800/543-4116 or 213/337-1041.
Anyone who has purchased or is considering the purchase of a powered wheelchair should be aware of the expense of buying and maintaining them. The purchase price of a powered wheelchair rarely is less than $3,500; for the more deluxe models or those with specialized adaptations, the price can exceed $12,000 and be as high as $20,000 or more. Thus, a powered wheelchair is a major financial investment. Like any major financial decision, purchase of a powered wheelchair should be undertaken with the utmost care to ensure the product meets the needs of the individual who will be using it.
Funding for wheelchairs or other assistive devices is dependent upon an individual's medical insurance and eligibility for medical and social services, income support or vocational assistance from a number of different resources. The ABLEDATA Informed Consumer's Guide on Funding Assistive Technology is available to answer questions about funding resources.
This ABLEDATA fact sheet is an introduction to the types of powered wheelchairs available and considerations in powered chair selection. Further help is found in the table of manufacturers and distributors of powered wheelchairs at the conclusion of this fact sheet.
ABLEDATA also offers fact sheets on Wheelchairs for Children, Manual Wheelchairs,
and Scooters. In addition, the Informed Consumer's Guide to Wheelchair
Selection is available. This publication includes a resource section
listing further reading about choosing a wheelchair and making model comparisons.
Individual copies of the Fact Sheets and the Consumer Guide are available from
ABLEDATA.
21st Century Scientific 208/667-8800
Chair type(s): Traditional
Action by Invacare 216/329-6000
Chair type(s): Traditional; Power Base
Australian Transcender Industries GPO Box 3908 Sydney 2001 NSW AUSTRALIA
Chair type(s): Specialty (Stair Climber/Rough Terrain)
Damaco/Freedom on Wheels 805/532-1832 or 800/432-2434
Chair type(s): Traditional
Everest & Jennings 314/369-3515 or 800/235-4661
Chair type(s): Traditional; Power Base
Falcon Rehabilitation Products 303/287-6808
Chair type(s): Specialty (Stander Chair: Must be ordered through Durable Medical
Equipment Dealers)
Fortress, Inc. 209/323-0292
Chair type(s): Traditional; Power Base
Gendron 419/445-6060 or 800/537-2521
Chair type(s): Traditional
Hadco Marketing Services 6601 NW 14th Street, #2 Ft. Lauderdale, FL 33313-4579
Chair type(s): Traditional
Hoveround 813/359-3075 or 800/964-6837
Chair type(s): Power Base
Invacare Corp. 216/329-6000 or 800/333-6900
Chair type(s): Traditional
Love Lift L.P. 800/456-8826
Chair type(s): Specialty (Lift Chair)
Meyra, Inc. 302/324-4400 or 800/833-9962
Chair type(s): Traditional
Motech Design Primulavej 6 4340 Tollose Denmark +45 49 19 41 20 (phone)
Chair type(s): Specialty (Racing Lightweight)
Orthofab 418/847-5225
Chair type(s): Power Base; Specialty (Stander/Recliner)
Permobil of America 800/736-0925
Chair type(s): Power Base
Quickie Designs 800/456-8168 or 209/292-2171
Chair type(s): Traditional; Power Base
Redman Wheelchairs 602/294-2621
Chair type(s): Traditional; Specialty (Stander)
Steven Motor Chair Co. 501/524-8448
Chair type(s): Specialty (Outdoor)
Theradyne 612/469-4404 or 800/328-4014
Chair type(s): Traditional
Wheelchairs of Kansas 800/537-6454
Chair type(s): Specialty (Chairs for large or obese individuals)