Selecting a Manual Wheelchair
Manual wheelchairs can cost anywhere from under $300 to over $4,000.
Generally, the more expensive the chair the lighter and/or easier it
is to propel. But paying more $$$ does not necessarily give the user
the best chair for the $$$. Many people need a very light weight
chair because the person loading it into the car cannot lift a
"standard" weight chair. Yet the person using the chair can or will
not be propelling it. In that case, a "companion" (it requires a
companion to push the chair) wheelchair for around $400 may be the
best chair at =any= price. [The picture to the right is this type of
chair. Note in the picture below it that the back can also fold-
making it even more compact.]
Sometimes the answer is not a lighter chair, but other means of
loading it. Devices abound for this purpose- see section on
"traveling with mobility equipment" for more information.
Weight is important for lifting into the vehicle, but the quality of
the bearings and the rigidity of the chair (includes folding chairs)
determine more than weight how far you will be able to go, given a
fixed amount of strength. I want to clarify that this statement is a
general one for choosing a "first chair", not for someone into sports.
Don't over buy or under buy your first chair. Assess your needs
realistically. But if you don't see sports in your future for the
next few years, you can save over $500 and possibly closer to $1,000
by getting a good light weight chair with fixed adjustments rather
than a sports chair. (Example get a Quickie LX or Breezy rather than
a Quickie 2).
The cheaper manual chairs (sometimes called "hospital" or "Medicare"
wheelchairs) are what you normally see in a mall or airport. They are
heavy and durable, but difficult to lift and propel. [The picture
above is an example of this kind of chair.] The last 10
years has seen a major reinvention of the wheelchair- manual chairs
today are lighter and much more efficient than chairs of a decade ago.
Back then, a chair just kind of "slid" open and then "flexed" as you
pushed. The advent of "sports chairs" has shown that a chair can
still fold, but be "rigid" when open- allowing the user to use
significantly less "power" on the handrims to go a certain distance.
The old chairs just sort of "folded" every time a person "pushed"- the
user was literally doing "push-ups" as s/he went down the road. Now
that energy is transmitted to the road, not to "squeeze" the user.
Many of these chairs allow for adjustments of where the rear wheel is
placed in relationship to the user, allowing for a "lighter" front end
and even easier maneuverability. These features- not available at all
15 or so years ago is now "standard" on many lightweight chairs- not
just "sports chairs". At the same time, prices have actually fallen
so many wheelchairs are cheaper now then 10 years ago. When inflation
is taken into effect, just about every wheelchair is cheaper now than
when I got into this business.
Unfortunately, for many people used to the old style "feel" of folding
chairs, the new chairs may feel uncomfortable, unstable, or just plain
flimsy. The difference in "feel" may be equated to that of a heavy
luxury car vs a light weight sports car. Many customers who have been
using wheelchairs for decades just can't seem to make the adjustment.
It is important to try different chairs before buying to see what
"feels" right for you. Once the new chair is purchased "hide" the old
chair for a couple of weeks to "force" the feeling of the new one on
you. Many times it works!
And speaking of "feel", you should "test drive" as many different
types, makes, and models of chairs as you can. Differences abound
even within certain "ranges". Invacare makes 2 chairs very close in
price, but with different "feels" for just this reason (Patriot and
9000). Quickie does the same thing. It pays to compare.
WARRANTIES are important on the more expensive chairs. The
more expensive, the more important. Please see my section on warranties for some
important information.
A CASE STUDY ON THE RECOMMENDATION OF A WHEELCHAIR
I recently had to recommend a wheelchair for a family member who
through a medical situation became a paraplegic overnight.
This person want's to be independent and to "push" a wheelchair.
This is what I recommended. Every situation is different, but it
gives an idea of some of the basics and what questions to ask:
1. The chair must fold. It must fold in the "traditional" fashion-
remove the cushion, lift the foot plates, and pull up on the center
of the seat upholstery. No solid back, no release lever, no removing
of wheels to load in car (though removable wheels are encouraged-
more on that later). There are too many reasons to list why you
want this- which is why it is number one on the list. It is not
negotiable. Failure to get a chair like this will mean disaster
in the near future (and an order for a folding chair).
2. The chair should have "molded" (i.e. nylon "mag" ) wheels with
flat free, no maintenance tires. There are various tires available
and what style/type is up for discussion but the tires themselves
should not require air and the wheels they are on should not require
any kind of spoke maintenance. These wheels will not bend and
their tires will not go flat. Hence, the reason for these is obvious.
3. The front casters should be a minimum of 6" in diameter, and I
would encourage your first chair to have 8" casters. These too
should be flat free, solid rubber preferred. This will help you
get over door thresholds and uneven surfaces outdoors. Future
chairs can have smaller sized casters, your first chair should
have these.
4. The chair must have anti-tipping rollers. They can easily be
removed as your skills improve, though for the first full year,
I would keep them on. Hitting the back of your head against the
concrete when you go over backwards can crack the sidewalk and
the city objects to that...
