Giving your manual wheelchair the extra push
Sometimes you just aren't ready for a power wheelchair, says Debbie Smith, an assistive technology supplier at Hall's Mobility Center in Centralia, Wash. If you're having trouble propelling a manual wheelchair but don't want or need to start using a power chair, an alternative propulsion device (APD) — or power assist — may be the solution.
Power assist devices enable you to propel a manual chair with less strength and reduced stress on the shoulders and upper body. They use a combination of programmable software, a lightweight battery and motors in the wheel hubs to add turning power to the wheels. Most are operated by slight pressure on the push rims of the wheels.
Some Quest readers have found that APDs help them to do four important things: save energy, decrease pain, stay strong and retain independence.
APDs decrease the amount of strength needed to propel your manual wheelchair, leaving you with more energy to increase your speed, or tackle ramps, hills and uneven terrain.
William Beall Jr., of Marietta, Ga., purchased his Magicwheels 2-gear wheelchair drive this year, because he wanted to go farther and faster and save some of the energy he used when wheeling his standard manual wheelchair.
Before he added the APD, Beall, 50, found that by the time he’d get to the top of the incline leading into his gym, he was burned out and couldn’t get the full advantage of working out. It got to the point that he wouldn’t go many places because it was too draining.
“I found out that, putting the Magicwheels in low gear, I can go up the ramp and push doors open without putting much pressure [on the hand rims] at all,” says Beall, who received a diagnosis of Friedreich’s ataxia (FA) at 23.
Beall’s 2-geared wheels are helpful during outings to the mall or gym or to his part-time job at Target. Now, instead of putting his energy into propelling the wheelchair, he can put it into his task.
The repetitive motion of wheeling a manual chair is hard on the shoulders, says Smith, which is why she considers protection of the arm and shoulder muscles the most important feature of the APD. These devices reduce the force needed to make the repetitive motion, an important benefit for people with neuromuscular diseases.
“I was looking for [power assist] wheels because I put a lot of miles on my shoulders,” Beall says. “I guess because I was 49, I wanted to find something easier on my upper torso.”
APDs also protect the wrists, hands and fingers by requiring less force on the hand rims. Some APDs, such as the Wijit and Natural-Fit hand rims, keep fingers from getting caught in the spokes or stuck between the wheel and hand rim.
These devices also leave the palm of your hand in a natural position. Therefore, the ball of your hand won’t get bruised.
If you don’t use it, you’ll lose it. That old saying is another reason why some people prefer using APDs instead of power wheelchairs.
“It’s important to keep using some of your muscles because your arm and hand muscles are needed for daily activities like eating, brushing your teeth, etc.,” Smith says. “When you’re propelling yourself, you’re getting that exercise in your arms; whereas, if you’re just in your power chair you don’t have any exercise motion going on because you’re just using a finger and joystick.”
Of course, you have to discuss with your neurologist and occupational or physical therapist (OT or PT) whether an APD is appropriate for you. They’ll take into consideration your diagnosis, strength and how your neuromuscular disease affects you. The decision is made on a case by case basis, because for some people an APD may be harmful in the long run.
Jacqueline Burch, who has congenital muscular dystrophy, uses a walker to get around her home in Lake Orion, Mich., and a manual wheelchair with e-motion wheels at school and for long distances.
Three years ago Jacqueline, 11, received her first set of e-motion wheels, because she was having difficulty propelling her manual wheelchair. Her MDA clinic team recommended the semipowered wheels instead of a power chair, because they wanted her to keep using her muscles so she’ll stay as strong as possible.
Carla Hagler, of Slidell, La., is using her third Wijit after her other two were destroyed in Hurricane Katrina. Found to have FA in 1977, Hagler, 43, says the Wijit allows her to go farther, giving her arms a good workout and helping her maintain her weight.
“I didn’t want a power chair because I’d be getting no exercise, not even moving my hands,” Hagler says.
Independence & transportation
Jacqueline Burch credits her independence at school to her power assist wheels that attach to her manual wheelchair.
“It’s easier to push because it has batteries on it,” says Jacqueline. “If you push lightly it will go faster, and it makes me more independent because I don’t have to have someone push me.”
Hagler, too, appreciates the independence the Wijit provides.
“I was becoming dependent on having someone push me, and now I’m more independent,” she says. “Now when I’m out at the mall, I can just go by myself. I can leave my husband [Shawn] to look at tools and man things.”
Transportation is key to independence, but not everyone has a wheelchair-accessible vehicle. Smith says that in her experience, people prefer manual chairs with APDs because they’re lighter and easier to transport than power wheelchairs.
Beall drives a Toyota Corolla and keeps a manual wheelchair with a set of Magicwheels on his car’s passenger seat for outings. When he’s ready to get out of the car, he pulls the manual chair across his legs and places it on the ground. The 2-gear drive adds about 10 pounds to the weight of standard manual wheelchair wheels.
Frank Mobility Systems