Fact Sheet on Power Wheelchairs

Introduction

One of the first decisions facing someone who needs a wheelchair is whether to get a manual wheelchair or a power wheelchair. For people who have limited use of their arms as well as their legs, a power wheelchair may be the obvious choice for independent mobility. For many others, including people aging with a disability and people with conditions such as post polio or multiple sclerosis that may get worse with time, the decision to switch from a manual wheelchair to a powered chair can be a
difficult – and often a liberating – choice. This fact sheet is aimed at helping both those who know they need a power chair and those who are considering whether an electric wheelchair would be the wiser choice. It describes the types of power chairs that are available, their features, and factors to consider in selecting a power chair.

Power wheelchairs make independent mobility possible for people with limited use of upper as well as lower limbs, since unlike most manual wheelchairs, they do not require the use of arms to roll the wheels. Power wheelchairs also provide welcome relief for wheelchair users who are starting to experience repetitive motion injuries in their shoulders and arms, as often happens as manual wheelchair users get older.

Types of Powered Wheelchairs

Most powered wheelchairs fall into two types based on overall configuration: Traditional style, which is essentially an adapted version of a traditional manual wheelchair, and platform style, in which a seating system is installed on top of a powered base. There are also many specialised types for particular purposes, such as powered chairs for use on difficult terrain or sandy beaches; chairs with seating systems that can raise the user to a standing position; chairs with elevating, tilt-in-space, or
reclining seats; powered chairs for children; and even powered chairs that can climb stairs.

Traditional vs. Platform Configurations

The traditional style power wheelchair is similar in appearance to a standard everyday wheelchair that has been reinforced to tolerate the extra weight of a power and control system. These chairs usually are powered by a battery attached behind or underneath the seat of the wheelchair. Power-assist systems are available that can be used to convert an existing manual wheelchair to a powered one.

Most powered wheelchairs are the platform or power base type, which consists of a seating system set on top of a power base. Typically, the base is rectangular with four or six wheels. Some models have a round power base, which allows for a tighter turning radius nearer that of a scooter. Another variation on the power base concept is a chair that includes built-in lifts to allow the user to raise and lower the seating platform. These are commonly referred to as Lift Chairs.

Drive System

The drive system is the means by which power is delivered to the chair’s wheels. Most powered wheelchairs have either rear wheel drive or front wheel drive. Center or midwheel drive also is an option. The drive type can have a significant effect on the manoeuvrability and handling of the wheelchair.

Powered Wheelchairs for Children

There is no general agreement about the age at which a powered wheelchair is appropriate for a child. Many experts as well as parents feel that powered wheelchairs are inappropriate for all young children because of the likelihood that the child will abuse the chair or engage in risky behaviour. They are reluctant to give a powered wheelchair to a child until the child is old enough to trust with the chair. Others are more willing to give a powered chair to a younger child, out of a belief that children with
serious physical disabilities will benefit developmentally from being mobile at an earlier age.

Another concern is that children and teens need wheelchairs that continue to fit them as them grow. Because of the high cost of replacing a wheelchair of any kind, and because providers may place limitations on how frequently chairs may be replaced, purchasing a new chair each year can be financially prohibitive. This is even truer for powered wheelchairs than for manual chairs, since they generally cost more. One way of dealing with this concern is to buy a powered growth chair that allows adjustments to be made in the existing chair to accommodate a growing child.

How the wheelchair looks is another consideration of special interest for children. It is important that wheelchairs for children and teens should be “friendly looking” or even “cool” to help the child or teen fit more readily into social situations. For this reason, child/youth chairs usually offer a more streamlined appearance and/or brighter upholstery or frame colours than most adult chairs.

Lightweight Powered Wheelchairs

Lightweight wheelchairs with frames made from lighter materials, such as titanium or aluminum, which were originally developed for wheelchair racing and sports, have become increasingly popular as daily use chairs. A major reason for their popularity is that they are easier to transport; for example, a caregiver or taxi driver can lift a folded lightweight chair into a trunk much more easily than a heavier steel-frame chair. Some powered wheelchairs can be disassembled and folded for transport, but the inclusion of a motor and a battery means that powered wheelchairs weigh more overall compared to
manual wheelchairs.

