Accueil / Blog / October 2019 / Configuration optimale du fauteuil roulant manuel pour une propulsion avec les membres supérieures

Configuration optimale du fauteuil roulant manuel pour une propulsion avec les membres supérieures

Partagé:

This month I have been asked by a clinician how can we determine what is the optimal manual wheelchair set up for an upper limb propeller. To answer this question we must first consult a few important resources:

  • Position on the Application of Ultralight Manual Wheelchairs: www.resna.org 
  • Preservation of Upper Limb Function Following Spinal Cord Injury: www.pva.org

What is it?

  • 35 clinical guidelines to help optimise chair set up to prevent upper limb injury
  • Focuses on
    • // Education 
    •  // Propulsion technique 
    • // Equipment selection 
    • // Wheel position 
    • // Recommendations are transferable to other user groups

Optimal set up

Rear wheel:

  • Tip of middle finger at centre of hub (another method to support CPG 9)

  • Why? So Centre of Mass (for maximum manoeuvrability) is positioned over hub of wheel
  • 70-80% of user weight over rear wheels (CPG 8 - Adjust the rear wheel as far forward without compromising stability)

  • 120° of elbow flexion at top of push cycle (CPG 9 - hand top dead centre – elbow angle should be 100-120°)
  • Optimal wheel access – 10 to 2 (CPG 5 - avoid extreme positions of the wrist)

  • Use wheel camber – increases lateral stability and brings top of wheel closer to user – more efficient push phase (RESNA 2012)

Front castors:

  • 20-30% user weight over castors
  • Use smallest castor fork – reduces turning circle and obstruction with feet or footplates

Why?

// Minimise resistance to turning & more efficient propulsion

// Provides compromise between indoor manoeuvrability and outdoor terrain navigation

Quickie wheelchairs are designed to be easily configurable to meet end user needs and also set up according to these guidelines:

// Folding frame wheelchairs – Quickie Life, Youngster 3, Neon2, Xenon2

// Rigid Framed wheelchairs – Quickie Life R, Simba, Argon2, Helium

RESNA (2012) emphasise the importance of achieving an optimal set up for all manual wheelchair users to maximise function and independence and reduce potential injury advising that: “The person cannot conform to the wheelchair, but the wheelchair must conform to the individual.”

 

Matt Eveleigh

Matt Eveleigh

Clinical Specialist Occupational Therapist (OT) - Clinical Education Specialist

Matt Eveleigh has worked for Sunrise Medical since 2013 and his current role is as a European Power Product, Market and Training Manager within the European Product Management Team. Prior to this he was the Clinical Specialist, STEPS Clinical Educator and JAY Product Specialist for the UK and Eire. He is a Clinical Specialist Occupational Therapist by background and has specialised in wheelchair and Seating for over 15 years.

DISCLAIMER: FOR PROFESSIONAL USE ONLY. THIS WEBSITE (AND THE DOCUMENTS REFERENCED HEREIN) DO NOT PROVIDE MEDICAL ADVICE. Sunrise Medical (US) LLC (“Sunrise”) does not provide clinician services. The information contained on this website (and the documents referenced herein), including, but not limited to, the text, graphics, images, and descriptions, are for informational purposes only and should be utilized as a general resource for clinicians and suppliers to then use clinical reasoning skills to determine optimal seating and mobility solutions for individual patients. No material on this website (or any document referenced herein) is intended to be used as (or a substitute for) professional medical advice, diagnosis or treatment. Never disregard your professional medical training when providing medical advice or treatment because of something you have read on this website (or any document referenced herein). Clinicians should review this (and any other materials) carefully and confirm information contained herein with other sources. Reliance on this website (and the information contained herein) is solely at your own risk.