Who is this Choosing a Manual Wheelchair Guide for?
Hello - this guide is a practical help and set of pointers for anyone starting their research for a manual wheelchair. This page is impartial and sets out information to do with types of chair, points to manufacturers websites and things you should know about to inform your decision when talking to retailers, or buying second hand privately. We constantly add to it. Where you spot that information is out of date (e.g. new manufacturer, broken links, etc..) please tell us so that we can update.
PLEASE NOTE: This information is provided as a free and impartial guide. We recommend that you speak to your local wheelchair services for advice on which wheelchair is suitable for you and what financial help you may be eligible to receive towards the purchase of a new wheelchair BEFORE committing to any purchase. You may also want to speak to a number of specialist wheelchair retailers, bearing in mind they are unlikely to have a full range of manufacturers to choose from and have a commercial incentive to sell you their products. Getting the right wheelchair is important and can avoid significant health problems such as balance, mobility and skin pressure issues. We cannot be held responsible for any decision you make as a result of the information provided. (Skip)
On a personal note, you may find that while local wheelchair services are set up to help and advise, the quality of the service can really depend on your local service. Some are wonderful and others may seem like a frustrating battle. If you want to see a load of wheelchairs in one place, there are a couple of big mobility equipment exhibitions (with various destinations up and down the country):
How to use this page more efficiently (skip)
The nature of mobility and disability is incredibly diverse, so this page is divided in to chapters. At each chapter heading, you are given the choice to skip to the next chapter if you feel that a section is not relevant to you, which will scroll down on the same page. However, all links open in a NEW window, so you don't need to worry about losing your place on this page. Where we link to manufacturers, you will have to do your own research to find out who retails them, as this information can change so rapidly.
On the face of it, choosing the right wheelchair can seem daunting. Break the information down into chunks and work out what you need it for, how much you have to spend (or whether you can get your wheelchair funded by Wheelchair Services or a Charity) and then read through what options might be availble so that your make an informed decision. The intention of this page is to run through all facets as a starting point to your research, so you can tick boxes and buy a new or second-hand, used wheelchair with confidence.
Not surprisingly, there are whole genres of wheelchair and you can get ones to support your needs and lifestyle. They range from more basic standard models starting around £100 and go up in spec and quality of build and detail / design and to cost over £10,000 for active user wheelchairs. A quick look at this Gerald Simonds page gives you an immediate flavour of what type of wheelchair you can go for: from lighweight rigid (great for active lifestyles where a balance between reducing weight and sound build quality for everyday use - and often abuse, jumping up and down kerbs and steps) to chairs which enable you to stand up. This is great if you need the height often, like social functions where other guests are standing & talking often and also has the health benefits of being upright (though standing frames do this too), though is slightly compromised for everyday useability and weight.
>> Do you know that the British Red Cross loan mobility equipment, such as wheelchairs, on a short term basis? If you have an elderley relative who has had a fall or need something for a friend who's staying over, they're a good port of call. Each branch seems to run an autonomous regime, so help, attitudes and equipment may vary between places, but generally I've heard only good things about them. If you click on the Red Cross Link you'll find their branch finder linked within the page, or you can click here.
Standard Manual Wheelchairs (skip)
... are cheaper than active-user wheelchairs as they are less technical and often used by people who can stand but have difficulty walking any distance, or who have a temporary condition so aren't looking to spend thousands on a full-time use chair.
They can be self-propelling or attendant and the key variable will be seat size (for different shapes and sizes of users) and weight of wheelchair - think about this one because whomever is putting it in and out of the car shouldn't be heaving more that they can easily cope with. As a general rule, the lighter the wheelchair, the more expensive it will be.
The image below is useful, as it illustrates what is described as a Standard Manual Wheelchair. This one can be self-propelling - though I wouldn't want to be pushing a beast like this around too far - and it also has handles to be pushed (=attendant). It also shows that standard can be accesorised to suit the user. Personally, I think the most depressing thing about these standard wheelchairs is the awkwardness and clunkiness of them. Try turning this bad boy in a tight space. But everything is to a budget and getting round is better than not getting round.
Footrests can be fixed, swing-away or removable and generally will have a strap or block to stop legs slipping off backwards.
