Not all wheelchairs are the same and much of the information online assumes the reader knows the basics already, the following article is a basic rundown of the types of chair available. There are lots of different types and I wont be able to cover them all so please feel free to ask if I’m not answering all of your questions.
Transit Chairs / Attendant Propelled Chairs
These are simple chairs and usually pretty inexpensive. The wheelchair user sits in the chair and is pushed around by helpers. There are no big drive wheels so the person in the chair cannot move themselves. This can be a good thing if the person in the chair doesn’t have the mental capacity to control a chair themselves. Often people with severe learning disabilities or conditions like dementia. In some cases having big drive wheels represents an entrapment risk, if the person in the chair isn’t pushing then why have the wheels there to trap fingers and clothing in?
Chairs like this are often the cheapest on the market so if budget is a big consideration and the wheelchair user can’t push themselves then save the money and opt for a transit chair.
That said, I have in the past seen people prescribed transit chairs simply because of budget constraints. This isn’t on. By putting a capable person in a chair that they cannot control, their independence and choice are taken away from them. Even if the wheelchair user can only push two inches, they should have the option to do so.
Many transit chairs fold up easily and can be stored in relatively small spaces.
Manual Chairs / Self-Propel Chairs
Manual wheelchairs fall into a number of categories, all of them are chairs that the user can push themselves in.
Standard Manual Wheelchairs
These typically weighs about 35 lbs. The chair is designed for people who have enough upper body strength and stability to push themselves. Price wise they are usually fairly cheap but more expensive than a transit chair. This kind of chair is often a ‘first base’ when you become a wheelchair user. They are fine for getting used to wheelchair life and will get you from A to B. That said, often long-term wheelchair users opt for something more sporty.
This kind of chair is minimally customisable, you can choose how wide the seat is, remove the arm rests and adjust the foot plates but that’s about it.
Most manual wheelchairs are foldable (much like a push chair) and have ‘quick release’ wheels, usually you push the small button on the centre of the wheel and simply pull it away from the frame.
The maximum user weight for this chairs is usually about 250 lbs. Chairs like this are also available for bariatric users, these chairs can safely support users up to 650 lbs. Each chair is different so make sure you check each models specifications.
Lightweight Manual Wheelchairs
These chairs are for those who struggle to push a standard chair or lead a very active life. Lightweight chairs give you more independence by being easier to push, they generally weigh as little as 28 lbs. With wheelchairs, the lighter the chair the higher the price so it’s an individual balance between cost and the useability of the chair. If you’re going to be using your chair more than 50% of the time I would recommend spending as much as you can. Later in this guide I’ll discuss pricing options.
Ultra Lightweight Wheelchairs
If (like me) you struggle with low upper body strength/ stability or have fatigue as a symptom I would recommend an Ultra Lightweight chair.These chairs, sometimes called ‘active user chairs’ are much easier to propel (push) and are more easily maneuverable and durable. Snazzy chairs like this can weight as little as 14 lbs.
Active user chairs come in two types, folding and rigid.
Folding chairs do exactly what they say on the tin, they fold up. This makes them easier to store and transport. The downside is that the more folding/moving parts in the chair the less efficient it is. When you push a chair the more rigid it is the easier it is to push and the smoother the ride. Folding chairs flex a little when you push them over uneven ground, this doesn’t make a massive difference on short trips or smooth ground but when you’re off-roading a rigid chair makes all the difference.
Rigid chairs often look a lot more sleek but do tend to cost a lot more, as an example my chair (not including the add-ons) cost about four thousand pounds.
Generally the more expensive and the lighter the chair the more customisable it is, most of them are made to each users exact measurements to make sure they are super comfortable and efficient too. Since you’re paying as much as a few thousand pounds and your chair is being custom-made to fit you also get to choose the colour. My first custom chair was bright orange and my current one is purple. My chairs reflect my personality and that makes me feel good about using them.
With highly customisable chairs you can choose the angle of the seat, wether or not to have push handles, arm rests or not, the type of foot plate, the height of the back rest and the types of wheels to name a few!
Electric Wheelchairs / Power Chairs
Power chairs come in a wide variety, they are all run off battery packs that are charged by plugging them into the mains. Power chairs are generally used for people who cannot push a manual chair, this can be due to fatigue, poor dexterity or muscle weakness (among other reasons).
Standard Power Chairs
These look and feel a lot like office chairs or car seats and are controlled with a joystick on the end of one arm rest. They can often be taken apart and put into large cars, the simplest of power chairs are minimally customisable and come in a range of sizes you can choose from.
Cheap and cheerful power chairs often have a limited battery range, struggle with steep hills and rough terrain. The more you spend the more your chair will be able to do.
Higher end off the shelf (standard plus) power chairs are more customisable and can handle longer distances and rougher terrain. These chairs have a better range of customisable options, these can include the type of food plate, the back rest, and the type of joystick / controls.
Custom Power Chairs
Your other option for power chairs is custom. Custom chairs are made to fit the users requirements, they have a vast selection of options. Custom chairs can raise the user up, tilt back into a laying position, raise the users legs and more. Custom chairs have a wider selection of controls, I’ve seen chairs operated by blowing into a straw, tilting a head and even eye movements.
Power chairs can stand the user up and lay them down, turn on the spot and even climb up small steps. The downside to these fantastic pieces of engineering is cost. You’re looking at many thousands of pounds
Chairs like this are designed to maximise the independence of people with very poor mobility or severely unreliable bodies. Having a chair that changes positions means the user can stay in the chair and shift positions to keep comfy and reduce pressure sores.
