Short Description

There is a great variety of powered wheelchairs on the market and there is much to consider before selecting a chair which maximises the user's function. Before buying, aim to try and compare a range of different models. Contact the ILC to arrange an appointment with an occupational therapist and/or for supplier information.

Options

WHEELCHAIR ACCESSORIES
The majority of manufacturers supply a range of accessories to accompany their wheelchairs. There are also suppliers that sell universal accessories for use with a range of different wheelchairs.
They may included the following:

SEATING:
- Deluxe seating: contoured back and neckrest
- Backrest extensions
- Manual or electric tilt - in - space
- Manual or electric reclining backrest
- Elevating legrests
- Backrest upholstery tightener
- Seat belt
- Cushions

CONTROLS:
- Sip / puff
- Chin
- Attendant
- Drop down

GENERAL:
- Clothes guards
- Calf strap
- Heel loops
- Tray
- Stump supports
- Thornproof tubes
- Oxygen bottle carrier
- Rear tilt bars

Models

Powered Wheelchairs With Special Features
Some wheelchairs have special features that allow people to be more independent or to provide additional support or comfort. Some features available include:

Stand Up Mechanism
These wheelchairs use either a manual or power control to stand the user up to a near vertical position. The user is stabilised in a standing position via chest and knee straps.

Powered Reclining Backrest
A reclining backrest is longer in length and includes a head support section. The recline mechanism has either manual or powered operation. A reclining backrest is usually used in conjunction with elevating legrests.

Tilt - In - Space
The seat unit in these wheelchairs can be tilted backwards, while maintaining a constant angle between the seat and backrests. This function has either manual or powered operation. People who have low muscle tone with limited head and trunk control may be better supported in a tilt - in - space wheelchair. It might also be used for resting, for altering weight distribution and to improve comfort.

More Details

Home Demonstrations
Some manufacturers of powered wheelchairs provide a home demonstration service, which allows the user to try out the vehicle in their home environment.
Check that:
. the vehicle can be manoeuvred over thresholds, through doorways and over terrain where it is likely to be used. Also check access in tight spaces eg to toilet, tight turns in hallways.
. the prospective user sits in the wheelchair and drives it (not just the sales representative)
. a health professional is there (where possible) to give advice
. Take your time over making any decision to buy. Do not buy from anyone exerting pressure on you to 'sign up' for their product. You must give yourself an opportunity to independently think things through.

Before committing to purchasing a powered wheelchair, check the following:
. does the prospective user has the necessary skills to handle a powered wheelchair?
. the wheelchair has the capabilities that are required of it
. the home environment can accommodate the wheelchair
. what is the delivery time?
. will the powered wheelchair arrive ready assembled?
. what guarantee and after-care service is available?
. how much is the company's call out charge?
. will spare parts be brought to the home?
. if the powered wheelchair has to be taken away for repairs will a 'loan vehicle' be offered?
. If the same vehicle can be supplied direct from the manufacturer or from other retailers, how do prices compare?
. what are the insurance and registration requirements

Features
Frame
A rigid frame is stronger than a folding frame but may make transporting the wheelchair more difficult.

Wheels / Tyres
Wheelchairs with smaller wheels are generally easier to drive in confined spaces; larger wheels are better over uneven ground.
All powered wheelchairs have a freewheel facility to disengage the motors so that the wheelchair can be pushed in an emergency situation. A powered wheelchair is heavy to push and manoeuvre manually.

Tyres
. Pneumatic tyres can provide a smoother ride but require regular inflation and can puncture.
. Solid tyres do not puncture or need inflating and may make it easier to manoeuvre on some surfaces.
. Puncture proof tyres are a compromise between solid and pneumatic tyres. They are made of an 'open cell' rubber compound to help with shock absorption.
. Deep tread pneumatic tyres provide increased grip and stability on slopes, muddy grass and rough or uneven ground.

