Tips

The aim of the wheelchair fitting is to restore mobility and to mobilize residual activities.
Wheelchair options:

• Power wheelchairs
• Manual wheelchairs
• Wheelchairs with folding or with rigid frame

Among other things, the choice is dependent upon the degree of disability, on the existing remaining functions and on the place of application.

The use of power wheelchairs is recommended, for example, when there is insufficient arm strength. They are offered with joystick or other control possibilities such as chin control, foot control, blow-and-suck control, etc., and can be individually adapted to the degree of disability.
When providing children with manual wheelchairs, it is always recommended to use wheelchairs for active use (instead of standard wheelchairs), since they allow individual and optimal adaptation to the child‘s requirements. Even when the clinical picture is changing they can be adapted up to a certain degree. In
addition, they offer better rolling and steering properties which contribute to motivate the users to drive themselves and finally lead to a better quality of life.

Advantages and disadvantages of a wheelchair for active use with folding frame:

• Easy transport due to compact folding size
• Slightly higher weight, since more screw joints are needed

Advantages and disadvantages of a wheelchair for active use with rigid frame:

• Higher frame stability
• Good maneuverabilit
• Low weight
• Larger folding size in comparison with folding wheelchairs

Selection criteria to find the most suitable wheelchair:

• Swing-away and/or detachable side panels and footrests should allow for easy transfer (standing up, changing seats).
• An angle adjustable backrest should allow relieving/resting positions.
• The wheelchair should have a low rolling resistance and low weight to be easy to push. Only necessary add-on parts and/or accessories should be attached to the wheelchair.
• Adjustments should fit the individual‘s specific requirements in order to best adapt the wheelchair and thus to achieve the most independent use of the wheelchair.
• The wheelchair should be able to grow with the child and allow later modifications. It should also offer the option to be enlarged or added-to in the case of a changing clinical picture.
• It should have an attractive appearance.
• A wheelchair fitting should be made as early as possible so as not to restrict the natural range of movement (wheelchair versus buggy).
• Seat height at eye level of children of the same age (20-22” wheels)

Special requirements for a wheelchair fitting with children:

• Anti-tipper/safety wheel
• Safety belt
• Spoke protectors, hand protection
• Casters not larger than 6" if possible
• Armrests only if absolutely necessary
• Seat cushion with interchangeable cover
• Adaptable back upholstery
• Height adjustable push handles
• Possibility for including seating shells, corsets, orthoses, etc.
• The wheelchair‘s center of rotation and the center of gravity must be close to each other to require as little effort as possible for moving.
• The rear wheel should be mounted as close to the center of gravity as possible to improve maneuverability and facilitate tipping of the wheelchair when clearing an obstacle (anti-tipper!).
• The seat width should be fitted correctly; otherwise a higher effort is required to operate the push rings.
• If possible, the back height should not go beyond the lower edge of the scapula – dependent on the degree of disability – so as not to compromise shoulder movements.