The main downside (besides the cost) is that many of these chairs are difficult to transport, if you’re using a power chair regularly and you may well also need an adapted vehicle.
Power chairs come in a variety of drive options. Front, mid and rear wheel drive. Which one suits you will depend on the type of chair, your environment and more. This is only likely to come up if you’re having a custom chair built so you can discuss your options with the therapist you by from. As a simple example a mid-wheel drive chair has the smallest turning circle but a front wheel drive chair will handle tight corners better because the pivot point is so close to the front of the chair. Rear wheel drive is often less maneuverable and less responsive but if you have tremors or spasms a less twitchy chair can be a good thing!
Power Assist
Power assist represents a middle ground between manual and electric chairs. There are a variety of power assist options but most of them are retro-fitted onto a manual chair. As an example I have Alber e-motion power assist wheels fitted onto my manual chair. These wheels are used like regular wheels but with a boost. You put in 10% and the wheels put out 80%. Most power assist options involve you doing some of the work and the kit doing the rest.
These are great for people with variable health conditions since they can be taken off a manual chair easily, this returns your chair to a standard manual one. I swap between regular manual wheels and my power assist ones depending on where I’m going and how I’m feeling.
Power assist is also a great way to build up strength and stamina if you’re trying to transition from a power chair to a manual. although the tech does a lot of the work the wheelchair user does still have to push. Power assist kits on a manual chair are also a lot easier to transport than a power chair. Since the kit is an add-on it doesn’t take up much more space than your chair does normally. My chair complete with power assist wheels will come apart and fit in the boot of almost any standard estate car.
The biggest downside of most power assists is cost. To fit a power assist to a manual chair you first have to buy the chair, then the power assist. In many cases it’s actually cheaper to buy a power chair. Another downside is the weight, although they are lighter than a power chair they are still pretty heavy.
Not all power assists are inside wheel hubs. Some, like the SmartDrive, fit behind or underneath the chair. There are also power converters, like the e-Fix, which convert a manual chair to a power chair.
I hope this has been useful. I plan to build up a range of posts on wheelchairs including basic skills, accessories and funding options. If there is anything you’d like to know specifically please feel free to ask.
As always, questions and comments are most welcome.
With EDS an average self propellant wheelchair goes out the window very fast unless one wants to permanently reside at a&e with shoulder dislocations and subluxations… But the NHS doesn’t actually provide funding for any of the powered options unless one is unable to take even a single step unaided and so many wheelchairs cost thousands and thousands of pounds… I wonder if you’ve ever come across this issue and what options, if any, you’ve found to be available for funding?
Currently stuck on a borrowed attendant chair, exploring options and feeling frustrated….
Zoe
It’s a tough situation, I have power assist wheels to minimise the strain on my shoulders but keep me active, I’ve gradually built up enough strength to use my manual chair safely without the power assist, I know a lot of EDSers with manual chairs and I think the key is very gradually building up strength..very gradually. Later on in this guide I will be covering wheelchair services and funding options too.. (little more research to do before I write that one) can I get back to you?
Oh it’s good to hear someone can do this! My shoulder is far too unstable for anything of the sort, but good to hear manual chairs are ok for some EDSers! 🙂 Funding is a huge issue isn’t it….?! Of course, thanks for the reply and hope this found you well.
Zoe
You’re welcome and I hope you’re well?
Thanks so much for this – very timely with my own post last week detailing my first use of a wheelchair on our holiday. I have been referred to wheelchair services, but my mum has also said she will buy one – I have been thinking that I should just go for a lightweight assistant chair as my shoulders sublux/dislocate so often. Alongside the EDS hypermobility, I also have chronic pain (with a spinal cord stimulator) and increasing POTS like symptoms – all really affect my mobility. Any advice would be appreciated!! Thanks
Happy I could help! A lightweight attendent propelled chair wont give you any independence, you’ll have to be pushed by someone else all the time. Perhapse power assist or a power chair would mean you can actually use it independently? If you’re seeing wheelchair services be sure to tell them about all of your problems at your appointment. 🙂
Thanks for this Jo, really useful info. I have a lightweight self propelled NHS wheelchair but still struggle to self propel for any length of time. My asthma is really bad & that massively affects my fatigue. We’ll be in a position to self fund in a few months & I’m thinking lightweight self propelled with power assist wheels might be the way. I want to maintain the strength I have but just need that bit of assistance. I’m having a hoist put into my new notability car so hopefully I’ll be a bit more independent but the end of the year!!
Good luck with it all Julie. I do love my power assist. It’s worth speaking to wheelchair services, you might be able to put power assist wheels on the chair they provided you with. It would split the cost while you save for a chair too 🙂
Such a helpful post Jo! I’m going to take this with me to my next wheelchair services appointment after that train wreck of advice I’ve received. The issue with the cost of power assist wheels is an important one, but it’s all relative. A power chair may be cheaper, but getting a car that is able to transport it if you don’t already have on adds more money. For me, it will be cheaper to get power assist wheels than buy a new car (apparently our estate car isn’t big enough or powerful enough). It worries me that in some cases people are not receiving the correct advice. I just hope mine is a minority case. Having this resource will be very helpful for people to go into their appointment with an idea of the different chairs available & what they are capable of. Xx
Tania | When Tania Talks
Happy I could help but really sorry this is all still going wrong for you! Power assist is relatively new tech compared to a power chair but it’s been around long enough that WC services should know about it! I’ll be doing a post about NHS chairs later on! xx