Manual wheelchair basics

Some people use a wheelchair full time; many more use one only for longer distances, appointments or days out while walking short distances at home. In both cases the chair should fit the person, not the other way round. This page covers the vocabulary and the questions to raise with the clinician or supplier who helps you choose.

Self-propelled or attendant

A self-propelled chair has large rear wheels with push rims so the user can move it alone. An attendant or transit chair has small wheels all round and is pushed by someone else; it is lighter and folds smaller, which makes it popular for car trips, but the user cannot move it independently. Some households have both.

Measurements that matter

• Seat width: too narrow presses on the hips, too wide makes the push rims hard to reach.
• Seat depth: there should be a small gap behind the knee so the seat edge does not press into the back of the legs.
• Seat height and footrests: feet should rest flat with the thighs supported.
• Back height: enough support without blocking shoulder movement for people who self-propel.

These measurements are best taken by a therapist with the person seated, rather than guessed from height and weight.

Cushions

A standard sling seat sags over time. A cushion improves comfort and posture, and for people who sit for long periods, pressure care is an important clinical topic in its own right. If someone spends hours a day in a chair, ask a professional about pressure-relieving cushions and how often to change position; do not rely on a general guide for this.

Brakes, tyres and folding

Wheel locks should hold the chair firmly when engaged. Pneumatic tyres give a softer ride but need their pressure checked; solid tyres are maintenance-free but firmer. Learn how the chair folds and unfolds before the first outing, and practise lifting it into the car you actually use.

Getting in and out safely

Most transfer accidents happen when the brakes are off, the footrests are in the way, or the chair is at an awkward angle. Lock both wheels, swing or remove the footrests, and position the chair close to the bed, seat or toilet. A therapist can teach a transfer method that suits the user and the helper. See transfer aids and lifts for equipment that can help.

Around the house

Thresholds, narrow doorways and thick carpets are the usual obstacles. Small threshold ramps and rearranged furniture often solve more than major works. The page on ramps, thresholds and stairlifts goes further.