Manual Chairs & What’s in a Name

Every issue of Mobility Management is a learning experience — that’s one of the most rewarding parts of the job — but this March issue was an even bigger lesson than usual.

Let’s start with beds and mattresses. We debut our Nighttime Positioning comparos with this issue (page 19), and include a sidebar on the coverage criteria differences for Group 1 and Group 2 support surfaces. It’s all in keeping with our dedication to proper client positioning 24/7.
Then there’s the cover feature, our annual funding case studies special. This year’s subjects: funding tips for getting payors to say yes to all-terrain wheelchairs, various types of wheelchair seat cushions, and transitions from manual mobility to power. Funding case study bonus: Check out a fourth case study about power assist, featured as part of our look at the 2009 manual wheelchair market.

That story  is within our annual Seating & Positioning Handbook, which features an industry survey of rehab providers. We asked what you’ll be recommending and purchasing this year; you spoke. See what your peers said.

But back to the manual wheelchair feature story. Among the experts weighing in were three men who use manual chairs every day — Josh Anderson and Marty Ball from TiLite, and Chris Veatch from NEXT Mobility. They approached their interviews with a dual perspective, as both industry insiders and consumers.

And they — as well as the story’s other interviewees — made me think of manual chairs in a whole new way.
I’ve always thought of ultralightweight manual chairs as the industry’s equivalent of go-karts: quick, maneuverable, minimalist and yes, a little flashy. But are they complex rehab equipment on par, customization wise, with Group 3 power chairs?

Thanks to this month’s interviewees, I think that answer is yes.
I now know, as Josh explained, that some ultralight chairs can have their seats tapered “so the front of the seat is a little narrower than the rear of the seat so it holds your legs in a little better…and we can do that with an Ergo Seat, which has a flat spot in the back of the seat designed to give you a little bit more pelvic stability.”

Wow: customization that extends to anti-tippers, casters and wheel locks. Cool.
“If you think of a set of leg braces and how they’re fit,” Marty added, “how they’re bent and twisted and turned to fit the user, we try to do the same thing with a wheelchair. We liken it to a wheeled orthosis, rather than a piece of durable medical equipment. It’s really gotten to that level, and so it’s more complex than a complex power chair, quite honestly.”

Never thought of it that way (with all due respect to our power chair friends).
Chris discussed yet another side of the manual chair — combine it with power assist, and you can create another option for consumers not ready to switch to power. It’s a choice that can save funding sources money, as well.
Hey, choices are good. Very good.

As Marty said, manual chairs have taken such a leap forward, “We need to have a different name for this.”
Since manual chairs deserve a “new name,” I vote for “complex rehab” — the kind so customized it needs to be excluded from competitive bidding. How about it, CMS?

This article originally appeared in the March 2009 issue of Mobility Management.

About the Author

Laurie Watanabe is the editor of Mobility Management. She can be reached at

Referrals and Prescriptions podcast