We often hear the words “I am looking for a small wheelchair”, without delving further into this statement it is impossible to know what the person needs.
A small wheelchair could refer to a wheelchair for a child, or one for an elderly person for occasional use that needs to be easily transported or on the opposite end of the scale it could mean a compact wheelchair for an active user. Whatever the specific scenario what remains important is the size of the wheelchair.
So what is size actually about?
Size is critical for comfort, posture, functionality and independence but it is only correct in the context of the user. Therefore no wheelchair should be small or large; they should just be perfect for the person sitting in it.
The important thing to learn therefore is how to ensure that a wheelchair is the right size for you.
A basic and simple rule to apply is to ensure that when you are sitting in the wheelchair you can comfortably place 2 fingers between your body and the wheelchair arms. This avoids issues such as pressure caused by rubbing or friction as well as ensuring that you have enough space to move around and lean from one side to the other comfortably.
Make sure that you don’t have more space than this however as the chances are this means the chair is too wide which means it will offer less postural support and will make manoeuvrability more difficult.
Height is very important, particularly if you are a wheelchair user who completes a standing transfer. The reason for this is that if the wheelchair is too low it will inhibit a safe and independent stand.
Another basic test would be to measure your leg from the floor (bottom of the heel) to the crease behind your knee, known as the popliteal crease, you ideally want the wheelchair to be at least 25mm higher than this measurement, more if it doesn’t impact on posture. For example, if the heel to popliteal crease measurement were 420mm then you would not want the chair to be lower than 445mm.
However, this must be balanced with being able to take weight through the feet in footrests and practical issues such as being able to get your knees under a table or bench depending on task requirement.
The importance of seat depth can be overlooked but is incredibly important, particularly in reducing risks of pressure damage for regular wheelchair users.
A seat that is too short places significant pressure on the buttocks as well as impacting on maneuverability through the smaller front wheels.
A seat that is too deep or too short encourages a slumped posture due to the way it changes the pelvic angles placing pressure through the tissue behind the knees.
An appropriate seat depth should allow the user to be sat with their bottom at the rear of seat and have space to allow for 25mm or 2 fingers between the seat and the back of the knee.
There are a number of other important measurements to consider when determining the appropriateness of a wheelchair such as backrest height, seat angle and armrest which is why a professional assessment is always the best option. Wheelchairs can come in all sorts of shapes and sizes, the important thing is that it is measured to suit the specific user to ensure that their health, well-being and independence are supported.
Written by Kate Sheehan