Kendra Betz MSPT, ATP

Manual wheelchair selection, configuration and skills training require critical thought and thorough interventions to optimize outcomes for those who rely on a manual wheelchair for primary mobility. Providing an appropriate manual wheelchair and necessary associated mobility skills requires careful consideration of available options, equipment configuration to optimize fit and performance, and extensive mobility skills training to facilitate maximum independence while preserving upper limb function. A clear understanding of the client’s unique presentation guides clinical determination for which manual wheelchairs and specific configurations will best meet the client’s comprehensive needs. A thorough evaluation should include a review of the client’s diagnosis and prognosis, past medical history, physical evaluation, functional assessment, psychosocial profile and environmental considerations.

There are clearly a wide range of manual wheelchairs available and technology options vary from one country to another. Manual wheelchairs vary by frame design, weight, durability, adjustability, customisation, availability of accessories, intended use and expected lifespan. While there are many options available, some wheelchairs are a much better choice for those who use a manual wheelchair as a primary means of mobility. The ideal manual wheelchair is lightweight, durable for long-term use, and custom-configured to meet the specific needs of the intended user.

Clearly, there are a multitude of considerations surrounding manual wheelchair selection and configuration to optimise propulsion. The ultralight manual wheelchairs have unique features that allow custom configuration to meet identified client needs. Once the appropriate chair is selected, the chair must be configured for optimized fit and performance, with careful consideration of the rear wheel orientation. Propulsion education and wheelchair skills training are essential in optimising mobility while preventing upper limb injury. Taking into account individual needs and preferences, research findings and clinical experience can guide solid clinical decisions and promote positive client outcomes. Selection of the ideal manual wheelchair that is properly configured, combined with comprehensive mobility skills training, can truly improve quality of life for those who rely on manual wheelchairs for everyday mobility.