While early intervention is key to effectively treating pain experienced by manual wheelchair users, injury prevention is better still. Power-assist systems (such as Frank Mobility’s e•Motion and Quickie’s Xtender) for manual wheelchairs have been around for years, but they’re not always an easy sell to either consumers or funding sources — just ask Johnson & Johnson’s Independence Technology division, whose iGlide manual chair seemed to come and go in a power-assisted flash.
But power assist isn’t the only preventive technology for manual chairs. Magic Wheels created great buzz recently by landing a coveted new HCPCS code — E2227 (“manual wheelchair accessory, gear reduction drive wheel, each”) — that went into effect on Jan. 1. This two-gear manual wheel was the subject of a five-month independent study to judge its effectiveness on reducing shoulder pain and improving function. Researchers Dr. Margaret Finley and Dr. Mary Rodgers said in an article on the study, “There were pain reductions two weeks after using the Magic Wheels, indicating a rapid response to the intervention. These findings indicate the potential for shoulder pain reduction with the use of a manual drive wheel during mobility, even in highly functional manual wheelchair users.”
Another type of common complaint among manual wheelchair users — wrist and hand pain — is addressed by ergonomic wheelchair handrims designed by Natural-Fit. The handrim has two separately coated components — a smooth oval surface for the palm of the hand, and a higher-friction, contoured slot for the thumb — to provide separate surfaces for propulsion and braking. The handrim, says Dr. David Boninger of Natural-Fit/Three Rivers Holdings, “has been shown in published research to reduce pain in the hands and wrists of manual wheelchair users.”
As for making manual chair users aware of such assistive technology, Boninger says, “There is absolutely no doubt that getting ‘preventive’ information out to end-users as soon as possible is a good thing to do — and yes, even before there is a problem, and even if they are young. Learning early on about getting the most appropriate equipment, making sure it’s set up correctly and knowing ‘best-use’ techniques can all help to prevent and/or delay the onset of overuse-related pain and injury. And just so you don’t have to take my word for it: The very first recommendation in the Consortium of Spinal Cord Medicine 2005 Clinical Practice Guidelines, available at www.pva.org, is all about education and prevention to help preserve upper-limb function in manual wheelchair users.”
