Dec 13, 2011

Types of wheelchairs

VolcanoRupture from Tacoma, Washington asks:

Yesterday I overheard a guy in a wheelchair on the bus talking to someone about different "types" of wheelchairs. I think I have a vague idea of what that means, but can you explain that a bit?

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This is something that a surprisingly large number of people do not notice about wheelchairs. Not all wheelchairs are created equal! Quite often, "real" wheelchair users will be picky about this – especially when it comes to wheelchairs used in TV shows and movies.

You will have to excuse me for the excessive criticism of TV show and movies in this blog post. I am referring to them because the creators of such productions often do NOT see the difference between different types of wheelchairs.

There are basically three kinds of wheelchairs, and I will give them nicknames:

1. The Hospital Clunker
2. The Fancy Sleek Wheelchair
3. The Battery-Powered Super Chair
4. The Sports Wheelchair (okay, that is not so much a nickname but rather the actual term for it)

Let's break them down one by one.

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1. The Hospital Clunker

This is the type of wheelchair that many TV shows and movies use, and is part of what draws the ire of "real" wheelchair users. Why? Because these wheelchairs are not made for everyday use. They are primarily used for transporting hospital patients or the elderly; they are heavy and best used when pushed by somebody else.

Most people with long-term mobility impairments will NOT use this type of chair because prolonged pushing will result in a higher rate of "wear and tear" and injuries. They weigh 35 to 45 pounds – is it any wonder you can get hurt wheeling yourself around the city with this?

Besides, they are ugly. Very ugly.

But TV shows and films continue to use these Hospital Clunkers on characters who supposedly have permanent disabilities. Before we even find out about the actor's background, we immediately know that they did not cast a "real" wheelchair user for the role. It is akin to casting a Middle Eastern person to play a character from India – it lacks realism and feels like a type of stereotyping or profiling.

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2. The Fancy Sleek Wheelchair

Most "real" wheelchair users who have permanent mobility impairments will use a Fancy Sleek Wheelchair. These wheelchairs are often one-piece frames made of titanium or high-quality aluminum. As well, these wheelchairs have one very important aspect to them – they are CUSTOM MADE to the wheelchair user's measurements.

Wheelchairs are custom made to "fit the user like a shoe." What that means is that the length of your legs must conform to the length of the frame so that they are aligned properly. Also, your thighs have to be on the chair in a way that you are not "sinking into" the chair. These two are especially important because long-term sitting can result in complications like pressure sores ("bedsores"), particularly those with limited sensation in their lower bodies, such as people with paralysis.

Another modification might be a backrest to ensure someone who is sitting down for most of the day gets proper posture support. This is something that Hospital Clunkers often lack.

There are other reasons for customization as well, such as making sure it suits a person's particular condition. For example, someone with a spinal cord injury might have different needs than someone with cerebral palsy, and the wheelchair's customizations will address that and include features that are most important to that person.

An example of a feature that does not work for everyone is the backrest height. My own wheelchair is configured for someone with a low spinal cord injury, which is fine for me. But if you put me in a wheelchair for someone with a mid-level injury, I will likely have a very difficult time using it.

Compared to the Hospital Clunkers, the Fancy Sleek Wheelchairs also weigh less – MUCH less. Some wheelchair frames (without wheels or accessories) can weigh as little as 13 pounds. My own wheelchair, which is made of titanium, weighs 25 pounds – and this is with the wheels and accessories attached. So even with that "extra weight," it weighs less than a Hospital Clunker by itself!

There are several TV shows and movies that got this part right, most notably Saved! and Glee (although the latter did not get it quite perfect when it came to the custom sizing).

As well, some of these chairs are quite good-looking. Check out some of the chairs from TiLite (my chair's brand), Colours in Motion and Invacare. Pay close attention to how the chairs look and compare them to the Hospital Clunkers. There is a big difference.

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3. Battery-Powered Super Chair

The Battery-Powered Super Chair is something you may not see so much in TV shows and movies but when it shows up, it is often used by a character who may not necessarily "need" it.

What does that mean? In short, in real life, Battery-Powered Super Chairs are often used by those who cannot otherwise use a manually-propelled wheelchair, such as those with quadriplegia (limited or no use of the upper limbs).