An alternative for someone looking for a lighter powered chair is the powered scooter, with a seat and hand controls atop a narrow three- or four-wheeled platform. The scooter seat provides less body support than a wheelchair seat, but for users with good upper body and arm strength and the ability to sit for extended periods, a scooter may be a somewhat less expensive alternative to a powered wheelchair. For a detailed discussion of scooters and their features, see the Fact Sheet on Mobility Scooters.

Elevating and Standing Wheelchairs

An elevating wheelchair has a power lift that elevates and lowers the seat as an aid in transferring or for other purposes. A standing wheelchair has a power lift with a frame for raising the user to a standing position. A wheelchair of this type may be helpful for individuals who have difficulty standing but who need to be able to stand at their jobs, or who want to stand as part of a physical conditioning routine.

Reclining / Tilt-In-Space Wheelchairs

Reclining wheelchairs and tilt-in-space wheelchairs are available for individuals unable to sit upright for sustained periods or who need to change position without leaving their chair. In a reclining chair, the back reclines independently of the rest of the seating system, while in a tilt-in-space chair the back, seat, and legrests all move together, allowing the person sitting in the chair to tilt back without losing balance. These features are available separately, or, in some models, together.

All-Terrain Chairs and Beach Chairs

For recreational use, there are powered wheelchairs designed specifically for moving over difficult surfaces. These include powered all-terrain chairs with four-wheel drive to aid in moving over rough ground, and powered beach chairs with balloon wheels for moving over sand.

Powered Wheelchair Components

Many powered wheelchair components are similar to those found on manual chairs. However, others such as controllers, batteries, and drive systems are unique to powered wheelchairs.

Folding versus Rigid Frames

Some traditional-style powered wheelchairs have cross-brace frames that allow the chair to be folded or collapsed for storage and transport once the batteries have been removed. Other traditional models and some power base chairs disassemble for transport. Wheels, headrests, armrests, and footrests may be releasable for storage or shipping. There are also powered wheelchairs with rigid frames that do not fold or disassemble.

Frame Materials

In the past, stainless steel was the only material available for wheelchair frames. The introduction of lighter frame materials such as aluminum, titanium, and composites made lightweight wheelchairs possible. Titanium in particular is also stronger and more flexible than steel, making it good for use in sports wheelchairs. Some lighter materials are now being used for powered wheelchairs of both traditional and power base types. However, although use of lighter frame materials may result in powered wheelchairs being lighter than they were in the past, powered chairs are still considerably heavier than manual wheelchairs, with weights ranging from 40 kilograms to more than 140 kilograms.

Seating System

Seating systems are often sold separately, which allows the wheelchair to be adapted to the individual user. It is important when selecting a wheelchair or a seating system to be sure that the two components are compatible. Power base wheelchairs, because of their modular construction, often have customized chair-style seating systems. The correct seat width and depth are essential for comfort and support, so whether or not the seating system is purchased separately, the right measurements should be selected at purchase. Most wheelchair models are available with a range of seat widths and depths.

Cushions

Cushions are important not only for comfort but also to prevent pressure sores and help keep the user from sliding out of the chair. Cushion types include air, gel, foam, and combinations such as air and foam or gel and foam. Air flotation cushions allow the user to adjust the amount of pressure in the cushion. Cushion thickness may range from 2 to 10 centimetres. Cushions may be made of moisture-absorbing material that draws perspiration away from the body, or have ridges or bumps to provide some air flow between the body and the surface of the cushion. Cushions may be contoured to reduce
pressure on the buttocks. Custom contouring is available to fit the shape of the cushion to the shape of the person sitting on it. To prevent sliding out of the chair, some cushions are higher in front than in the back. Seat belts and harnesses are also available for this purpose.

