Mobility Aids and MS: Manual Wheelchairs

Nothing says disability like a wheelchair, and the wheelchair is one of the greatest fears of MSers. But MSers are not alone in this fear. Last year a Disaboom survey asked: "Would you rather be disabled or dead?" 52% of the respondents said they would rather die. There are more than 54 million Americans -- many of them MSers -- who might disagree. Contrary to a death sentence, a wheelchair can ensure a return to life and living.

A manual wheelchair is dependent on a caregiver who is willing and able to push the chair or a person with full upper-body function, including arms that can control the chair. Otherwise, a manual wheelchair is not the solution. In this high-tech world, many options besides manual wheelchairs are possible. However, in some situations, such as when the wheeler wants total control, a manual chair is precisely the right one to choose. Selection is another challenge.

An institutional chair is used to transport a patient between rooms or between hospitals and should not be used long-term by anyone who needs a wheelchair permanently. It is called "institutional" because of its use in hospitals and nursing homes. Although it is often a rental chair, it is not appropriate as a permanent personal chair.

The first step in selecting a wheelchair, just like walking aids, is measurement. A standard chair, the one we usually picture, has a cross-brace frame, removable arm rests, swing-away footrests, a mid- to high-level back, and push handles. Lightweight chairs were at one time the choice of athletes, but their maneuverability and sporty style now make the lightweight chair preferred by everyone.

Selecting a chair means putting together various components beginning with the material used to make the frame: stainless steel, aluminum, chrome tubing, or any of several others metals and alloys. Next, the armrests -- the wheelchair fits under a desk more easily without arms, but a person with balance problems needs the armrests. Upholstery can be fabric, synthetic, or even leather. Seating systems depend on the patient's needs and can range from firm to extra soft cushions and gel. Braking can rely on the user's hands or can be parking brakes or wheel locks. The number and type of wheels depends on how the chair is to be used. Footrests can be rigid, extendable, flip up, and they can be removable. Anyone who needs help with wheelchair specifications can enlist a physical therapist who specializes in this type of equipment.

Because there are many types of people who use manual wheelchairs, there are also many different specialty chairs designed to accommodate varied everyday needs, ability levels, and lifestyles. For example, there is a chair that allows controlled movement with only one hand, and another that converts to a standing chair for weight-bearing requirements. Many of these are portable and easily fold-able to store in small spaces such as the backseat of a car.

The everyday chair may not be the best one for everything. To allow and encourage other activities, there are, once again, specialty chairs. For example, even with a roll-in shower, a manual wheelchair is at risk for rust specifically around the joints and connections.  But even wheelchair users like to be clean, so the shower chair was developed. Sitting up straight is not always comfortable for long periods of time especially for someone who is prone to pressure sores.  The tilt wheelchair, capable of converting from a sitting to a reclining position alleviates that problem.