Wheels are varied, though most likey you'll have plastic (see picture below) or metal spokes and they're be pretty basic. Watch you don't catch your fingers in the metal spokes! With the front caster wheels, the bigger they are the less likely they will be to snag in cracks in the pavement and little holes. But there wlll be a compromise in userbility too.
Tyres can be solid - which makes them puncture proof but are heavier and over time will get pitted making for a bumpier ride - or pneumatic - which makes them lighter, easier to fit and builds in a degree of suspension / added comfort but can puncture. You can get tyres with a kevlar lining which helps prevent punctures or frankly, your local bike shop can sell you a tyre liner (easliy fitted - view YouTube Fitting A Tyre Liner video).
Armrests will provide comfort, support AND keep your clothes from getting wet and muddy with the tyres. Depending on your mobility impairment, you may find flip arms give you access to transfer on to beds, loos, etc.. or you may find that fixed arms give you more support to stand up.
Brakes should be called Wheel Locks as you brake using the wheel pushrims (or synonym, handrims). But let's not split hairs! If you're using the metal ones, watch you don't scrape your toddlers leg on them as you pick him / her off the floor and onto your lap. If they aren't locking the wheels when applied then inflate the tyres properly or adjust their setting.
If you're spending long periods of time in the wheelchair, getting the sizing right is really important for your comfort. You will want to assess:
You'll likely need a cushion and depending on your situation and condition, these can be pretty simple and cheap or very technical and expensive. GET ADVICE: Heat and moisture can cause skin tissue breakdown which can cause serious long term problems, particularly in the very immobile and elderly.
There are things called Seating Clinics (example here), which may be provided through your GP, Wheelchair Services or Spinal Injury Unit. They offer trained advice on aspects of seated life, including cushions and can try you out on different cushions with pressure mapping (see next paragraph). If you get a wound or sore, go and get medical help immediately. Your local GP can refer you to a Dressings Nurse / Clinic. They're very specialist and know their stuff and can use better dressings than you can buy in Boots or Supadrug.
Pressure Mapping (skip) - If you haven't already learned that skin breakdown and pressure ulcers (sometimes called bedsores or pressure sores) are an enormous and life threatening risk to wheelchair users (not to mention whopping and demoralising pause-button on life) then you need to understand it. Now. This is not to scare monger, it is just to put it right at the top of the list so that it is taken seriously. Products and analysis evolve constantly and PREVENTION should always be the priority.
Seating clinics (go via your Spinal Injury Unit or local Wheelchair Services) and many wheelchair cushion retailers use pressure mapping to test wheelchair cushions which are suitable for your use. In my opinion, it would be fantastic to measure and test wheelchair and cushion all at the same time to get the package at the same time - something which Roma are doing (clicking on link scrolls down page to video.
A Pressure Mapping system is a pressure sensing mat which links to a computer via an electronic interface module (the linky bit) and a specialist bit of software which converts what the mat senses into a dynamic image. The mat is placed ON the cushion UNDER the wheelchair user. The image on the computer will show, via colours, how much pressure is being applied - and therefore whether the user is likely to have pressure problems. Cool colours (blues, greens) are good news and hot colours (oranges and reds) are bad. Different cushions and ways of sitting (e.g. horizontal or raked seat) will produce different results. It is a question of trial and error to see what works best for each individual, though a trained clinician will likely be able to advise based on years of experience.
If you want to see a video of this, look up Wheelchair Cushion Pressure Mapping on Google or YouTube. They're mostly long and tedious American corporate videos, so I haven't included one here!
[14-Apr-15] I am going to add a new section here - and link it to a dedicated new page - based on my recent experiences. I feel this is a CRUCIAL part of wheelchair life and yet one where knowledge is curiously scattered and not imparted to the wheelchair user. After eleven and a half years as a paraplegic wheelchair user, I have recently visited Consolor and been hugely relieved at the solution they offered me. The frustrating part is that others in the system have had the opportunity to impart this information before and didn't. Shame because I could have avoided time, expense and trouble!
Wheelchair Voucher Scheme (skip)
This scheme offers users the option to get a voucher so you can choose your own wheelchair instead getting a wheelchair which they recommend. The value of the voucher is decided locally after assessment and usually to the same value as the chair they'd offer you. The chair you've set your heart on is likely to be better than their option and cost more.
