Shoulder Preservation Part 4: The Recommendations for Shoulder Preservation with Manual Wheelchair Propulsion

Shoulder Preservation Part 4: The Recommendations for Shoulder Preservation with Manual Wheelchair Propulsion



Let’s continue our conversation on propulsion with a manual wheelchair. Last week, we briefly looked at 7 of the recommendations based on clinical practice guidelines.  Today, we will begin our dive into those recommendations.  Let’s start at the top.

Provide manual wheelchair users with SCI a high-strength, fully customisable manual wheelchair made of the lightest possible material.

What does this mean?  We need to break this down into several parts.

High strength: This means that we need the chair frame to be strong enough for the individual using the chair and the environment the chair will encounter.  We can think about 3 of the popular manual wheelchair materials aluminium, titanium, and carbon fibre.

Each material has different properties and will give a different ride experience to the user. We must consider not only the material of the frame itself, but also how this frame is designed. The shape of the frame can greatly impact the ride experience for the user. Next week we will go into a discussion on these common frame materials and how we might choose one over the other based on each individual and their goals.

Fully Customisable: What does fully customisable mean? Does that mean that we can change the cushion and the backrest options? Or does that mean more?  Here is a great video where Josh Anderson discusses the importance of the fit of a wheelchair:




Think about fitting the wheelchair like a prosthetic.  This means fitting it across dimensions to get that perfect fit. If we think about this idea of prosthetics, we can understand the importance of the perfect fit. What happens to an individual when their prosthetic leg for example does not fit properly? Pain, skin breakdown, inefficient mobility, etc… Does this sound familiar for when we have a client with a manual wheelchair that is poorly fitted? We can all think about the hospital wheelchairs as an example. These wheelchairs are designed to fit everyone and for the hospital staff to get a client from point A to point B. Hopefully you have all attempted to propel this wheelchair and you remember how hard it is to even reach the wheels. This is an extreme example of a poor fit, but important for us to consider just how important the fit is for that full-time manual wheelchair user. We will dedicate another upcoming blog to getting this ultimate fit and what that truly means.

Lightest Material Possible: The key word there is possible. We must keep in mind the client’s environment and goals when deciding on the material. We will go into the weights of the main 3 materials next week but, what else do we need to consider? What if I choose the lightest material possible for the frame of the wheelchair for my client and then I give them every accessory they may every need on that chair?

It is crucial for us to not just consider the material of the frame, but to consider every component that goes onto that frame. This includes wheels, tyres, backrests, and armrests which is some of the areas that we often see a lot of weight being added to the wheelchair. Make sure when you are deciding on these components that you consider the client’s safety first along with their goals and then look into the weight of the different components.