Rigid ultralightweight manual wheelchairs have long been considered the preferable design for active self-propellers. With fewer moving parts, including no folding mechanism, rigid frames can be lighter weight, with more energy per push that’s translated directly to propulsion.

But in complex rehab, there is always the exception — a client who, thanks to a specific combination of factors, prefers a folding frame to a rigid one. Sometimes, it’s as simple as a client acclimating to a folding frame and not wanting to change. For other clients, there are unique circumstances.

Enter SFC (Retired) Mark Holbert, U.S. Army 3rd Special Forces Group.

Special Forces, Unique Circumstances

In 2010, while serving in Afghanistan, Holbert stepped on an IED. He lost his right leg at the knee, and his left leg much higher up. The locations of the amputations make wearing and using his prosthetics a challenge.

Holbert is an active wheelchair user, frequently traveling for business and leisure, working as a government contractor, riding his trike (Special Forces buddies converted his motorcycle so he could continue to ride with them), and training and competing as a triathlete.

He is also the face of Sunrise Medical’s new Xenon 2, a folding ultralightweight chair. Yes, Holbert prefers a folding frame.

Angie Kiger, M.Ed., CTRS, ATP/SMS, Clinical Strategy & Education Manager, was involved in Holbert’s dealings with Sunrise and learned that Holbert wears his prosthetics intermittently. “He wears them at work, a lot of the time for cosmetic reasons,” Kiger said. “Every time I saw him at his house, he was out of his prosthetics. He said, ‘When I’m at home, I don’t wear them.’ He’s not been able to find ones that fit well.”

Kiger and Robert Agostino, a Sunrise Medical account manager involved in the fitting, asked when Holbert wore his prosthetics, how often, and how much they weighed — all crucial to dialing in the new chair.

“The challenge was that sometimes he’s going to be in the chair using his prosthetics, and other times he would not be,” said Sunrise’s Associate Product Manager/Manual, Jesus Ibarra. “So we had to find a balancing act between those two distributions of weight and load. What we ended up doing was playing very carefully with the amount of seat dump that he uses, his back angle and the position of the rear wheels to find that sweet spot for him where he has that stability that he needs as well as the ability to have a functional push.”

The back of Holbert’s Xenon 2 is closed a few degrees, something Agostino appreciated: “Typically, folding frame chairs have a fixed back angle, and there’s little that you can do with it. But with the adjustments on the Xenon 2, you do have the ability to play with your back angle.”

Kiger added that Holbert “said he felt stable, he felt good. He does have an anti-tipper, but he’s always had that on his folding chairs, because he’s well aware of the big difference when he’s had them on and off.”

From Folding to Rigid…& Back Again

Holbert has used a rigid chair — a Quickie Q7, as a matter of fact — but he prefers a folding chair in large part because of how often he transfers to his accessible van by standing up.

“When he drives, he wears his prosthetics most of the time,” Kiger said. “He’s not overly stable on them, and he doesn’t take a whole lot of steps on them. He wants to be able to grab the chair and throw it into his van very easily. What he loves about the Xenon is how quickly he can grab it — it folds up, it locks into place and then he can just slip it into his vehicle. He said he likes it for travel, and he’s able to play around with it a little bit as far as height goes. He scoots forward in his chair — he likes to be able to change position a little depending on whether he has his prosthetics on or not. It was a personal preference for him. He said he did have a rigid, and then he went back to a folding.”

Closing the Gap

In an ideal world, devices such as folding and rigid ultralight chairs would be comparable enough in all the major categories — so the ultimate choice could come down to a personal decision of what works best for a particular client.

In the past, folding chairs have been seen as complicated and even clunky compared to the sleek, minimalist look of a rigid frame. Folding chairs had so many extra parts that weighed so much more and stole so much of its user’s propulsion energy.

But continuing improvements in how frame materials are used and how frames are designed are reducing the weight of folding frames and streamlining their designs. Is it fair to say, then, that we’re getting closer to telling clients that rigid and folding frames are comparable in critical performance categories?

“It’s getting there,” Kiger said. “We’ve been telling people, ‘You’ve got to have a rigid.’ But whether it’s the swingaway mechanism for the legrests, or they’ve just always been in a folding chair, or they want it for the convenience of a smaller vehicle, the reality is some folks prefer folding.”

“There still is a weight penalty when going with a folding-frame chair,” Agostino said. “Now, thanks to new materials and new designs, that has been minimized, to where someone can have a folding chair that gives them performance similar to a rigid-framed chair without adding as significant of a weight penalty as historically they’d had.”