Manual Wheelchairs - World Health Organization
Manual Wheelchairs - World Health Organization
Manual Wheelchairs - World Health Organization
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50 I guIdelInes on the provIsIon of manual wheelchaIrs In less resourced settIngs<br />
• Rolling under surfaces. The user’s ability to pull up to a table is determined by the height of<br />
the user’s knees (the length of the user’s lower leg plus the minimum safe height of the footrest<br />
above the ground). Some types of fixed armrest also prevent users from pulling up to tables and<br />
counters.<br />
• Turning around in confined spaces. The smallest area in which a wheelchair can turn around<br />
is determined by its maximum diagonal measurement (see Table 2.6).<br />
Table 2.6. Aim: to improve the ability to turn round in confined areas<br />
n reduced weight.<br />
n easier to handle and transport.<br />
Advantages Disadvantages<br />
By making the wheelchair shorter and narrower<br />
n A shorter and narrower wheelchair will be less stable.<br />
<strong>Wheelchairs</strong> can only be as narrow as the user’s width<br />
plus the wheels.<br />
See Tables 2.4, 2.7 and 2.8 for related effects.<br />
By moving the rear wheel forward in relation to the user<br />
n reduced rearward stability.<br />
n Improved access to hand rims. With a longer push stroke,<br />
both forwards and backwards, the user is able to use<br />
fewer strokes to turn in confined spaces.<br />
n With more of the user’s weight directly over the rear<br />
turning wheel, the wheelchair is more responsive to<br />
turning.<br />
See Table 2.7 for related effects.<br />
If the wheelchair has easily removable footrests<br />
n n Increased ability to pull up close to surfaces and objects. removable parts can be lost or broken.<br />
Manoeuvrability over obstacles determines the user’s ability to negotiate obstacles such as soft<br />
ground or raised obstacles. When negotiating obstacles, the user is at risk of tipping backwards<br />
or forwards and falling out of the chair (a common cause of injury); thus it is also important to<br />
consider stability when evaluating a wheelchair’s ability to manoeuvre over obstacles (see Tables<br />
2.3 and 2.4).<br />
• Manoeuvring over soft ground, such as mud, sand, grass, gravel and snow, depends on the area<br />
of contact that the wheels have with the ground and the amount of weight on the wheel. Ways of<br />
improving manoeuvrability over soft ground and their associated advantages and disadvantages<br />
are shown in Table 2.7.