Also, whereas they'd maintain and service their chair, you'll have to do this at your own cost if you take the voucher and buy privately.
You can only get one voucher every five years.
The following is an extract from the NHS Wheelchair Services page.
"A wheelchair voucher scheme has been available since 1996. It gives you greater choice in the wheelchair you receive. You're given a voucher to the value of the chair you would have been offered after your assessment (which is determined locally in each individual case). You can then put the voucher towards the cost of a chair that you buy privately or in partnership with the NHS."
If you agree to maintenance of the chair by the NHS, you will have to return the chair to the NHS when you no longer need it. However, you can opt for private maintenance, which will allow you to keep the chair permanently.
Not all NHS wheelchair services offer the voucher scheme. Services decide locally whether to have a scheme and how that scheme is applied.
You cannot exchange the voucher for cash. The voucher is non-taxable so it does not affect any disability benefits you receive."
If you are an active wheelchair user, buying a lightweight chair costing upwards of £2,000-£5,000, then measuring is CRUCIAL. You can rely on the retailer to do this for you, but my advice is to understand what they're measuring and how this will affect you and life in the chair. As NHS wheelchair vouchers last 5 years, you'll probably be using this chair everyday for this kind of period. Getting it right will affect you!
Küschall, Quickie, and EPC all have pages which offer advice for measuring for a wheelchair and which measurements you are taking. If the chair is adjustable, then they'll put it together to the closest fit. It can always be tweaked at a later stage. If the wheelchair is a bespoke and welded one then getting these measurements right is important and they'll be put into a CAD drawing, so things like the rake of the legs may be set for you, though you may want to input based on previous experience or advice. As a personal note, I found Steve Dent at ORacing to go to the N-th degree for measuring.
They will also discuss options with you, which we address further down the page. Some of these are very important for comfort and pressure relief, like ergo seating (yes or no?) and choice of back.
Broadly speaking, wheelchair cushions fit into three categories: low, medium and high risk. If you are unsure about your category, ask. If you fall into medium or high risk, then ask advice.
Below is a list of cushion brands (I'm never sure who owns which brand these days, so it may be that the linked pages are to retailers and not the manufacturers). What you'll find when you click on the pages is too many options for each brand to be immediately fathomable. So, take notes, ring retailers and try sitting on them with pressure mapping to check how they perform for YOU personally with your own wheelchair set up. (If you are new to wheelchair use as a result of Spinal Cord Injury, your SI unit will sort this out for you before you leave).
These are the main medium and high risk wheelchair cushion brands and they all handle pressure relief in slightly different ways. For low risk cushions, the market place is FULL of them, so not listing them here.
I don't want to add too much information here, because you need to take professional advice. I will say that most retailers will let you trial one for a couple of weeks before purchase. If they don't, ask yourself if you want to deal with them, as medium-high rish wheelchair cushions can cost roughly £250-£550. Worth getting right...
Active User Wheelchairs (skip)
It's useful to have a reference list of wheelchair manufacturers. As a predominantly UK based website, this list is biased towards makes which are readilty available in the UK, though the manufacturers may not necessarily be UK based. (Please email if you want inclusion.) It is an impartial list and makers are listed in no particular order.
"Since 2003 (year of SCI injury) I've had 3 wheelchairs. The first two were Küschall and my new one is ORacing. I loved my 1st Küschall K4 and was impressed at the abuse it took over the years. My next one I found uncomfortable and finally a couple of bolts sheered, so I had to go back to my first one until taking delivery of my ORacing F2. I went for this chair primarily because I like Steve Dent enormously: his attention to detail and measurement are excellent. It is a fully welded chair so there are no bolts to sheer."
In choosing a manufacturer and /or retailer, my prime advice would be to seek peer reviews on the product, retailer and after-sales service. Measuring you correctly for your new wheelchair is a key part of the service and product purchase. Having trust in your retailer is hugely important because it doesn't matter how good a wheelchair is, if it doesn't fit you due to sloppy measuring, it'll cause you problems and will be a huge waste of money. And you will sign to take responsibility for the measurements. Once you sign them off, if the product is bespoke for you, you'll have no recourse to change of mind or refund. So you need to understand what you are signing and how a wheelchair should be
"Remember that when a retailer advises you on a wheelchair, s/he is bound to sell their own products and so you need to do your own research."