Upholstery

Upholstery for wheelchairs must withstand daily use in all kinds of weather. Consequently, manufacturers provide a variety of options to users, including nylon, vinyl, and leather. Many manufacturers also offer a selection of upholstery colours, ranging from black to neon, to allow for individual selection and differing tastes among consumers.

Brakes

Most powered chairs utilize a dynamic braking system in which the motor and brakes work together to slow and stop the chair when the joystick or other controller is released, and which automatically engages the brakes when the power is off or when the chair is not being powered in a forward or reverse motion with the controller. Traditional-style chairs frequently also have “parking brakes” (wheel locks) similar to those found on manual chairs which are available in several different designs and can be mounted at various heights to maximize convenience for the user.

Wheels and Tires

Traditional-style chairs generally use the standard four-wheel configuration, with two large wheels at the back and two smaller ones (casters) at the front. The standard tire used for the rear wheels on most wheelchairs is a pneumatic tire, for which the standard sizes are 20 or 24 inches. Smaller and larger sizes, however, also are used as are solid and semi-pneumatic tires. Casters, too, vary in size (generally ranging from six to eight inches in diameter, although smaller sizes are also used) and composition (pneumatic, solid rubber, plastic, or a combination of these). Power base chairs typically use four wheels of the same size, usually 8 to 10 inches in diameter. These chairs may have pneumatic, semi-pneumatic, or solid tires.

Footrests

A variety of footrest assemblies are available on both types of powered wheelchairs, including footrests that fold, swivel, or flip up; rigid single unit footrests; removable/detachable footrests; adjustable length footrests; and footrests with a combination of features.

Armrests

Armrests may be full-length to provide full support for the user’s arms, or they may be desk-length (half length) to allow closer access to desks and tables. Armrests of both types may be flip-up, fixed, or detachable. Flip-up armrests can be raised when necessary to fit under a table. Since most people who use powered wheelchair need the upper body support provided by armrests, they are rarely omitted.

Controls

Powered chairs generally include as a standard feature a manually controlled joystick to regulate the chair’s speed and direction. However, most manufacturers offer customized control options to accommodate the varied abilities of the user, including sip-and-puff (pneumatic) systems, head and chin switches, push-button controls, trackballs, and tillers. Many chairs also have programmable control features which allow the user or a dealer to adjust or set the chair’s speed and control limits as the user’s abilities change. There are also manufacturers who do not make wheelchairs, but who offer specialized control systems for powered wheelchairs, including voice-activated controls. When purchasing controls and switches from a source other than the chair’s manufacturer, it is essential to determine that the selected control is compatible with the chair.

Batteries

Batteries are a determining factor in the range and power of a powered chair. Generally, larger batteries mean that a wheelchair has greater power and the range between charges. Many chairs require two rechargeable 12-volt batteries. Most wheelchairs utilize U1, group 22 or 24 batteries, although other batteries are also used. More manufacturers are designing chairs around the group 24 battery because it affords a longer range. The type of battery required is also an important consideration in terms of safety, maintenance, and transport. Powered chairs may utilize lead acid, gel cell, or sealed wet batteries. Gel cell batteries require the least maintenance and have less danger of leaking than do the other battery types. Also, a number of airlines will only transport powered chairs with gel cell batteries.

Selecting a Powered Wheelchair

As part of the wheelchair selection process, the person who will use the wheelchair may consult a professional such as a physical or occupational therapist or a physician specializing in orthopaedics or rehabilitation medicine. The professional can offer informed advice on many of the chair’s features, including the most appropriate kind of seating system and what special features and adaptations are needed. However, even if a professional is consulted, the user must also actively participate in the selection process, since he/she will be most aware of the user’s needs and circumstances. The choice of a powered wheelchair should be based on the how a person intends to use the wheelchair, the physical and functional capabilities of the user, and the user’s personal preferences. There are special issues about powered wheelchairs for children, and the cost of a wheelchair is always a concern.

How Will the Chair Be Used?

