Key Considerations When Setting Up a Manual Wheelchair

Choosing and setting up a manual wheelchair properly is essential for ensuring comfort, mobility, and overall well-being. Whether for temporary or long-term use, a wheelchair that is adjusted correctly can enhance independence and prevent discomfort or injury. Below are the key considerations to keep in mind when setting up a manual wheelchair.

1. Assessing the User’s Needs

Before selecting or adjusting a manual wheelchair, it’s important to consider the user’s lifestyle, physical needs, and level of mobility. Key questions to ask include:
Will the wheelchair be used indoors, outdoors, or both?

• How much self-propulsion is required versus caregiver assistance?
• Does the user have specific postural or medical needs?
• Will the wheelchair need to be transported frequently?
• Understanding these factors will help in choosing the right frame, seating, and accessories.

2. Seat Width and Depth

A well-fitted seat prevents pressure sores and enhances comfort. Consider the following:
Seat Width: The user’s hip width plus 2.5 cm (1 inch) on each side ensures enough space without excessive width, which can make propulsion more difficult.
Seat Depth: Measure from the back of the pelvis to the back of the knee, subtracting around 3-5 cm (1-2 inches) to prevent pressure against the back of the knees.

3. Backrest Height and Angle

The backrest should provide adequate support without restricting movement. Key guidelines include:

• Lower backrests (below the shoulder blades) allow more upper body movement for self-propellers.
• Higher backrests provide more trunk support, beneficial for those with reduced core strength.
• Adjustable backrest angles can improve posture and reduce strain on the back.

4. Seat-to-Floor Height

Proper seat height ensures the user can comfortably propel the wheelchair and transfer in and out. Consider:

• The user’s foot placement: Feet should rest flat on the floor or footrests without excessive bending at the knees.
• Compatibility with tables or work surfaces.

5. Wheel and Caster Adjustments

Different wheel configurations affect ease of movement and stability.
Rear Wheels: Placing them closer to the user’s center of gravity can improve maneuverability.
Caster Wheels: Larger casters improve stability on rough terrain, while smaller casters provide better indoor maneuverability.
Camber Angle: A slight inward tilt of the rear wheels (camber) enhances stability and reduces shoulder strain during propulsion.

6. Armrests and Footrests

These components play a crucial role in comfort and ease of transfers.
Armrests: Choose between fixed, flip-back, or removable armrests based on the user’s transfer needs and daily activities.
Footrests: Adjustable footrests ensure proper leg positioning. Swing-away or removable options help with transfers.

7. Cushions and Support Accessories

Seating and positioning accessories enhance comfort and prevent pressure sores.
Cushions: Choose pressure-relieving materials like gel, foam, or air-filled cushions based on the user’s risk of skin breakdown.
Lateral Supports: These help with trunk control and posture.
Headrests and Straps: Useful for individuals requiring additional upper body support.

8. Brake and Safety Adjustments

Properly adjusted brakes and safety features are critical.
Ensure brakes are easy to engage and release without excessive force.
Anti-tippers can provide additional stability, particularly for users with high activity levels or when navigating slopes.

9. Regular Maintenance and Adjustments

Once the wheelchair is set up, ongoing maintenance ensures longevity and performance.
Regularly check for loose bolts and worn-out tires.
Ensure cushions and seating supports remain in good condition.
Adjust components as the user’s needs change over time.

Final Thoughts

A well-adjusted manual wheelchair significantly enhances a user’s quality of life by providing comfort, safety, and ease of mobility. Taking the time to carefully set up and customize a wheelchair ensures that it meets the user’s individual needs, making everyday tasks easier and more enjoyable.
If you need assistance in selecting or setting up a manual wheelchair, feel free to reach out to our team for expert guidance!