Customised wheelchairs assist people with disability who require specific modifications and specialised postural supports to provide them with mobility and prevent secondary deformities and pressure problems associated with their disability. This may vary from simple modifications to an entirely unique design. Customised wheelchairs can also be used as a medium of expressing personal style and image (Emmer & Soldatenko 2006).
Wheelchair modifications for upper limb conditions:
- plastic coated push rims provide the occupant with more traction to propel the manual wheelchair forward which is also useful for occupants with weak hand grip
- capstans/projections: rubber coated projections on the push rim can assist with the upper limb coordination of both wheels to manoeuvre a manual wheelchair
- moulded and height adjustable armrests can be used to provide support for individuals with frozen shoulder or skeletal deformities such as scoliosis as well as providing security for the occupant and assist with transfers
- supports: a range of wheelchair accessory supports are available including midline and lateral head and neck supports or lateral thoracic supports
- one arm drive wheelchairs for upper limb amputees that allows both wheels to be propelled with one hand.
Wheelchair modifications for lower limb conditions:
- calf straps that attach behind the calves on the footplate hanger and prevent feet from falling backward or hitting the castors
- lower limb amputees require modifications to the wheelchair axle position to ensure their centre of gravity is balanced.
Wheelchair modifications for conditions involving the trunk and abdomen:
- reclining seating system so the angle of the backrest can be changed for individuals with low sitting tolerance such as severe spasticity
- height adjustable seats to assist individuals with transfers
- rear or front suspension to absorb forces present during wheelchair propulsion ensuring occupants experience decreased pain or involuntary muscle movements and increased ride comfort.
Operational modifications:
- specialised devices for users that have limited motor control with functions such as chin or puff/suck controls
- extended brake levers to reduce the force required to engage/disengage the brake and minimise forward reach required to access the lever
- anti-tip device used to reduce the chance of the wheelchair tipping backward when manoeuvring around kerbs and footpaths.
Specialised modifications:
- child seat attached to the front of the wheelchair for mothers who require a wheelchair to mobilise
- lengthened or shortened wheelchairs for tall or short wheelchair users
- reinforced wheelchairs for large framed users
- performance wheelchairs for athletes or very active users
- welded brackets on the wheelchair base made to fit the individual, making it non-adjustable
- indoor and outdoor wheelchairs for use over a variety of terrains
- hemi wheelchairs with a lower seat height and armrests to fit under a desk or table
- modifications in terms of appearance including frame colour and design, upholstery, spoke guards, wheel castors or zip-on frame covers or bags.
Modifications for transporting or storing the wheelchair:
- quick release hubs: a push button mechanism to allow the easy removal of the rear wheels when the wheelchair is being transported
- quad release axles: levers attached to the quick release hubs for occupants with limited hand function.
(Emmer & Soldatenko 2006; Faulkner 2007; Brechtelsbauer & Louie 1999; Cooper 1998)
It is recommended that a person wanting to make modifications to a manual or mobilised wheelchair seeks advice from a qualified occupational therapist. Qualified occupational therapists can be found on the Australian Association of Occupational Therapists (please see Related Links on this page).
Relevant Links
References
Brechtelsbauer, M.D. & Louie, A. 1999, Wheelchair use among long-term care residents, Annals of Long-Term Care, vol. 7, pp. 213 – 220, viewed 16 October 2007, <http://www.annalsoflongtermcare.com/article/1636>.
Emmer, G. & Soldatenko, G. 2006, Custom wheelchairs: The trend from functionality to individuality, Med Services Europe, Zurich, viewed 16 October 2007, <http://www.e-bility.com/articles/wheelchairs.php>.
Faulkner, D. 2007, Custom wheelchairs – Opening up the world, Ezine Articles, Essex, viewed 16 October 2007, <http://ezinearticles.com/?Custom-Wheelchairs---Opening-Up-The-World&id=554695>.
Cooper, R. 1998, Wheelchair Selection and Configuration, Demos Medical Publishing, Denver.