5. The chair must have brakes (don't laugh...). I prefer
push-to-lock if they go lower than the cushion as it makes
transfers easier, though some pull to lock get close enough to
the tires not to be a problem. I also prefer the first chair
to have "hill holders" incorporated into the brakes for ramps
that aren't to code (and for hills).
6. The chair must have push handles. If it is a folding chair,
it will have them automatically. There will be times that you
will WANT to be pushed and it gives a place to hang a backpack.
7. The chair must have arms. Some very active users don't have
arms on some of their chairs. You are the 16 year old learning
to drive. You are not learning in a Ferrari (this applies to the
sports chair you are in right now- more later). The learning I'm
talking about is NOT in the hospital just like learning to drive is
not just driver's ed. You will need arms for weight transfer,
pressure release (yes, you could push on the wheels) and
transferring into the chair. You will also want them for the
times you are being pushed. The type of arm is up for debate- more
information further in this article.
The arms can always be removed by you. To keep the chair as narrow
as possible (those door ways- and remember you will be visiting
people's homes in the future) the arms should be "space saver"
sometimes called wrap around).
8. There is an excellent chance you will be standing. Because of
this, I strongly recommend front rigging that swings away as well
as the foot plates that flip up. It will make a standing transfer
much easier as the front of the chair will be "clear" of obstructions.
Most folding chairs I'm recommending come with this feature
automatically.
9. I feel your first chair should have essentially zero camber
in the rear wheels. This has to do with keeping the chair as
narrow as possible. You will have other chairs for special
uses- those can have camber. I mentioned removable wheels.
I like this feature for times when the chair has to be loaded
into a small car or by someone unable to lift the entire chair.
I can even foresee you removing the wheels, lifting them over
you to the passenger side of a car, then folding the frame and
lifting THAT over you to load a chair, though that would not be
the preferred way every day of driving (but rental cars can
be ordered with hand controls and that is a scenario where
you may do it). This basic starter chair for you is not going
to be the lightest you encounter. That is fine. The extra weight
and wider wheels gives better grip on a wet bathroom floor and even
on just a hardwood/tile floor for transferring. The extra mass
also makes the chair more forgiving on ramps and other surfaces.
You will have other chairs, and as your skills improve over time
you may decide that a sports chair- even a non-folding one is
appropriate for your daily ride. But you will still need that
starter chair at times.
Tire selection is not critical but these points have to be
discussed (pros and cons vis a vis you) and I have no passion
regarding this (though my advice is in the order presented).
1. Solid no tread tire. (a good compromise from the others below
and lasts the longest-i.e. least maintenance required).
Also available with some tread, but tread does not last all that long.
2. A "bicycle" sized/style treaded tire (24"X1 3/8") grey tire WITH
FOAM TUBELESS FLATFREE INSERT (best for traction- not only outdoors,
but for holding the chair stable when transferring- particularly on
a wet or waxed floor). This is the "heaviest" of all the tires but
that is not all bad as its "mass" gives you a "flywheel effect" once
you get moving.
3. #2 above but with a more narrow 1" treaded tire. Great, but tread
life is not great for active users. A little lighter than #2.
4. The hospital provided chair you are in now probably has a 3/4" "primo
skin" tire. It may be filled with up to 110 pounds of air (very,
very high maintenance) With an inner tube (NEVER RECOMMENDED), it is
the lightest "outdoor" tire available, but I consider it an "indoor"
tire. Some people put a foam tubeless flatfree insert in that (which
makes it heavier, but lighter than 1-3 above). This really does
not have great traction and the tires do not last long. If you were
going to go with this, choose #1 instead. Outdoor tires can be used
indoors.
In the past, some indoor sports chairs used an inner tube
with a tread glued to it as the tire for very light weight.
These were called "sew up" tires. Never to be used outdoors,
they had a very, very short life and were prone to leaks. I don't
even think they are being made- being replaced with the primo "skin"
tires in #4.
Wheelchair tires usually are grey in color. Instead of being "doped"
with carbon black they are made with chalk or plastic resins as the
binding agent. This also makes the tire softer for a better grip. This
is to keep marks to a minimum on light color floors. Black bicycle
tires can be used on wheelchairs- they are a tenth of the price and
last much longer but any place you go indoors- the people will hate
you. Not recommend. Some solid smooth tires are also black. This
is NOT what I am talking about and they will not leave marks.
Arms: Get them. They are cheaper when you order the chair and you
can take them off (leave the sockets on). Whatever style you choose,
get the space saver wrap around arms. I will discuss this further below.
Arm styles come in flip-back and sports arms. Flip back can also be
ordered in user adjustable height and two lengths- desk and full.
