
This article is sponsored by Merits. In this Voices interview, Mobility Management sits down with John Domanick, VP of Sales, Merits Health Products USA, to talk about how they are driving innovation at every turn with the release of their new front-wheel drive powerchair models. He breaks down the benefits of this system versus mid-wheel and rear-wheel drive powerchairs, and he explains the key drivers that make Merits’ AXCEL models the most tech-friendly solutions in the market today.
Mobility Management: What’s new at Merits?
John Domanick: We’ve been pretty busy at Merits, especially over the past year or so. We’ve successfully launched several new and innovative power mobility products that have filled some key product gaps in the rehab technology space—areas our customers have been asking us to address. I think these launches have been well received in the marketplace.
For example, we launched the Ultra 3A, a Group 2 single-power, K0835-coded power chair base. The 3A was developed to expand our capabilities in this particular code set, largely in response to the new power-seat elevation coding that CMS implemented in spring 2024. Historically, the Ultra has offered a power tilt system, a power-articulating foot platform, and a power-seat elevator, but users were limited to choosing only two of those actuators at a time.
We recognized that this wasn’t ideal—especially now that power-seat elevation is covered and funded. So, we went back to the drawing board to rethink the electronics and programming of these powered seat functions. The result was the Ultra 3A. Now, with the K0835 Group 2 single-power base, we can offer power tilt, a power-articulating foot platform, and a power-seat elevator—all without limiting consumer or clinical choices. This change has been very well received in the marketplace, with many of our customers calling it a “solution-maker” because it fits their needs so well within this code set.
Another example is the K0836 captain-seat tilt we launched on the Ultra. This niche product is designed for individuals who qualify for tilt but don’t necessarily need an active pressure-relieving cushion. The captain-seat tilt provides positioning and pressure-relieving benefits without requiring funding for a specific cushion, making it an excellent solution for this particular need.
Finally, we updated our Vision Sport, our flagship Group 2 product. While it previously offered seat elevation, it wasn’t coded under the K0830 and K0831 code sets. We revisited PDAC and had it recoded, ensuring it aligns with the new Group 2 coverage. This recoding gives us four platforms in that code set, strengthening our lineup in the Group 2 category and enhancing our Ultra line.
Let’s talk about Merits’ new Axcel and Axcel Narrow. Both of which are front-wheel drive power chairs. How did the Axcel chairs come about, and what situations or concerns does the Axcel line seek to address?
Continuing our innovation journey, we introduced the Axcel and, more recently, the Axcel Narrow under the Group 3 power wheelchair code. What’s notable about these models is the extensive R&D that went into their development, focusing not only on performance characteristics, but also on clinical efficacy. We considered the needs of consumers, their specific diagnoses, positioning requirements, and input from assistive technology professionals (ATPs).
We paid close attention to the “fit and finish,” as I like to call it—borrowing a term from the automotive industry here in Detroit. We wanted to ensure the Axcel is not only functional but also a clinically effective power mobility device. To that end, we chose a front-wheel-drive platform for its stability and maneuverability.
The Axcel Narrow was designed to provide a more compact front-wheel-drive base. This was inspired by the trend a few years ago when many manufacturers introduced narrower mid-wheel drive models to create smaller footprints. These are particularly useful in tight home environments, manufactured homes, or older housing stock with narrower doorways compared to the wider standards seen in newer construction. The Axcel Narrow maintains stability while giving consumers better access to more areas in their home environments.
Another keyl aspect of both the Axcel and Axcel Narrow is what we call “serviceability.” These chairs need to be set up, serviced, and adjusted—not just for initial delivery, but throughout their lifespan. We focused on making these tasks as straightforward as possible. During the evaluation process, we fine-tune seating functions and parameters so the consumer has a positive experience and can fully understand the platform’s capabilities.
We also prioritized efficiencies for our provider customers. Whether it’s setting up a chair for evaluation, preparing it for delivery, or making adjustments over time, we wanted the process to be easy and efficient. Service and repair can be a cost center for providers. These devices have a five-year useful life, so they must adapt to the consumer’s evolving needs—not just today, but over the next several years.
By simplifying setup, service, and adjustments, we’ve designed the Axcel and Axcel Narrow to meet the needs of both consumers and providers more effectively.
Historically, what have been the different strengths and weaknesses for front, mid, and rear-wheel drive configurations?
There are three primary configurations for power wheelchairs: rear-wheel drive, mid-wheel drive, and front-wheel drive. Each has its own strengths and, as I like to say, its liabilities.
Starting with the traditional configuration, rear-wheel drive has been the standard since the beginning of powered mobility. Rear-wheel drive chairs are very stable, comfortable, and intuitive to drive. They perform well at higher speeds and handle moderate obstacles decently. However, their larger wheelbase results in the largest turning radius, which can make maneuverability in tight spaces challenging. For example, transitioning from one hallway to another often requires a wide sweep to clear the rear-drive wheels. This can be a limiting factor in older homes with narrow doorways or tight layouts.
Mid-wheel drive, on the other hand, offers a very compact footprint and the smallest turning radius. It’s intuitive to drive because it turns on its own axis, much like walking. If the front clears, the back will follow, which is helpful for maneuverability. However, when handling obstacles, mid-wheel drive sometimes struggles without enough power to overcome thresholds or uneven surfaces, especially in softer environments like grass. This can lead to issues such as high-wheeling, where the drive wheels lose traction and spin.
