About – Power Wheelchairs

Electric-powered mobility devices issued by an equipment vendor to provide a means of primary mobility for a user who is unable to ambulate or is unable to ambulate safely or for functional distances.

Overview

Purpose: Powered mobility for independent movement. All patients with Duchenne muscular dystrophy will expect to require use of a power wheelchair for some or all of their independent movement. Power wheelchairs are best distinguished from ‘scooters’ by the use of a joystick to operate them and that they offer many more features such as the ability to use special seating supports, power seating, and specialty controls for operation.
Most Appropriate Stage for Use: From Mid-Ambulatory through Non-Ambulatory Stages
When to Use: Initial use may be to supplement ambulation for long range and to improve safety with mobility. Long term use will usually be for all mobility in all environments.
When to Avoid: When a user is a young child, they must always be under close adult supervision. As the child matures and demonstrates safe operation and good judgment, normal age appropriate supervision is all that is needed.

IMPORTANT FEATURES

Powered Seating: Available on most power wheelchairs and is critical for the user’s health. The powered seating motions help to find a comfortable position, change position regularity, and shift weight for skin protection.
Tilt: This feature rotates the entire seat rearward as a single unit. It is useful for shifting the user’s weight off of the lower extremities to allow for improved circulation as the foot supports raise with the seat. It is also useful to tilt for ground clearance of the foot rests when outdoors and to give the user stability when traveling down a slope such as: going down a hill or exiting a van with a ramp. Tilt alone does not provide for any joint movement of the user’s hips and knees as the foot rest and back rest angles are fixed in relation to the seat base.
Recline: This feature changes the angle of the backrest in relation to the seat. It is useful for allowing a change of trunk position which allows the user to move between positions of task performance and rest while maintaining the support from the backrest. Recline is critically important for maintenance of hip range of motion. Without this feature and the regular change of hip position, most individuals with Duchenne will develop hip contractures that will limit hip mobility which in turn affects the spine.
Power Elevating Leg Rests: This feature allows the user to extend the foot supports to place their feet and lower legs in a variety of positions. They will let the user keep the feet in close for transfers and maneuvering in tight confines and extend them out for stability, comfort, and maintenance of knee range of motion.
Seat Elevation: This feature raises the height of the wheelchair seat. It is very useful when the user is reaching for items, to assist with transfers, positioning at various height counters/tables, improved social interaction and increased visibility and safety when crossing streets and negotiating parking lots.
Stander: The standing feature can place a user with low to no muscle strength into a standing position. It offers all the benefits of a static standing frame with independent use on their power wheelchair base. This makes it possible to stand wherever and whenever the user wishes to stand. In a standing position, users with arm function can accomplish a variety of activities such as meal preparation, self-care, and even independent use of the toilet for urination. Standing can help maintain lower extremity joint range, improve digestion, and lower incidence of urinary tract infections and all without the risks of frequent transfers to a separate standing device.
Drive Controls: The standard control for most power wheelchairs is a joystick. However, for users with diminished hand/arm function, there are a wide variety of alternative drive control options. These include:
– Low force, short throw joysticks
– “No touch” Fiber Optic and Proximity switches

Wheel Base Configuration:

Rear Wheel Drive (RWD): With the large drive wheels in the rear, this configuration is easier to drive at high speeds and has better capability over uneven terrain. However, the turn radius is the largest of the configurations and the front casters can impede footrest movement and width.
Front Wheel Drive (FWD): The large drive wheels are in the front and the front turn radius is the shortest. With drive wheels pulling from the front, this configuration does well on uneven terrain and can be configured to travel at high speeds with special tracking electronics. The absence of pivoting casters in the front give the most foot room for wider footplates and standing space for transfers.
Mid Wheel Drive (MWD): The drive wheels on this style are in the middle of the base. This style has the shortest overall turning diameter. These wheel bases maneuver very well indoors and in many outdoor environments. With the drive wheel in the center and the casters on both the front and the rear, this configuration is the most likely of the three to get stuck on obstacles and grade changes. Newer designs have improved the traction and minimizing this occurrence.

TIPS:

Each wheel base configuration has pros and cons. For a first power wheelchair, try them all out in your home environment, lifestyle events, and transportation if at all possible. Once a user becomes accustomed to the way their particular type of chair moves, a change of base configuration will require the user to adapt to a new way of operating the power wheelchair and moving through spaces. If a change of configuration appears to offer benefits, be sure to do a trial day with the new style of wheel base indoors, outdoors, in the vehicle, etc. to be sure that the user is aware of how the change is likely to affect mobility.

Manufacturers

AMY Systems: http://amysystems.com/amysystems-alltrack-m-series/
Drive DeVilbiss Healthcare: http://www.drivemedical.com/index.php/power-mobility/power-wheelchairs.html
Invacare: http://www.invacare.com/cgi-bin/imhqprd/inv_catalog/prod_cat.jsp?s=0&catOID=-536885238
Permobil: https://permobilus.com/products/power-wheelchairs-by-permobil/
https://permobilus.com/product/f3/
https://permobilus.com/products/power-wheelchairs-by-permobil/front-wheel-drive/
https://permobilus.com/products/power-wheelchairs-by-permobil/mid-wheel-drive/
Pride Mobility Products Corp: https://www.pridemobility.com/c/jazzy-power-chairs?tabid=tab-index2
Quantum: http://www.quantumrehab.com/
Stealth Products: https://stealthproducts.com/splash/drivecontrols/
Sunrise Medical: http://www.sunrisemedical.com/power-wheelchairs/quickie/rear-wheel-drive/s-6-series