Also, be aware that there is a difference between a bespoke wheelchair - which is made entirely to your measurements - and a fitted wheelchair - where you are measured and they pick the parts which best fit you and use the built in adjustments to get it right. There are advantages to both: on my first chair, I was advised to get adjustability to give me scope to change as I settled into chair life. Now, I see that I don't make adjustments, so I want it welded and strong, measured for me.
"When it comes to measuring, some companies will come to you, others insist you come to their premises or suggest you visit them at an mobility exhibition. The geography of your interaction may be one of the biggest factors in choosing which company or manufacturer to go for. I'd still recommend you go on forums or review sites and see what people say about them."
Here is a list of links to the main wheelchair brands easily available in the UK. (I'm happy to include others you feel I may have missed, please get in touch.)
I can't comment on Roma Sport's Lighweight Wheelchair. However, I really like where their measuring and body contour pressure mapping is going as part of their service and commitment to getting the right chair to their customers. And I hope that this sets the agenda for other manufacturers to follow suit. Have a look at their corporate video (below). With most retailers' current set up, there is a degree of trial and error" until you are on the finished product, including your own cushion, you cannot know what pressure issues you will or (hopefully) will not have.
[Note to self - reference Tilt Seating, Standing Chairs, Paediatric Chairs for Kids.]
What might you look for or like to know exists in terms of Wheelchair Options and Accessories? (skip)
Ergonomic Seating for wheelchair users comes as a result of research in to posture and efficiency of drive. In a nutshell, it is a slight reconfiguring of the tubular framework on the wheelchair seat so that instead of being a flat or raked seat, it combines both a flat section under the bum and a raked section pointing the legs up slightly. The purpose of this is to better position the pelvis so that the spine is then better aligned, causing fewer postured-based problems over the years. You can read more detail on this PDF by RGK. Please note: whilst research indicates the benefits of ergonomic seating, in practise it doesn't always suit everyone (author included). This is another area where we'd advise consultation with trained clinicians and, if possible, try it in the flesh WITH pressure mapping. At this stage it isn't an exact science, for example, no-one can say definitely what the lengths of each section of the ergonomic seating kinks should be.
One Arm Drive - for people who lack the use of one arm or hand and have the strength on the other side to propel forward. There are two basic principles for this idea: one is a double rim on one side, such as the version designed by Nomad (when they were in business and still available though not sure who owns it now) and shown in the photo on the left. Or you can get a lever system which works both wheels and the steering and with it's gear system can go forwards and backwards. You can see this in the video on the right, below:
Wheelchair Etiquette (skip)
Just a DisabledGear.com note on Wheelchair Etiquette before you go. Don't panic: the chances are if you're looking up all this information for someone else you're already a considerate person and understand too well some of the requirements (and frustrations) of a wheelchair user. So here's my little list of tweaks that make a welcome difference and will mark you down as a person with extra.
> When you talk to a wheelchair user, it removes the crick in our neck, if you position yourself infront of us and come down to our level: pull up a chair or crouch on one knee. And if there's lots of background noise, chances are we'll hear what you're saying (make it interesting)!
> If you're thinking about pushing a wheelchair user anywhere (however short a distance), ASK FIRST! I can't emphasize this enough.
> And while we're at it, please don't kick the chair or push on the wheels in that fidgety way. You'd wonder what I was doing if I kicked your ankles for no reason or kept jabbing you. It really is the same because we feel the vibrations through the chair.
> The "Does s/he take sugar?" cliché: we know that embarassment causes all this. But when you do it, your social awkwardness is really something you should work on.
> Don't create taboos. If your child points and asks a question like "Mummy, why is that person in a wheelchair?" then engage with your child and (hopefully) the person in the wheelchair. Children are wonderfully and factually curious and their questions are straight. If the person is the wheelchair is ill-humoured about a factual and friendly question and response, the issue is one of character and not disability.
...if you've read all this, and have 12 minutes to spare, you might be interested in this TED talk: "How do you build a wheelchair ready to blaze through mud and sand, all for under $200? MIT engineer Amos Winter guides us through the mechanics of an all-terrain wheelchair that’s cheap and easy to build — for true accessibility — and gives us some lessons he learned along the road." Click on the link to watch within the TED website or view the embedded video below.