Technology options have never been better for tailoring power wheelchairs to be fun and functional.
Assuring that a client reaches the highest functional potential in a power wheelchair is a complex process. It can be even more daunting to build a level of “fun” into the functional role of the device. Yet with power wheelchair accessories spanning a greater range than ever, the process presents an exciting challenge for both user and therapist. To meet this challenge, the user and therapist both must understand what the marketplace offers, and begin the process of building a highly accessorized power wheelchair that will satisfy today’s savvy users.
IN THE BEGINNING
The road to accessorizing a power wheelchair with fun and functional technology begins with the basics. The first step is to choose the correct base and an ideal combination of battery, motor, and drive wheels. Narrowing down seating components is also critical, as is identifying the most appropriate backrests, headrests, armrests, lateral supports, and footplates. These can all make a significant difference in a client’s function while adding a distinct layer of cool and flair.
To further enhance a system’s appearance, manufacturers may add a stylish variety of fabrics to a back or foam cushion—in some cases at no additional cost. Fabrics that depict superheroes or the latest fashion print can be used to line the outside of the power wheelchair back, reflecting the user’s individual taste. The result: a pleasing level of cool that reinforces user satisfaction.
Choosing the correct cushion is also vital for a client’s health, comfort, and function. The first step in selecting the best product is to assess the client’s transfer method, pressure relief technique, and skin integrity. Air, foam, honeycomb, and gel cushions all can be appropriate for the right power wheelchair user. If a client needs an air cushion, “designer covers” are available in a variety of styles to add a layer of customization. This accessory can be both practical and fun.
Power positioning technologies add even more function to the possibilities. For example, seats that elevate up and down can help users access hard-to-reach areas in their surroundings. This also can make transfers easier, and allow users to engage with others at eye level. For users who cannot independently shift weight, recline and tilt-in-space options are extremely helpful. They can assist in personal care activities and help manage posture for the user.
THE “WOW” FACTOR
At some point, the functional and highly stylized new power wheelchair is delivered to the client. The client loves the chair but wishes it did more. The client asks the therapist what can be done to make the chair not only more functional, but deliver an even higher “wow” factor for the user experience. What does the therapist say?
To provide a client the best response to this question, it is important for therapists to periodically ask themselves how much they really know about “extras” that can be integrated into power wheelchairs. Most clients will not be satisfied with a restricted set of options.
Since many of the accessories that are available are not funded by insurance, most therapists and suppliers do not know as much about them as they should. Following are some fun and functional ideas that are popular today, and which many users may want to add to their power wheelchairs.
Let’s begin with function, since that is what lies at the core of any power wheelchair, and a characteristic for which there can be no compromise. There are many options that can be added to a power wheelchair to optimize its function, and meet the needs of the client.
Depending on the chair and the manufacturer, some of the functional items may be built into the power wheelchair system. For example, many Group 3 wheelchairs with specialty controls contain extra features with their control modules. At least two power wheelchair manufacturers offer accessories that allow the user to control the wheelchair, but also feature environmental controls. These systems are designed to allow the user to control devices such as televisions or other appliances using infrared signals within the display.
Many power wheelchair users rely on computer technology for communication, recreation, or work. Mouse emulators are devices that use Bluetooth technology to allow users who are unable to operate or reach a standard computer mouse to utilize the emulator and operate devices such as desktop or tablet computers. Many power wheelchair companies manufacture Bluetooth mouse emulators designed to be used on the wheelchairs they build. Specialty electronics companies also manufacture different types of mouse emulators. Each device functions differently, so a full evaluation of the client’s function and needs should be completed to determine which mouse emulator is best.
Mobile devices such as tablets or smartphones are part of everyday life for many people. However, many power wheelchair users do not have the level of hand and finger function needed to operate these devices. To solve this problem, the market offers a device that enables connection of powered wheelchairs and adapted switches to Bluetooth-enabled electronic devices. The device allows the user to use a scanning process to open applications, answer phones, and type e-mails and texts. It is similar to a single-switch scanning system and can be cumbersome. However, it interfaces with their specialty controls, and many wheelchair users can operate them successfully.
New power wheelchair users may find they frequently need assistance in developing the ability to safely operate their wheelchairs. This may be especially true for young children. Watchful monitoring can be a good strategy for helping young users learn to command their new power devices. One technology that supports this strategy is a remote stop switch that uses radio frequency. This device allows the attendant to press a button on a keychain-sized switch to stop the wheelchair if the user moves too close to the street or there are other dangerous situations. Wheelchair manufacturers and specialty electronics companies offer these devices, which can be used on most power wheelchairs.
