WCs: Designs & Accessories

Folding Manual Wheelchair.

• Frame folds for storage

• Pros: Easier to transport/store

• Cons: Heavier, more moving parts

Fixed Manual Wheelchair

• Rigid frame

• Pros: Lighter, more stable seating

• Cons: Harder to transport

Companion/Travel Manual Chair

• Small wheels, minimal features

• Pros: Lightweight, convenient

• Cons: Not self-propelled (someone has to push it)

Standard Weight Manual Wheelchair

• Institutional, 35-50 lbs, “Walmart loaner chair”

• Pros: Durable

• Cons: Heavy, limited features

Lightweight Manual Wheelchair

• <35 lbs, more adjustability

• Pros: Easier to maneuver

• Cons: Less durable than standard

Ultra Lightweight Manual Wheelchair

• ~13 lbs, custom features, usually for using WC as primary mode of mobility

• Pros: Ideal for long-term use

• Cons: Expensive, must justify

Hemi-Height Manual Wheelchair

• Lower seat height allows foot propusion

• Pros: Great for patients using feet to move; not just for hemiplegia

• Cons: Leg rests can be hard to manage; limited clearance

Amputee Manual Chair

• Axle is moved back to balance weight loss from limb(s)

• Pros: Prevents tipping backward; safer balance

• Cons: May need anti-tippers; can be harder to maneuver

Reclining Manual Chair

• Backrest reclines with hydraulic control

• Pros: Great for weak patients who can’t sit upright long; improves comfort

• Cons: Risk of sliding forward (shearing); bulky

Tilt-In-Space Manual Chair

• Seat and back tilt together; body angle stays the same

• Pros: Good for pressure relief, prevents sliding

• Cons: Heavier, usually more expensive

Bariatric Manual Chair

• Built for larger users; wider seats & reinforced frames

• Pros: Stronger, more durable

• Cons: Heavier; sometimes limited accessories

Anterior Locking Brake

• Push lever forward

• For patients who find forward motion easier

• Preferred by patients with weaker arms

Posterior Locking Brake

• Pull lever backward

• Common for most users

• Standard on many models

Scissor Mount Brake

• Brake underneath seat & slides outward to lock

• Ideal for active users or sports chairs

• Keeps brakes out of way during transfers

Brake Extensions

• Lever extensions added to brake for easier reach

• Allows locking chair with opposite hand

• Helps patients with limited reach, unilateral weakness, or poor grip strength

• Increases leverage for locking brake more easily

Attached Armrests

• Fixed in place; cannot be removed or swung away; common for standard chair

• Pros: Durable, fewer parts to break; supports transfers

• Cons: Limits transfer space; not adjustable

Removable/Swing-Away Armrests

• Can be detached or swung out to the side

• Pros: Allow easier side transfers; flexible

• Cons: Easy to misplace or damage; more moving parts

Full-Length Armrests

• Extend the full length of the seat; usually standard

• Pros: Support entire forearm; good for trays or positioning troughs

• Cons: Harder to get close to tables or desks

Desk Arms

• Shorter in front to fit under desks/tables

• Pros: Easier access to surfaces; reversible with removable option for transfers

• Cons: Less arm support

Height Adjustable Arms

• Can be raised or lowered to meet user needs; helps patient with weak trunk & needs more UE support

• Pros: Customizable for comfort, posture, and support

• Cons: More moving parts to break; may add weight

Footrests

• Support just the foot; may include heel loops

• For users with good leg control who do not need calf support

• Pros: Lightweight; easy to fold up or swing away for transfers

• Cons: No support for lower leg/calf; may allow leg to dangle

Footrests with Heel Loops

• Footplate with back strap to prevent foot from slipping

• Pros: Added safety and stability

• Cons: Heel loop may stretch or wear out over time

Legrests

• Support foot and calf; often padded

• For users with LE injuries, weakness, or need for elevation

• Pros: Better for edema, post-op support, and patient comfort

• Cons: Heavier; more complex

Elevating Legrests

• Can be raised to a horizontal position

• For patients with knee surgeries, LE edema, or neurological conditions affecting leg tone or positioning