The choice of a chair should depend in part on its intended use, including the types of environment in which it will be used and how it will be transported. Will it be used primarily indoors or outdoors? Will it be used in the home, at work, for recreation, or in a variety of settings? Will the chair need to be transported? If so, how will it be transported – in a van, a car, or by some form of public transportation? Are there stairs or other barriers to be considered? The answers to these questions will help determine
the best chair for the user.

Most powered wheelchairs are designed for both indoor and outdoor use, but chairs differ in their manoeuvrability and handling on different surface types, and it is important to consider whether the chair will be used on flat surfaces or steep inclines, on floors and sidewalks or on rough terrain, or on surfaces such as sandy ground that give limited traction to wheels.

Since powered wheelchairs run on batteries, battery capacity is an important consideration, especially if the chair will often be used to go up and down hills or for longer trips. Battery capacity is usually stated as range, or the maximum distance the wheelchair can travel between charges of the battery. The maximum range may be as little as 10 kilometres or as long as 60 kilometres. Actual range can be reduced by factors such as the user’s weight, use of additional powered features, speed, and the type of terrain on which the chair is used.

The use to which a chair will be put is also a factor in the selection of a drive type. According to the authors of The Powered Wheelchair Training Guide (Axelson, Minkel, Perr and Yamada, 2002), “Front-wheel drive chairs have good traction going downhill, but can lose traction over sandy or slippery surfaces when going uphill,” while in contrast, “[t]he rear-wheel drive chair has the same difficulty with driving backward.” “Mid-wheel drive chairs have the potential for better traction than either front-wheel or rear-wheel drive chairs,” they write, and “may also be easier to manoeuvre in tight environments than either front-wheel or rear-wheel drive wheelchairs,” although “the user has to get used to tipping back onto their small anti-tip wheels when going up a hill or during rapid acceleration.”

Transportation is another important consideration. Is a wheelchair accessible van or bus available to transport the individual in the chair, or is it necessary for the chair to fold or disassemble in order to be carried in a car boot?

Besides everyday use at home, work, or school, the individual may wish to use the chair for recreational activities. If the chair will be used for outdoor recreation, a variety of all-terrain models are available.

Physical and Functional Capabilities

Powered wheelchairs usually offer a variety of control options to suit a person’s physical capacities. Joystick controls mounted on an armrest are usually standard, but other options are available for individuals who are unable to use a joystick, such as switch controls or sip-and-puff controls.

Personal Preferences and Style

Since the person who uses a wheelchair lives with it constantly, personal tastes and values should also be considered. The wheelchair should be compatible with his or her personality. Style and colour may be just as important as how the chair feels to the body. As with manual wheelchairs, the design of powered wheelchairs traditionally stressed function over style. Today, however, the appearance of powered wheelchair models has become more streamlined, and many models are available in a variety of frame styles and upholstery colours.

Pricing a Powered Wheelchair

Anyone who has purchased or is considering the purchase of a powered wheelchair should be aware of the expense of buying and maintaining one. The purchase price of a powered wheelchair rarely is less than several thousand dollars, and can be much higher for the more deluxe models or those with specialized adaptations. Thus, a powered wheelchair is a major financial investment. Like any major financial decision, purchase of a powered wheelchair should be undertaken with care to ensure the product meets the needs of the individual who will be using it.

When comparing retail prices, consumers should be careful to ask the retailer which features and options are included in the stated price and which are extra. For example, does the stated price include the seating system or only the power base? Are the battery and battery charger included with the chair or are they extra-cost items? The manufacturer should have a price list available that indicates which features are standard and which optional, and showing how the price is affected by options selected and any custom or individualized modifications.

Funding Sources

For further information, please visit Mobility Aid Funding Sources.

A Good Start …

New power wheelchairs are being introduced to the market every year. One of the easiest ways to keep up-to-date on what is available is to bookmark or favourite Mobility Mate. We list unbiased and detailed information on mobility products for people with disabilities. Information on all types of wheelchairs available in the Australia is included in the Mobility Mate product listings, as well as direct links to retailers and manufacturers.