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How to Determine Proper Fit in a Wheelchair

Making sure their wheelchair fits comfortably is critical to one's health.

By

How to Determine Proper Fit in a Wheelchair

Spc. David Helfman (left), and Spc. Keisha Barajas, both with U.S. Army Civil Affairs Team 31, fit Ahmad into his pediatric wheelchair Feb.7. Ahmad was one of three Iraqi children in Mahmudiyah to receive wheelchairs donated by Wheelchairs for Iraqi Kids.

Photo (c) Public Domain

The prevalence of disability increases in the U.S.

According to statistics from the Centers for Disease Control and Prevention (CDC), roughly 50 million American adults claimed to have some form of disability in 2005. This was an increase in both quantity and percentage of the US adult population from 1999 and 2002.

The Top 10 Causes of Disability, According to U.S. Census Bureau's 2004 Survey of Income and Program Participation

  1. Arthritis or rheumatism (increasing)
  2. Back or spine problems (increasing)
  3. Heart Trouble (decreasing)
  4. Mental or emotional problem
  5. Lung or respiratory problem
  6. Diabetes
  7. Deafness or hearing problem
  8. Stiffness or deformity of limbs/extremities
  9. Blindness or vision problem
  10. Stroke

Age Distribution

The prevalence of disability increases with age. Women at all ages have a higher incidence of disability than men. Almost 3.5 million people reported using a wheelchair, and another estimated 10 million used a cane, crutches, or walker to assist them with mobility.

Considerations for Properly Fitting a Wheelchair

With such high, and growing, incidences of mobile disability, we should make sure that those who rely on a wheelchair to perform Activities of Daily Living (ADLs) and Instrumental Activities of Daily Living (IADLs) are comfortably fit to the chair.

Proper fit can favorably impact:

  • Posture
  • Breathing
  • Pressure ulcers (sores)
  • Discomfort
  • Pelvic problems
  • Hip problems

6 Steps to Determine Wheelchair Fit

  1. Measure Seat Width and Depth
    • Determine seat width by measuring the person's hips from one end to the other, in a straight line. Then add two inches to this measurement to select a proper wheelchair seat width.
    • Determine seat depth by measuring from the back of the hip to the back of the knee of the person while seated. Then, subtract one inch from this measurement to choose the correct seat depth.
  2. Selecting the Arm Type and Height
    • Full-Length Wheelchair Arms: These are best-suited for people who will be frequently doing stand-up pivot transfers. The full-length arm provides the proper support a person needs to help push themselves up to stand.
    • Desk-Length Wheelchair Arms: These are recommended for when a wheelchair-bound person will want to be comfortable sitting at a desk or table. The shorter arms allow them to get closer to the table edge.
    • Arm Height: The height of the wheelchair arm can vary. Measure from the elbow to the seat of the chair while the person is holding their arms up with their elbows bent at a ninety degree angle. When available, height-adjustable arms are recommended.
  3. Footrest Style
    • Elevating Leg Rests: People who suffer from edema, swelling, or injury and are ordered by their doctor to elevate their leg(s) should sit in a wheelchair that has leg rests that can lock allowing the person to extend and elevate the leg.
    • To determine the length of the footrest, measure the distance from the back of the person's knee to the heel of their foot.
    • Articulating Leg Rests: These are useful for taller people. The leg rests can extend longer, while the elevating piece of the leg rest rises.
  4. Back Height
    • Have the person sit in the wheelchair, then measure the distance from the person's collarbone down to the seat.
    • For patients with a condition that requires additional back support, there are options for higher back rests, and even reclining back rests, which will allow a doctor to prescribe the appropriate weight redistribution that certain patients may require.
  5. Wheelchair Seat Height
    • If the person needs to use their feet at any point to propel themselves in the chair or move, measure the distance from the back of the knee to the heel. The seat height should allow for the person to reach the floor with their heel.
  6. Weight Considerations
    • Wheelchairs are built to accommodate certain weight limits. Make sure you know the person's weight so that you can fit them to a wheelchair that can support them safely.
    • Some people in wheelchairs fold up their own chairs and place them in their cars so that they can travel in a regular car seat. In fact, many people who use wheelchairs still have the ability to drive. Therefore, take into account the person's upper body strength when selecting a wheelchair. Weaker patients will require lighter wheelchairs.

Sources

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