Some people do not like them because they look so "wheelchair"
(i.e. not cool). They add a bit of weight, but I think that the
PT staff may be putting too much emphasis on the extra pound that
these arms may weigh (ditto for the one extra pound for inserts
in the tires). I recommend you get the flip back arms. They are
still removable, but as I said, they can be taken out of the way
in the most cramped area and they are still "attached" to the
chair. Desk length arms are usually the best as you can "drive"
under a table. With full length arms, you would have to flip back
the arms first, then pull forward. With adjustable height arms
(you push a button to adjust- like reclining a car seat). If you
choose full length in adjustable, you may be able to lower them enough
to go under most tables . The advantage of full length arms is that
if you are able to stand (for transfer or to use crutches, etc),
the added length gives you something to hold on to as you push
yourself up. Some therapists do not want you to have space saver arms
so you can "reverse" a desk arm to make it effectively a full arm
(cannot be done with a wrap around style). I would rather have
the chair 3 to 4" more narrow and achieve the full length effect
as I wrote in the paragraph above (or order them full to begin with).
I like sport arms, except:
1. They are cumbersome to swing "out of the way" in cramped
transfer situations (i.e. you must plan ahead).
2. If you remove the arm (instead of swinging it around out of the
way), you have to have a place to put it (that is not in the way of
your transfer- say to a car).
3. If you use a car topper wheelchair loader in the future they must
be removed before the chair is loaded on to the topper.
4. If you travel by air, the arms MUST be stowed in your luggage
(trust me- you will never see them again if left on the chair).
5. Unless a "clothing guard" is used (usually a removable solid
insert going into a socket), you can put nothing next to you in
the chair. No cell phone, no keys. Flip back arms have a built-in
clothing guard. If you use a clothing guard with sport arms, you
have just doubled the issues of #3 and #4.
MANUAL WHEELCHAIR "FAQ's":
Q: What will a light weight wheelchair weigh? Cost?
A: A good light weight wheelchair will weigh 26lbs or less (sometimes
a lot less). To make it lighter, order it with quick-release
axles. They can be put on most chairs (but not all). This will
allow the rear wheels to be removed (takes 2 seconds- 1 second on
each wheel) with the push of a button. The chair will now weigh in
at about 18 lbs. Lightweight chairs will cost from $500 to
$4,000+, depending on other features. A good wheelchair dealer,
with a large selection, can help guide you in a proper purchasing
decision. For example, if you are not playing sports, (and have no
intention to), your price range should not go much higher than
$1,200.
It may be that your existing chair will be fine with quick release
axles installed on it. You say you have an ultra-lite. If you are
talking about the model made by Everest & Jennings, that came
with quick release axles and weighs about 26lbs with the wheels on.
If that is the case, and he still can't lift the chair (with the
wheels off), then an external wheelchair carrier may be the ticket.
These devices start at under $200 and go up to $400. Most require a
trailer hitch (around $75 at Midas Muffler) because modern cars can't
accept anything mounted on bumpers. The cheaper one will require
someone to lift about 1/2 the weight of the chair straight up 1 foot.
The more expensive require even less energy as they tilt down to the
ground. All work on geometry (weight of the chair to assist) and not
on electricity.
Q: I have a friend with MS who uses a wheelchair when out and about
(moderately mobile in-house). What light-weight, user-powered
chairs would you recommend?
A: The best way to get an "education" on what kind of wheelchairs are
out there and what is best for a particular person is to visit
several wheelchair dealers. Visit companies that have many
wheelchairs on display, and talk to wheelchair users in your area
to find the names of "good" dealers. Expect that the person using
the chair will have to visit a couple of these dealers with you at
a "second" visit.
To answer your question "generally" about the types of wheelchairs:
Some wheelchair users just can't propel themselves at all and want a
wheelchair that is very light so that their companion" can lift it
into the trunk of a car. These same people may have a need for a
power wheelchair, but either don't want to travel with one, can't
afford one (along with the van and lift required), or simply don't
mind having someone else push them. The companion wheelchair is very
light (approx 18 lbs) and inexpensive .
An easy to propel manual wheelchair can cost from $300 up to $4,000
(no typo, that's four thousand bucks), depending on the weight and
other features. As the price goes up, the weight goes down, along with
getting the ability to adjust the chair to make it easier to push,
steer, etc. Most (but not all) of these chairs are "sports chairs"
and, as the name implies, are designed for wheelchair sports. While
they may be easy to push, they are also easier to "tip over", may not
have enough "mass" for a person (particularly an elderly person) to
transfer easily into, and simply may not be comfortable for some
people. They also require more service as the adjustments loosen.
Their weight rarely goes below that of a companion chair (18 lbs)
without removing the rear wheels, which many users don't want to be
bothered with.
All the information provided herein is Copyright © 1993 1994 1995
1996 1997 1998 1999 2000, & 2001 Stuart L. Portner. All rights reserved.
May be printed and reproduced for individual use, but may not be distributed
without the permission of the author.
BACK to Wheelchairs and Scooters menu