Manual Wheelchairs - World Health Organization

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Fig. 2.1. example of a manual wheelchair and its parts push handles rear wheels push rings brakes castor wheels 2.2.1 General considerations in wheelchair design desIgn and productIon I 41 backrest armrest cushion Wheelchairs should be designed to enable their users to participate in as many activities as possible. As a minimum, a wheelchair should enable the user to lead a more active life without having a negative effect on their health or safety. Comfort and safety are two important factors affecting the quality of life of long-term users (2). The user’s health and safety The health and safety of users should never be compromised in order to reduce costs. Although it may seem that any wheelchair is better than no wheelchair, this is not true when the wheelchair causes or contributes to injury or other health risks. A wheelchair should be designed to ensure the user’s safety and health. There are many ways in which users can be injured by their own wheelchairs, as illustrated by the following examples: • A wheelchair without a cushion or with an inadequate cushion can cause pressure sores. This in turn may require the user to spend many months in bed; without appropriate care and treatment this often leads to bedsores, secondary complications and even premature death. • Unstable wheelchairs can tip and lead to users falling and injuring themselves. • Wheelchairs that are too wide or are unduly heavy can cause shoulder injuries. • Sharp edges on surfaces can cause cuts that in turn can lead to infection. • Poor design can result in places on the wheelchair where the user or others can get their fingers or skin pinched. • Wheelchairs that cannot endure daily use in the user’s environment may fail prematurely and can injure the user. seat frame calf strap footrest 2
42 I guIdelInes on the provIsIon of manual wheelchaIrs In less resourced settIngs Strength and durability Wheelchairs used outdoors are subjected to greater wear and tear than those designed for indoor use or use on smooth roads and paths. A wheelchair must be strong enough not to suffer a sudden failure while being used. The wheelchair should be built to have the longest possible useful life and require the fewest repairs. A wheelchair should be designed so it can be repaired near the user’s home if it fails, and replacement parts should be easily available. Suitability for use Wheelchairs should be appropriate for the environment in which they will be used and for the specific people who will use them. One wheelchair design will not suit everyone. When designing or selecting wheelchairs, it is necessary to think about the environment and the way in which the wheelchair may be used (Box 2.2). Box 2.2. Some environments and uses to consider when designing or selecting a wheelchair n riding for long distances over rough roads. n going up and down many kerbs every day. n Accessing built environments: narrow doorways, small turning areas, steep ramps, desks and tables, bathroom facilities (e.g. sitting and squatting toilets). n exposure to moisture such as rain, high humidity, snow, ice, hail and body fluids such as urine and sweat. n User showering while sitting in the wheelchair. n exposure to extreme temperatures. n User transporting goods on the push handles, upholstery, footrests or other parts of the wheelchair. n Passengers riding on footrests and armrests. n People lifting the wheelchair by one armrest, footrest or push handle when the wheelchair is occupied. n Transporting the wheelchair in confined spaces or other cramped or crowded conditions. How the wheelchair will be produced When designing a new wheelchair, or selecting a pre-existing wheelchair design, it is important to know where the wheelchair will be produced. In different locations, the technical skills, available technology, materials and components available for production will vary. For this reason, a wheelchair designed for one region may not be suitable in another region. However, the fundamental design might be quite similar.
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Barriers to participation of users
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References polIcy and plannIng I 12
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Other resources Cooper RA. Wheelcha
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Manual Wheelchairs - World Health Organization

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