Footrests
. Removable footrests decrease the weight of the chair and enable easier transfers. However they can be mislaid.
. Swing away footrests give better access to the wheelchair seat during transfers.
. One piece footrests provide a greater area of support for feet. Some may not be detachable and may interfere with transfers.
. Elevating footrests are available for people who need to have their legs raised, or for those who have stiffness in their knees.
. Height adjustable footrests accommodate the user's leg length.
. Angle adjustable footrests - may be adjusted to reduce leg spasm
Wheelchair footplates can generally lift up. Optional heel loops and a calf strap may prevent the legs and feet from slipping backwards.

Armrests
Armrests provide security as well as support for the elbows. There is a range of different styles to choose from:
. Full length armrests are equivalent in length to the seat depth and provide support when standing up and sitting down. They may include an attachment for a tray. However, they can prevent a close approach to a table.
. Desk style armrests are shorter in length and allow access to work surface, but do not offer as much arm support when needing to stand up.
. Adjustable height armrests can be adjusted to provide maximum support and comfort.
. Removable armrests reduce the size / weight of wheelchair and may help with transfers, storage and transportation.
. Fold up / fold down / swing away armrests may be more convenient for someone who needs to transfer sideways.

Backrests
The backrest should be high enough to stabilise the lower back. The backrest height generally reaches shoulder blade level or beyond.

. Folding backrests - reduce the overall size of the wheelchair for ease of storage and transporting; and can help when positioning slings for assisted transfers.
. Non folding (fixed) backrests provide firmer back support and secure attachment for more supportive backrest systems.
. Semi or fully reclining backrests can either be reclined manually by an assistant or some can be adjusted electrically by the user.

Seat
The seat size and style has a direct impact on posture and comfort. Room must be allowed for outdoor clothing if the wheelchair is to be used outside.

A slung seat and backrest are standard features but do not provide sufficient comfort and support over long periods. Padded and/or contoured seating gives additional comfort and increases shock absorption. As a minimum, the wheelchair seat should be fitted with a foam cushion, or a cushion with higher pressure reducing properties if the user is vulnerable to pressure sores

For additional support requirements, a range of seating systems is sold separately. Usually an occupational therapist or physiotherapist is involved in the selection process to find the most suitable system. The seating system must be compatible with the wheelchair chassis.

Brakes
All powered wheelchairs have automatic brakes which activate when the control is released. For extra security, some wheelchairs have an optional hand brake.

Wheelchair Controls
Wheelchairs are fitted with a control console that will generally include:
. An on / off switch or key
. A control to drive and steer the wheelchair (usually a joystick)
. Speed adjustment dial or switch
. Horn
. Switches for lights or indicators
. A battery level indicator.

On some wheelchairs, the control console can be dropped down or swung away to improve access to the wheelchair seat during transfers.

Joystick and alternative controls
Most chairs have a proportional joystick control that requires minimal hand movement to control speed and direction. It is usually mounted on the left or right armrest.

Alternative controls
These may include a tray mounted joystick; dual and attendant controls, switches mounted so that other parts of the body can be used to control the wheelchair such as the chin, head or foot; touch sensitive switches; a suck / blow switch etc. Centrally mounted controls may help to improve body symmetry and help to promote a stable seating posture. Most controls can be programmed to accommodate tremor, speed etc.

Batteries and Chargers (see MAINTENANCE)

Factors To Consider

Purpose
- for what purpose is the wheelchair required?
- Indoor mobility requires level or ramped access into the home. Consider width of doorways, room sizes and space along routes of travel.
- Outdoor use: Will the user be able to handle the wheelchair over uneven ground, pass pedestrians, across roads etc. Over what distance and what routes does the user intend to travel? What distance it the wheelchair capable of achieving on a full charge - this can be effected by battery condition, user weight, type of terrain, weather, accessory use eg lights.

Cognitive and sensory function:
The user must have the ability to handle the controls as well as be able to judge distances and widths. People with visual, perceptual or intellectual difficulties should seek medical advice and have a thorough assessment with a health professional.

Storage
The wheelchair should be stored in a secure and waterproof place, close to a power point to charge up the vehicle's batteries. It should not obstruct essential circulation space (not become a fire hazard)

Stable sitting base
Correctly positioning provides support and security. If the seat is too wide, the user may need to sit asymmetrically. If the seat is too narrow, it will be uncomfortable and increase the risk of pressure sores. With poor sitting balance or a asymmetrical posture, a supportive seat unit with additional postural supports may be necessary.

