In the last of this series, we get technical and discuss how I have set up my everyday wheelchair to maximise my function and lifestyle requirements.
My everyday wheelchair is not just a wheelchair. Through twenty-nine years of experience, I have dialled this one in to fit with my needs perfectly. Clinically, I may face some scrutiny on the way I have set it up but functionally I don’t think I could improve on it.
I sit low with my rear seat height at 14 ¾’, and I sit on a 2’ cushion. There have never been any pressure or skin issues over my time as a wheelchair user, so I am confident in the quality of the cushion and my ability to recognise when I may be susceptible to pressure issues. As I’ll explain below the lower the profile of the cushion is better for me.
I have a 6’ long ergo seat that rises to 19’ front seat height. That gives me over 5’ of dump but in a way that keeps my pelvis in a neutral position. I can’t begin to tell you how much this has improved my balance. Sitting low is the key here. I have ample wheel to push on, my centre of gravity is low to the ground, I can reach things easily and I feel like I’m ‘in’ my chair rather than on it. I feel safe and being low gives me confidence to explore terrain that is challenging. For me, sitting high is great for my posture and shoulder integrity, but functionally I can’t do stuff and I feel unsafe.
To compliment my low set up I have positioned my caster housing as far forward as the manufacturer would permit me and I have opted for Frogs Legs forks with 4’soft roll casters. This is extremely important for the times I am leaning on my knees picking up puzzle pieces and Lego, changing nappies or anything ground based. The Frog Legs are imperative if I have a kid on my lap and there are any obstacles like lips or rough terrain to navigate. I love them!
I have my chair as short as possible which makes turning in tight spaces achievable. It makes my wheelbase quite short but I have positioned my camber bar in a spot where it’s just tippy enough. With my caster housing in its furthest forward position, I can lean on my knees without the rear of my chair tipping up. The confidence I get from this set up is immeasurable.
Considering my level of injury, sitting low with suspension on my front casters kinda makes sense right? Imagine a young, c5/6 quad, sitting beautifully in a postural sense, but then unable to reach anything on the floor because of the rear seat height and 4’cushion, scared of any sort of camber on the footpath because of the lean it induces, exhausted because they have very little wheel to push on. These issues ripple through to other aspects of independence too. The lack of confidence affects decisions to drive a car, getting a job and socialising. This is not conducive to someone living an active life and therefore opting for a power chair just so they can access the environment outside their house.
Sitting low may not be good clinically for me but the life I am able to live more than makes up for that.
It all comes down to compromise. I may be at the extreme end of the scale but I wouldn’t have it any other way. Life as a wheelchair user is hard enough, so I want to at least make propelling my wheelchair one of the easiest things I do. I want to be able to get on the ground and play with my kids and feel confident I can get back in my chair. But most importantly I want to maximise my limited function.
This set up is not for everyone, but I hope this insight gives you some further things to consider when you have an active client, with kids, who want to participate as much as possible in family life.
I have really enjoyed producing this series for you and I am planning on doing more of this in the future.
If you have any questions please feel free to hit me up cpalmer@gtk.com.au
Until next time, stay safe.