Configuring for Ultralightweight Success

• By Laurie Watanabe
• Oct 01, 2010

Among long-term self-propelling wheelchair users, “Many studies document the incidence of shoulder pain and other upper-extremity pathologies,” says Invacare’s Mike Babinec. “Repetitive strain injuries are very common. Propulsionrelated injuries shouldn’t necessarily be expected, but certainly anticipated.”

The good news is that clinicians and providers can help position clients, quite literally, for long-term ultralightweight success.

“To lower the risk,” Babinec says, “an individual first needs to be fitted with an optimally configured manual chair for them and their needs. The chair should be measured and adjusted to meet their specific postural needs, with center of gravity (fore/aft) and wheel position (height) optimally set for the most efficient propulsion, wheel, handrim, tire and caster size and choice appropriate for the individual, and kept as lightweight as possible… Rigid chairs have an advantage over folding chairs for this population, as less of the user’s energy is absorbed into the frame.”

Accessories, he says, “should be kept to a minimum, as these can add unnecessary weight to the overall system. The seating system within the chair needs to promote an optimal posture and position for optimal comfort, function and safety. Pressure management issues must be addressed!”

On the training side, “Propulsion methods need a high level of attention to prevent upper-extremity dysfunction and should promote longer/even propulsion strokes that limit high impact onto the handrim.”

And problems, Babinec says, need to be tackled by the seating & mobility team immediately. “Any pain or dysfunction occurring while using the manual chair — upper extremity or elsewhere — should be addressed and treated accordingly without delay to prevent these issues from becoming chronic.”

This article originally appeared in the SCI Handbook October 2010 issue of Mobility Management.