I have been using a wheelchair since 1984. It is my primary mode of mobility. I use it most of my waking hours, except when I am bathing, toileting and driving. My independence depends very much on its seating comfort and maneuverability. Since I spend so much time in one, it must fit my body like how shoes fit the feet. To this end, the wheelchair I use has to fulfil three criteria which I used to order a wheelchair for myself recently.
One: The wheelchair must be made to fit my body. I must be able to maintain a good posture to prevent slouching, back-related problems and pressure sores. The customization is also to ensure that I do not slide off the seat and my legs and feet are properly positioned.
Two: It must be easy to push which means it must be as light as possible. Otherwise, the repetitive exertion from propelling a heavy wheelchair may cause disabling injuries to my upper limbs in the long run. This is also to ensure that my wife who lifts my wheelchair into and out of the car boot must be able to do it with minimal strain and effort, lest she gets injured as well.
Three: The wheelchair must be durable. It must be able to stand up to daily use and abuse. Customised wheelchairs are handmade and expensive. Having to replace them every couple of years would be a severe drain to my finances.
Taking these criteria into account, it is apparent that getting a wheelchair is more than a straightforward matter. To fulfil those criteria, the aspects that need to be considered are the measurements, design, material and components such as cushion, front casters, rear wheels and side guards.
It is advisable to get a therapist specialised in wheelchair seating to do an evaluation for customisation. However, I could not find one where I live so I did my own measurements and posed questions at the CareCure forum for advice. Most of the members in the forum are wheelchair users with professional and personal experience in this area.
Wheelchair users looking to get a customised wheelchair for the first time must also consider the adjustability of the backrest, footrest, seat dump and center of gravity. These all allows further tweaking of the adjustments for a perfect fit. Wheelchairs with very little adjustability is more suited for people who are sure of the measurements they require and are already using one with those dimensions dialed-in.
Ultra lightweight, lightweight or standard? These terms describes the weight of the wheelchair. The price is converse to the weight, the lighter it is, the more expensive it is, vice versa. The lighter the wheelchair the easier it is to push. As a rough guide, ultra lightweight wheelchairs weigh below 12 kg, lightweight from 12 kg to 16 kg, and standard from 16 kg upwards. Apart from the frame, components such as rear wheels also add weight to the wheelchair as a whole.
Titanium or aluminium? The alloys of these two metals are the most common materials used for making ultra lightweight and lightweight frames. Carbon fibre and magnesium are the other two material used for high-end wheelchairs. Frames made from these two materials are very expensive. Standard wheelchairs are made from steel. A wheelchair with titanium frame costs more than one made from aluminium. It is also lighter. Besides, titanium do not need to be painted. Scratches can be polished off with steel wool pads.
Rigid or folding? The rigid wheelchair has less moving parts, namely the cross brace of a folding wheelchair. Less moving parts translates to less maintenance and lighter. Pushing a rigid wheelchair is more energy efficient as less energy is lost to the flexing of the frame.
The folding wheelchair takes up less space when folded and is easier to store in the car boot when going out. In all probablity, the rear wheels of the rigid wheelchair have to be removed before it can fit into the same car boot.
My first customised wheelchair was a folding aluminium. The new wheelchair is a rigid titanium. Selecting a wheelchair to suit my needs and budget was only part of the process. The real work was in getting the measurements right and the necessary accessories which I will discuss in the next post.