How to Choose the Best Manual Wheelchair for Your Needs

Mobility is important. Being able to retain your freedom and independence in the face of chronic illnesses or disabilities can make a remarkable difference in your ability to manage or recover from chronic illnesses. It may even impact your ability to enjoy life through seniorhood.

You might only need help for a few days, or you might need assistance for the rest of your life. Either way, if you’re considering a manual wheelchair, this article will help support you in your journey to make better decisions about your health. In this short consumer guide, you’ll learn what to look for and how to choose between the many available options.

Manual wheelchairs remain the most easily-accessible, budget-friendly wheelchairs on the market today, and they offer just as much versatility in style, features, and support, too. If you’re set on a manual wheelchair but aren’t sure where to start, this article will help you better understand your options.

What to Consider

Newer inventions like the scooter, electric wheelchairs, and the amazing LEVO Standing Wheelchair are giving people with injuries and disabilities more freedom and independence than ever. Unfortunately, it isn’t always possible (or even advisable) to access and use these high-tech products for every patient. Every patient is unique; it’s okay to take a different approach or start small.

Depending on your situation, any of the following criteria could influence your decision:

• Your own needs and abilities
• Your caregiver’s needs and abilities
• Your home or workplace environment
• How easy it is to transport
• Your budget

As a patient, your first step should always work with your care team to review your personal healthcare situation. We also encourage you to call your local pharmacy if you have questions.

Questions to Ask Yourself Before Shopping for a Manual Wheelchair

Before you shop for a manual wheelchair, ask yourself the following questions to nail down your needs:

• What’s your budget?
• Is your chair covered by insurance?
• Are you physically able to sit upright in a chair?
• Do you have the physical strength to push the wheels yourself?
• Do you rely on a caregiver?
• Do you travel or spend the majority of time at home?
• Have you ever struggled with bed sores or ulcers?
• Does your home and/or neighborhood accommodate wheelchairs?
• Will you use your chair for more than 4 hours per day?
• Do you struggle with dizziness or weakness?
• Do you know your wheelchair measurements?
• Do you require support for amputated limbs?
• Will you work at a desk for part or all of the day?

Each of these questions can impact which manual wheelchair style is right for you. Depending on your answers, it could even point to a need for a different solution altogether. Above all else, understand that all manual wheelchairs require the user to be stable enough to at least sit upright with support. Conditions that spur on weakness, dizziness, or instability may show that a patient is better suited to a more robust solution instead.

In the next few sections, we’ll discuss a few of the most common wheelchair styles and how they do or don’t suit patients who fall under the categories mentioned in the questions above.

Self-Propelling Wheelchairs

Self-propelling wheelchairs are by far the most common. They’re used in hospitals and care centers because they’re flexible enough to suit the needs of someone who is only slightly disabled as well as someone who is entirely dependent on a caregiver. Most models have large, 24” to 60” back wheels.

Wheel size is dependent on the size of the individual; children’s chairs will necessitate smaller wheels than adult chairs. Most self-propel chairs do also have a set of smaller front wheels tucked in on either side of the foot rests for stability. Nearly all self-propelling wheelchairs fold up for easy storage or transportation in a trunk.

Patients who are new to wheelchairs or using a wheelchair temporarily will find that a self-propelled manual wheelchair is very suitable for most needs.

There are certain situations where using a self-propelled wheelchair could present a safety or comfort risk. You must have the upper body strength and ability to push the wheels to make the chair move, and that can be too much for elderly or extremely infirm patients. It’ also an added challenge for those with upper body paralysis and/or compromised cardiovascular health.

Patients who have experienced loss of limbs and those who have extensive arthritis in one or both hands will also find it difficult to self-propel. Likewise, small children under the age of five may struggle also. Most toddlers and young children just don’t have the strength to turn the wheels, though size and weight can play a major role in their capabilities.

Keep in mind that the larger the wheels, the more easy they will be to push. Larger sizes may be needed for adults or children if function declines.

Transit Wheelchairs

Transit wheelchairs differ from self-propelling wheelchairs in that they have smaller wheels and a lower center of gravity. This allows for a caregiver to push the chair through small spaces like grocery store aisles or hospital washrooms with ease. It’s a style that’s most suitable for people who spend the majority of their time with a caregiver, nurse, or medical care team, and is one of the most common options for children, seniors, and people who aren’t well enough (for whatever reason) to self-propel.