Ease of steering
A joystick is the standard control. es are available. The majority of controls are programmable to match the user's requirements for speed etc

Ease of manoeuvrability
Wheelchairs designed primarily for indoor use tend to be smaller and more manoeuvrable than wheelchairs designed for outdoor use. The outdoor chairs usually have very wide turning circles and wide / deep treaded tyres for easier movement over rough or soft ground. Some models have suspension incorporated into the frame to provide a smoother ride over rough terrain.

Ease of transferring
The user must be able to transfer in and out of the wheelchair safety with or without assistance. Features such as lift up / swing away footrests, removable or fold down armrests will enable closer access to the wheelchair. Consider space for positioning for transfers. Powered wheelchairs can only be moved manually when the motors are disengaged. A parking brake is often provided for added security.

Where assistance is required, a range of equipment available to help with transfers such as sliding boards and rotating discs, or if necessary, use a hoist (Consult the ILC for advice)

A stable wheelchair
A user with a high level leg amputation(s) may require a wheelchair that is weighted at the front end to reduce the risk of tipping backwards. Stability can also be decreased if the wheelchair backrest is reclined or the wheelchair seat tilts backwards (tilt-in-space).
Check with suppliers the recommended maximum height and maximum gradient for each wheelchair and the technique you should use to climb and descend kerbs and slopes safely.

Ease of transporting
Folding or dismantable wheelchairs can have heavy components.
Ask the supplier for weights of component parts.
An assistant may be able to drive the wheelchair, unoccupied, into the back of a station wagon via ramps.
Wheelchair hoists can be fitted to the back of a car to lift component parts or the whole vehicle into a car; or a wheelchair can be transported on a rack or trailer.

A vehicle that meets the assistant's needs
Dual or attendant controls enable an assistant to control the wheelchair from the push handle. Is the assistant able to maintain the wheelchair eg pump up tyres, charge the battery, and dismantle and assemble the wheelchair.

Incline Transitions
When traversing curbs and steep ramps:
RWD - rear stabilisers (anti tippers) can interfere by "bottoming out
during steep incline transitions
MWD - front stabilisers can sometimes lift drive wheels from the ground during steep incline transitions
FWD - generally stable through steep incline transitions

Control
There is very little difference in the way the three configurations actually handle except for a slight veer by some FWD and RWD power wheelchairs on sidewards slopes. However, the perceived control of the wheelchair may differ more. This may influence the user's comfort.

Manoeuvrability
The front turning radius and the full turning radius influence a wheelchair's manoeuvrability.
. FWD have the smallest front turning radius of the three configurations. Its full turning radius is smaller then the RWD
. MWD have the next smallest front turning radius and the smallest full turning radius
. RWD have the largest front turning radius and full turning radius

Transfers
FWD and RWD chairs usually have lift up and/or removable footplates to facilitate transfers in/out of the chair. MWD chairs may have the same footplates but front stabiliser wheels may hinder transfers.

Performance Comparisons
Generally FWD and MWD wheelchairs are more manoeuvrable however variances in the size of wheelchairs can influence this.
RWD and MWD chairs perform better in the area of "perceived" control.
The space allowed on public transport for carrying mobility equipment is an area of 1300mm by 800mm.

Wheelchair spaces
All new Sydney buses feature special 'kneeling suspension' and a ramp to provide easy access for less mobile passengers.

There are spaces for two wheelchairs on the new buses. These will accommodate most manual and electric wheelchairs with max. length 1250mm, max. width 750mm, max. turning circle1500mm, and max weight 200kg.

For safety reasons, passengers in wheelchairs are advised to face the back of the bus, bracing their wheelchair against the side of the space, applying the brakes and securing the seat belt of the wheelchair.

Wheelchair accessible buses display a blue and white wheelchair sign on the front of the bus, and on the easy access door.

Maintenance

Follow the manufacturer's guidelines for maintaining the wheelchair as well as correct use of the chair and charging batteries.