• Pros: Useful for LE injuries, contractures

• Cons: Adds weight; can be tricky to manage

Swing-Away Legrests

• Swing out to the side for transfers

• Pros: Makes lateral transfers easier; reduces obstruction

• Cons: More moving parts; potential for wear or breakage

Removable Legrests

• Detachable from the frame

• Pros: Simplifies transport and storage

• Cons: Risk of losing parts or difficulty reattaching

Front Wheel Drive Power Chair

• Open front with less distractions

• Pros: Good on inclines, open front

• Cons: Wide turning radius

Mid-Wheel Drive Power Chair

• Still relatively open in front

• Pros: Smallest turning radius; Good for limited space

• Cons: Not ideal for uneven surfaces

Rear-Wheel Drive Power Chair

• A lot of chair visible from front

• Pros: Better traction on uneven surfaces

• Cons: Tippy on steep inclines, wide turn radius

Joystick Power Chair

• Hand-controlled lever that moves chair in all directions

• Most common; used by patients with good UE function & coordination

• Pros: Highly responsive; many models available; customizable sensitivity

• Cons: Requires fine motor skills & arm strength

Sip & Puff Power Chair

• Uses breath pressure through straw-like tube to control direction & speed

• Patients with high-level SCIs or severe quadriplegia

• Pros: Completely hands-free; intuitive with practice

• Cons: Requires learning; sensitive to moisture; may trigger falsely

Head Array Power Chair

• Sensors around the headrest respond to head movements

• Patients with limited use of limbs but good head control

• Pros: Doesn’t require hand or breath control; discreet

• Cons: Requires consistent head positioning; takes training

Chin Control Power Chair

• Small joystick mounted near the chin; moved by jaw or chin motion

• For patients with good neck control but poor UE function

• Pros: Allows full chair control with moderate movement

• Cons: Fatigue or neck strain; needs fine control

Foot Control Power Chair

• Foot-operated system with directional input via pedals or switches

• Rare; used when hands and upper body can’t be used but leg movement is intact

• Pros: Keeps hands free

• Cons: Complex setup; can be tiring or imprecise

Scooter

• 3-4 wheeled powered mobility device, usually with tiller steering

• Users with good upper body control & mild mobility limitations

• Pros: Easier to transport, simple controls, good for short community distances

• Cons: Large turning radius, not customizable, not for indoor tight spaces

All-Terrain Wheelchair

• Designed with rugged wheels & suspension to handle rough outdoor terrain

• Active users who need access to trails, grass, sand, gravel

• Pros: High durability, great for outdoor recreation

• Cons: Heavy, bulky, expensive, limited indoor use

Standing Wheelchair

• Transitions from sitting to standing using powered lift

• Users with SCI, MS, or conditions requiring pressure relief, bone loading

• Pros: Pressure relief, improved circulation, independence with ADLs

• Cons: Very expensive, heavy, requires strength or caregiver help to use safely

iBOT

• High-tech chair with gyroscopic tech that climbs stairs, balances on 2 wheels, raises to standing height

• Highly active users with varied mobility needs; tech-savy users

• Pros: Stair climbing, curb management, standing eye-level communication, self-balancing

• Cons: Extremely expensive, limited availability, must be trained

Power Assist Chair

• Adds powered wheels or motors to a manual wheelchair to assist with propulsion

• Users with enough strength to push but needing help on inclines or long distances

• Pros: Reduces strain, improves endurance, lightweight add-on

• Cons: Not full power chair, limited speed/power, may be costly

What is the purpose of cushions on a chair?

• Redistribute pressure

• Maintain posture

• Assist balance and stability

• Increase sitting height

• Allow for more prolonged sitting

Foam Cushion

• Pros: Cheap, contourable

• Cons: Not for wounds, less durable

Gel Cushion

• Pros: Moves with patient, better pressure relief, easier with sliding transfers

• Cons: Heavy, hard to slide

• Ex: Jay

Air Cushion

• Pros: Best pressure relief

• Cons: High maintenance, less stable, difficult with sliding transfers

• Ex: Roho

Honeycomb Cushion

• Pros: Breathable, washable, countoured, comfortable

• Cons: Less pressure redistribution, not for wounds

• Ex: Supracor

Hybrid Cushion

• Pros: Combines types, Best of both

• Cons: Expensive

• Ex: Jay Fusion, Roho Hybrid Elite

Back Support Cushions

• Improve sitting posture & prevent spinal deformities

• Users with trunk weakness or balance issues

• Prevent pressure injuries to spine & scapulae

• Accommodates or corrects spinal asymmetry

Seat Belts

• AKA pelvic positioners

• Velcro, latch, or auto-style belts mounted to chair frame

• Maintains pelvic alignment & seated posture

• Adds safety

• For patients at risk of sliding, poor core strength, or spasticity

Anti-Tippers

• Small wheels/bars attached to back of chair

• Prevents tipping backward/forward during propulsion or incline

• Amputees, recline/tilt chair users, or active pushers at risk for falls

Lateral Supports

• Foam or rigid pads mounted to sides of backrest

• Keeps trunk upright; prevents leaning to one side

• Users with poor trunk control, scoliosis, or hemiplegia

Troughs

• Long padded arm supports attached to armrests

• Cradles weak/flaccid or spastic arm to prevent injury

• Patients with hemiplegia or shoulder subluxation

Trays

• Flat surface mounted on armrests or frame; can be clear, padded, or angled

• Provides surface for feeding, writing, or supports UE posture

• Patients needing activity surface or upper limb stability