Because transit wheelchairs are almost always designed to be lightweight, they may be ideal for families, patients, or care centers that need a wheelchair for transitions from home to a vehicle or vice versa. They’re also exceptionally useful for short outings, appointments, assisted physiotherapy sessions, and trips to other guided services. Patients who want the ability to self-propel aren’t able to do so period with a transit wheelchair. If you’re partially ambulatory–for example, recovering from a broken leg–you should choose a self-propelling chair instead.

Being unable to self-propel isn’t always a bad thing–it’s ideal for caregivers who look after dementia patients. The stationary assisted design prevents patient from wandering off alone if they become confused or disoriented. Robust braking and locking systems prevent tipping or rolling if the patient becomes agitated, too.

One Arm Drive

For amputees, people with arthritis, people with one-sided weakness, and those suffering from fractures of the arm, wrist, shoulder, or clavicle, pushing a self-propelled wheelchair can be difficult or even downright impossible. One arm drive chairs make it possible for these patients to support independence for a much longer period of time. Instead of pushing the chair with the wheels, patients can use a single lever on the side they have the most function on instead.

Operating a one arm drive chair is simple (so simple, in fact, that some people prefer them even if they have full use of both arms). Just push the lever on the side back and forth with one hand to rotate the wheels and propel the chair backwards or forwards. When it comes time to turn or move backward, a simple rotation of the lever or a press of a second smaller lever will let you adjust direction and angle before you move forward or backward. Some one arm drive chairs work in tandem with a patient’s standard cane; just insert the end of the cane into the lever hole and use it as the lever instead.

For all other intents and purposes, most one arm drive chairs carry the same features as a typical self-propel wheelchair: a balanced center of gravity and large 24” to 60” back wheels, as well as standard footrests and armrests. But the ease of use and flexibility for customization on most models makes it a real winner for people with:

•  hemiplegia
• arthritis
• MS
• other disorders that affect the hands, arms, and upper body

Amputee Support Chairs

The vast majority of amputee support chairs also fall within the earlier two categories (self-propel or transit), but they carry a few significant differences. Contoured seat pads and multiple padded support systems at any point from the shoulder down to the foot alleviate pressure on residual limbs and joints. That’s beneficial because it reduces the risk of pressure sores or pain after a long day in the seat. Added support for residual limbs and adjusted pressure points can significantly impact how well you adjust to your new life after amputation, so don’t be afraid to speak to your care team if you’re not comfortable. Comfort is just as important as function!

The one main drawback to amputee support chairs lies in the fact that it’s never a situation where one size fits all. Your care team or family will need to measure you for the chair to make sure you have the right fit. If the chair doesn’t fit right, the supports won’t sit at the right height, and that means pressure, achiness, and general discomfort. Even if your measurements line up, every amputee is unique; you may need further customization or orthotics to make your new chair comfortable.

Whenever possible, amputees should choose a manual wheelchair that has supports that can be adjusted on the fly. Seek out chairs with levers and switches that let you move your residual limb supports into a variety of positions depending on what you’re doing or how you’re feeling. When you need to work at a desk, you can lower them or draw them inward. When you’re heading out down the road, you can extend them for more stability.

Specialty Position Chairs

Though the majority of specialty positioning chairs are electric, it is possible to find fully-adjustable manual wheelchairs, too. Most come at a slightly higher price point, but have contoured, padded seats or backrests that either recline, angle in a specific direction, or keep the patient’s body positioned at an incline.

Chairs that lean, recline, or otherwise angle are most ideal for patients with:

• Widespread weakness
• Paralysis and/or loss of sensation
• Certain seizure disorders
• Certain forms of dysautonomia
• Instability or muscle weakness
• Dysautonomias and other CNS conditions
• Kyphoscoliosis, spinal curvatures, and skeletal birth deformities

Your care team will most likely recommend a reclining chair if they feel it’s necessary for your overall health. But some patients choose these chairs simply because they feel more comfortable at a slight incline, rather than in the normal 90-degree sitting position, too. Furthermore, a chair that reclines can make it easier to take a small catnap in the backyard or even to sun yourself at the beach. It’s all about finding what works best for you.

Which to Pick?

Deciding to purchase a manual wheelchair is a big decision, and it can feel daunting or even frightening if you’ve never used a wheelchair before. It’s important that you have the support network needed to make your transition as effortless and easy as possible. If you have questions about mobility aids or your condition and whether a manual wheelchair might be right for you, call your local pharmacist. He or she can empower you with the information you need to make the best decision for your needs.