Types of Batteries
Two main types of battery are available:
. Lead acid / wet batteries require checking and topping up with distilled water. There is a risk of corrosive spillages and they are unsuitable for air travel.
. Gel batteries are more commonly used. They are maintenance free and are so called because their conducting chemicals are suspended in a gel like substance so no 'topping up' is required.

Charging batteries
Need an accessible mains electricity power socket. Check that the charging point on wheelchair is easily accessible. Charging of wet batteries should always be done in a well ventilated room as gases are given off. It is also recommended that batteries are not charged in a room where someone is sleeping.

Licence & Insurance Requirements

Registration requirements for motorised Personal Mobility Vehicles:
Motorised personal mobility vehicles which weigh more than 110 kg when unladen and which are capable of travelling at more than 10 km/hr are not exempt from registration (in accordance with Part 16 of Schedule 1 The Road Transport (VR) Regulations 1998) and therefore must be registered if they are to be used on a road or road related area.

Vehicles which weigh not more than 110 kg and travel at less than 10 km/hr and which are specially constructed to be used, and while upon a road or road related area are used solely for the conveyance of a person with a disability, are EXEMPT from registration.

CTP Coverage for Registered Personal Mobility Vehicles:
Any vehicle which must be registered must also have Compulsory Third Party (CTP) insurance. CTP insurance will cover the at fault owner / driver for damages payable to another person / persons injured in a motor accident which occurs on a road or road related area.
For vehicles weighing more than 110kg and travelling faster than 10km/hr, the RTA issue a Conditional Registration Certificate with in built CTP coverage. (There is a fee for this which is renewable annually).

CTP Coverage for Exempt Personal Mobility Vehicles:
Motorised wheelchairs which are EXEMPT from registration are not compelled to carry Third Party Insurance (section 8 Motor Accidents Act 1988 and Part 16 of Schedule 1 The Road Transport (VR) Regulations 1998).

As of June 2002 the RTA no longer issues Unregistered Vehicle Permits for personal mobility vehicles which are EXEMPT from registration.

(i) Nominal Defendant Scheme:
If the owner or driver of a vehicle which is EXEMPT from registration is found to be at fault in injuring a person on a road or road related area the injured person may make a third party claim against the Nominal Defendant Scheme. The Nominal Defendant would pay compensation, however, in accordance with section 31(3) of the Motor Accidents Act 1988 it would not seek to recover that payment from the at fault owner or driver of the vehicle if it was EXEMPT from registration and therefore legally on the road.
It is important to note that the Nominal Defendant Scheme operates only in relation to accidents which occur on a on a road or road related area. It should be noted in this regard, that the definition of "road related area" contained in both the Motor Accidents Act 1988 and the Road Transport (Vehicle Registration) Act 1997 is broad, incorporating as it does:

a) an area that divides a road, or
b) a footpath or nature strip adjacent to a road, or
c) an area that is open to the public and is designed for use by cyclists or animals, or
d) an area that is not a road and that is open to or used by the public for driving, riding or parking motor vehicles.

The Nominal Defendant Scheme is administered by the Motor Accidents Authority. This cover is only available in NSW.

Personal Liability Cover
The personal liability cover extended as part of a Home Contents Insurance Policy is the best option for coverage not given by the Nominal Defendant Scheme. Not all insurers offer this extended cover.

Ask your insurer the following questions. If you don't like what you hear, shop around.
. Do you have a policy that will cover my motorised wheelchair if it is damaged or stolen?
. Will this policy also provide cover for damage my motorised wheelchair my cause others, including personal and property damage?
. Does the cover extend outside the site (my home) and within Australia and what is the value of this cover? (Typically it should be $10 million).
. Am I covered on public roads as well as private property?
. Are there any exemptions?

Standards

For some types of equipment, specific Australian or other Standard(s) are applicable to the materials used in, the manufacturing processes applied to and the installation of products. Compliance with relevant Standards is indicated by written certification that a product has been tested and assessed as compliant with specified Standards. Purchasers are advised to check with the supplier or manufacturer of this item as to its compliance with relevant Standard(s).