Front-wheel drive places the big drive wheels in the front, which makes it excellent for overcoming obstacles and provides good stability. It has a smaller inside turning radius compared to rear-wheel drive, making it easier to navigate certain environments. However, at higher speeds, front-wheel drive chairs can experience fishtailing, where the rear of the chair swings out during turns. This configuration requires attention to clearance behind the chair, especially in tight spaces.
All things considered, these configurations really come down to individual preferences and specific needs. Other factors like the user’s diagnosis, environment, transportation methods, and in-home accessibility all play a role in determining the best option. Medicare’s in-home restriction is also a consideration, but people live beyond their homes—they want to experience life and be part of the community.
At the moment, we offer front-wheel drive and rear-wheel drive configurations. Ultimately, the choice depends on what’s most stable, functional, and easy to maneuver for the individual user.
The Axcel and Axcel Narrow are both front-wheel drive chairs, but the Axcel Narrow drives more like a mid-wheel drive chair. Why is that, and how is this system helpful to consumers?
Two things come into play here. First is the design configuration. For example, the Axcel has a 39-inch wheelbase, whereas I’ve seen rear-wheel drives with wheelbases as long as 47 inches. How you’re sitting in the chair makes all the difference. In a front-wheel drive chair, the drive wheels are in front of you, whereas in a mid-wheel drive chair, the drive wheels are typically in line with how you’re seated.
From a technological standpoint, both the platform design—where the drive wheels are positioned relative to the seat—and the programming parameters play a role. We’ve done extensive research to fine-tune the performance parameters so the chair operates smoothly and efficiently. This programming gives the Axcel a mid-wheel drive feel, whether you’re turning on the inside or outside. While it isn’t a mid-wheel drive, it’s designed to eliminate the back-end swing often associated with front-wheel drive chairs.
The second factor is the suspension system built into the Axcel and Axcel Narrow. We use an oil-dampened suspension that absorbs everyday bumps and jolts, whether from uneven sidewalks, gravel, or incline transitions. This feature minimizes the jarring effects for a smoother experience for the user.
Additionally, the Axcel Narrow’s compact design—at just 22.5 inches wide, two inches narrower than the standard Axcel—enhances that mid-wheel drive feel. It’s a much more compact base, making it more maneuverable in tight spaces.
Another consideration is how turns affect certain users with specific diagnoses. In some front- and rear-wheel drive configurations, the user’s head moves significantly through space during turns. We focused on finding the sweet spot for the drive wheel position relative to the center of gravity to create a more intuitive driving experience, minimizing head movement during turns.
All of these factors were carefully considered in the Axcel’s design, which is why the chair offers both functional and comfortable performance that others don’t.
Technicians are under a lot of pressure to quickly diagnose and fix problems with power chairs. How has Merits designed the Axcel family of power chairs with ATPs and repair techs in mind?
These design parameters are always top of mind as we move forward with other products, focusing not only on clinical efficacy but also on serviceability and setup. One standout feature we offer on the Axcel is the Frequency Seating System.
The Frequency system is unique because it allows independent adjustments of seat width and back width. In most power-based platforms, increasing the seat width automatically increases the back width, but Frequency enables these adjustments separately. This flexibility accommodates the unique postural needs of each individual. For example, someone might need to grow the seat width due to changes in the hips over time while keeping the back width unchanged. Similarly, for individuals with a mesomorphic build—narrow hips and broader shoulders—or an endomorphic build, we can adapt the seating without requiring special modifications.
This has been very well received in the marketplace because it offers flexibility and long-term usability for a five-year useful life product.
From a serviceability and setup standpoint, we’ve implemented thoughtful features to help providers. For example, we’ve prioritized using common fasteners wherever possible. Adjustments for leg length, headrest positioning, or seat dimensions can often be made with a 4-millimeter hex key or T-handle wrench. This minimizes the need for multiple tools to reduce setup time and confusion.
We’ve also focused on making serviceable parts like wheels, casters, and batteries easily accessible. The Axcel and Axcel Narrow feature a rear-battery access door, eliminating the need to transfer a patient out of the chair to change batteries. This toolless access is particularly beneficial when a caregiver isn’t available, or the user is out in the community.
Other design elements, like quick-removal shrouds and automotive clips for drivetrain or motor access, allow repairs and maintenance to be done efficiently. Electronics and cables are routed through channels under the arms to keep them hidden and prevent snagging during use. Control and power modules are placed under the seat for easy access during modifications or repairs.
Finally, we’ve streamlined the evaluation and setup process. In a clinic setting, it’s often unclear what adjustments are needed until the patient is in the chair. With the Axcel, most of these adjustments can be made while the patient is seated for quick fine-tuning to achieve optimal positioning and comfort. These on-the-spot adjustments take just a few minutes, making a big difference during evaluations and fittings.
Editor’s note: This article has been edited for length and clarity.
Merits Health Products is a leading provider of power wheelchairs, scooters and stairlifts. To learn more visit meritsusa.com
The Voices Series is a sponsored content program featuring leading executives discussing trends, topics and more shaping their industry in a question-and-answer format. For more information on Voices, please contact sales@agingmedia.com.