Assistance device             (wheelchair)

The wheelchair selection process involves the client,the interdisciplinary team,and the equipment supplier or vendor.family members,primary care providers,and others from the client’s home,work,and leisure environments also can contribute important information useful in choosing  an appropriate wheelchair system.
The selection process has a functional orientation and includes the consideration of multiple factors:
The client’s needs and goals
The client’s home,work,recreational,and other community environments;
The client’s physical and mental status and anticipateded course of the disease or disability;
Functional and community resources;
Appearance and social acceptability issues relates to both the  client and to  others in the client’s environment;
The  ability of the wheelchair system to  interface with  other assistive technology used by the  client.
Assessment of the individual
    The assessment process typically evolves around concerns for both sitting posture and mobility needs. The therapist can best assisst in the seating and wheelchair selection process by understanding the client’s medical and personal profiles.
Wheelchair types
Wheelchairs can be divided into three general categories:
Attendant propelled chair
Manual chair
Power mobility devices
Attendant propelled chair
Attendant propelled chairs are designed to be pushed by another individual beacause of the use’s brief or chronic inability to propel or operate manual and power wheelchair systems in a functional or safe manner.

   Attendant propelled chairs may be full size or may be smaller and created for use in limited spaces.such chairs may be used briefly ,such as for transport in the community,or may be used for extended periods,thus requiring carful attention to postural needs and functional activities.
Manual chairs
    The manual wheelchair is typically selected if the person is able to propel the wheelchair independently  (fig. 30.1)
The manual wheelchairs are  characterized by propelling and braking using the upper limbs.
Power mobility devices (motorized wheelchair)
Power mobility devices are used by individuals (1)who cannot propel a chair using either the hands or the feet,(2)for whom the energy expenditure required to walk or propel a manual chair is contraindicated,(3)who have musculoskeletal complications such as arthritis in upper limb joints(4)who are prone to repetitive strees injury (5)who have neuromuscular dysfunction that may cause associated reactions in the lower extremities are used for wheelchair propulsion.

Numerous factors that are unique to power wheelchairs require consideration in making a selection. The therapist should determine whether the device will be used primarily indoors or indoors and outdoors.
In addition,the therapist should consider the batteries ,which at present are the best solution for power.
Common wheelchair componets
Armrests of wheelchair can be fixed,detachable,or swing away.the latter two styles may allow greater ease in sliding board and other sideways transfers than fixed armrest.
The front rigging consists of leg rests and footplates.leg rests may be fixed,swing away,or detachable.

Tires can be either pneumatic(air filled),semipneumatic(airless foam inserts),or solid core rubber and are mounted on spoke or molded wheels.
Seatbelts,safety vests,and harnesses vary in design and are used for both safety and positioning purposes.
Wheelchair sizing
Measurements of the individual form the basis for determining wheelchair frame size,needs for adjustable ranges in component parts,or need for customization to meet special requirements.

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