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.
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 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.