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Issue_H November 2013 15 Dash Life
9. OCCUPANT CONTROLLED MOBILITY
Handrims
These are provided for the occupant to grip and push
round to propel the wheels. Best results will be
obtained by a long pushing stroke, which gives a
continuous and smooth forward motion. Many users
find that gripping across the tyre and handrim at the
same time gives better control. We recommend that
when operating in this way, wheelchair gloves are
worn.
Users with gripping difficulties may find larger section
or Capstan types, with easy grip features, more
practical.
When using a handrim to turn a chair round in a tight
space, push one wheel forward, whilst pulling the
other wheel backwards. Always make sure when
carrying out this manoeuvre, that there are no
obstructions or bystanders in the turning space
required.
Balance Training
Physically active, independent people require
wheelchairs, which allow them to safely negotiate
kerbs and achieve efficient control and
manoeuvrability.
It can be hazardous for an occupant to attempt
wheelie positions on wheelchairs, which are stable
above 10 degrees rearwards static stability, as
physical effort needed to manoeuvre and pull a
wheelie can be excessive, consequently increasing
the risk of accidentally tipping over backwards.
Maximum efficiency of hand propulsion occurs when
occupant centre of gravity and wheel centre coincide,
and is dependent on the occupant shape and size.
Physically active people should have wheelchairs
with fine wheel position balance settings, i.e. below
10 degrees rearward stability. These chairs should
have rear stabilisers when supplied to inexperienced
users, allowing the user to practice balancing
techniques with the reassurance that the chair will not
accidentally tip over backwards.
During training, the Therapist, or Training Supervisor
can therefore build up the confidence of the occupant
in stages, by initially setting the wheelchair up in a
safe balance position, with the stabilisers acting
positively, and progressing gradually towards
optimum performance settings, with the stabilisers
only acting as a back up.
Once satisfied that the occupant has developed the
full range of wheelchair skills, and provided that the
medical condition is not compromised, the therapist
can authorise removal of the stabilisers, and the
occupant then takes full responsibility and control of
the wheelchair.
If stabilisers are removed for ascending or
descending a flight of steps additional carers and
handlers should be present, and they should be
refitted when the manoeuvre has been completed.
Outdoor Safety Hints
Most pavements slope slightly towards the kerb
and the wheelchair may have a tendency to
pull towards the road
.
Occupant controlled
Active User wheelchairs with cambered wheel
setting reduce this tendency.
The fitting of polyurethane tyres eliminates punctures,
and provides reassurance of not being stranded
some distance from a service centre, but the use of
these tyres imposes a harder ride and the wheels
must be checked more frequently, to ensure that
there is no deterioration of spoke tension and
security. Polyurethane tyres have slightly less grip
than pneumatic tyres; therefore, self propelled chairs
fitted with polyurethane tyres are also fitted with a
high friction brake shoe grip.
When out at night, ensure that both you and your
wheelchair are visible, consider both clothing, and
light reflective trim features.
10.
TRANSPORTATION
Wherever possible it is recommended that wheelchair
occupants transfer to a vehicle seat during a journey,
with the wheelchair securely stored separately in a
purpose made storage area.
Stowing the wheelchair in a car boot
The folded chair should be placed close to the
car boot with armrests, footrests and other
removable parts detached to split total weight
into component form. Wheelchairs with
detachable wheels reduce the weight for lifting.
The person stowing the chair should grip
convenient fixed parts of the chair, and lift
STABILISERS ARE FOR OCCUPANT
SAFETY. THEY SHOULD NOT BE
REMOVED UNTIL THE USER IS ABLE
TO DEAL WITH BACKWARD FALLS
AND TIP OUTS
keeping the back
straight, bending from
the hips and knees. If
in any doubt about
handling the weight,
assistance should be
sought.