Occasionally you may see someone with paraplegia (impairment in the lower limbs only) use it to prevent everyday "wear and tear" on the body but it seems that unless you are middle-aged, it is not very common to see that (and even for middle-aged people, it is not too common now). Nowadays, the technology for Fancy Sleek Wheelchairs seems to be improved to the point where Battery-Powered Super Chairs are not necessary for those with paraplegia.

These Super Chairs, while handy, pose a physical and possible psychological challenge.

Physically, these chairs are difficult to transport: they often weigh several hundred pounds each. If you drive a car like I do, it is next to impossible to bring one of these chairs unless you have an adapted/modified van.

Psychologically, there is often a fear among Fancy Sleek Wheelchair users that a Super Chair will make you seem "more disabled." This is by no means a knock on Super Chair users, of course, but there is a perception that Super Chair users are quite far down the hierarchy of those with mobility impairments. I am NOT saying this is fair or right, but that is how things seem to be right now.

I have been through this psychological aspect before. I went through several instances where I would be at a disability-related event and the demographics among the attendees would be mostly Super Chair users. As a Fancy Sleek Wheelchair user, I cannot begin to express how out of place I feel when this happens. Though I did not feel "better" than them simply because I use a Fancy Sleek Wheelchair, it is possible someone unfamiliar with disabilities will have that view.

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4. Sports Wheelchair

Some people think that Fancy Sleek Wheelchairs are sufficient for playing sports. Throw a basketball to a Fancy Sleek Wheelchair user, and he can play some one-on-one hoops with you, right?

Unless that person is really ambitious, there is a better way to do it – use a Sports Wheelchair.

Sports Wheelchairs are like the Sleek Wheelchairs – one-piece and lightweight. However, they have a few features that Sleek Wheelchairs may not necessarily have:

1. Tilted back wheels (called "cambered" wheels): this makes quick sharp turns possible.
2. Anti-tip wheels behind the seat: this prevents flipping backwards during play without slowing you down.
3. (Sometimes) collision frames near the footrest: this makes contact with other wheelchairs possible without causing injury to the user's legs or feet.

Try looking for these features in the photo above.

In addition, there may be accessories that may be used in sports but not in Sleek Wheelchairs, such as leg or torso straps (to prevent from falling forward out of the wheelchair).

Unfortunately, many TV shows and movies like to show competitive wheelchair sports being played in only Sleek Wheelchairs. While it is possible to play some sports with them, it is highly unlikely they will be used in competitive play. Sleek Wheelchairs are not as easily maneuverable as Sports Wheelchairs (due to the non-angled back wheels and heavier frame) and will very likely result in an upper body injury in competitive action due to that reason.

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That was a long read but I hope that clears some things up. So the next time you see someone in a Fancy Sleek Wheelchair, you can do things like differentiate between that person and someone in a Hospital Clunker with a temporary injury.

2 comments:

  1. This is great, but a bit thin in the powerchair category. First of all, you left out scooters, which tend to be used by older folks, and those who have some ability to walk, as they don't fit into tight spaces such as restroom stalls. Second, as with manual chairs, there are clunker or basic power chairs that are aimed more at the elderly or someone who doesn't need advanced functions. Then there are the robo-chairs that have functions such as tile, recline, elevate, stand, etc. and are custom fit.

    I see mostly low-end powerchairs on TV, which is not surprising considering that you can pick one up for a few hundred bucks on Craigslist. But if they want to accurately portray someone with a severe disability, they should do the research and get a proper chair - or better yet, cast someone who really uses one!

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    Replies
    1. I'll be honest – As a low-level para, I'm not very familiar with powerchairs so that's why it's a bit thin. Feel free to add your thoughts to that, since you seem to know more about it than I do!

      Also, I talked to many people who actually don't see scooters as a "type of wheelchair" but it seems that way of thinking is far from universal. Some places consider scooters to be wheelchairs, and some do not. In order to reduce confusion, I decided to omit it from this particular entry.

      The TV/movie thing always gets to me. It's not impossible to get a "proper chair" – in fact, I'm sure a company like TiLite, Quickie, Colours, Permobil, etc. would be more than happy to lend one to a production in exchange for product placement. "Glee" is a show that does that; they seem to have an agreement with Colours. It can actually prove to be an advantage.

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