PRESSURE SORE AND EDEMA PREVENTION
Remembering to do pressure and edema relief can be difficult for many wheelchair users. In fact, many users do not properly develop the habit until they, themselves, have developed pressure ulcers or significant edema. One accessory clinicians and suppliers frequently recommend to help power wheelchair users perform regular pressure reliefs is an egg timer, smartphone timer, or smartphone developed specifically to provide an audible reminder to begin and end a weight shift. These can be successful for many clients, but some may need more assistance or feedback.
One manufacturer is currently developing a smartphone app as a power wheelchair accessory that offers a high level of sophistication in helping users maintain a consistent repositioning regimen. This app is engineered to show the client the proper sequence, timing, and amount of power positioning functions (tilt, recline, elevated leg rest or ELR) so that pressure and edema relief are completed successfully. The app also is designed to display the current amount of tilt, recline, ELR, or seat elevation so the client can use each feature properly. Additionally, it will remind a client to perform weight or edema relief at prescribed intervals.
This app also uses a web interface to allow clinicians and providers to check whether the client is using the power features as prescribed, and provide feedback to the client. This feature could help improve compliance with pressure and edema management programs and help to prevent problems such as pressure ulcers.
Some items can be both fun and functional. Many times a client wants to add lights to a wheelchair, but either the chair does not have a light package available or the client does not want to spend up to $1,000 for a manufacturer’s light kit. An accessory such as LED lights, however, can provide a “Fast and Furious” appearance to some power wheelchairs. Systems that feature headlights, taillights, and/or multicolored ground effects are all available. These kits are made by hand for each client so they are customizable and fun. The systems are waterproof and include a battery, so there is no need to tether to the onboard system or have concerns about electrical problems.
A budget-sensitive option for power wheelchair lights may be found at a local bicycle store. Bicycle lights that can be attached to a wheelchair are stocked by some stores, with costs varying from $5 to $100, depending on the type of light.
While the federal government seems to believe people who use wheelchairs do not need to leave their homes, it turns out that some of them do. Even more unbelievable is that power chair users go outside during winter in cities where it is actually cold. One accessory that can be valuable for users in these environments is a hand heater. The hand heater also can be purchased with a cone cover that protects the drive control as well as the user’s hand, while a small heating device beneath the armrest maintains the air inside the cover at a comfortable temperature. Individuals affected by arthritis in the hands also may find this helpful in relieving pain and operating a wheelchair. The cone alone can be helpful during a rainstorm, as it can protect the joystick from light rain.
It seems like everyone has a tablet computer or smartphone these days. The market offers wheelchair-specific mounts for these devices in fixed, removable, or swing-away configurations. Other accessories include wheelchair mounts designed to accommodate communication devices, laptops, tablets, cell phones, cameras, and cups or bottles. Some wheelchair manufacturers also offer products that will mount or support those devices to their frames.
For those who want to save money or simply add variety to how they use certain devices, mounting systems are available and can be attached to wheelchairs according to where or how a device is used. These accessories are not manufactured specifically for wheelchairs in most cases, which may keep their costs relatively low. Gooseneck tubing is an example of such commercially available materials that can be used to position devices on a wheelchair.
The bottom line is that there is a plethora of options to choose from based on the device, wheelchair arm length, or whether swing-away or fixed mounts are needed.
Most people think spoke guards and hubcaps are available only on manual wheelchairs. Fortunately, that is not true. Power wheelchairs can have cool and funky designed hubcaps. An Internet search can provide hundreds of designs from manufacturers that can be mounted on both manual or power wheelchairs. They are relatively inexpensive and can add flair to any chair. Users can choose from a variety of styles, or create one that is unique.
There are countless other items offered by the medical side and commercial side that can assist power wheelchair users. From canopies to nonattaching lap trays to cute armrest pads, there are products that can meet the needs of almost anyone. The key is to be persistent, and make effective use of online searches. With only a bit of time, creativity, and, of course, money, it seems anything can be accomplished. Therapists and their clients should work together to locate accessories that will create a power wheelchair solution that is fun and functional. They also should share with others what those successful searches reveal. If the treasure they find helps one client, there are likely many others who would benefit from it as well. RM
Lauren Rosen, PT, MPT, MSMS, ATP/SMS, is a physical therapist and seating and mobility specialist at St. Joseph’s Children’s Hospital in Tampa, Fla. She is the Program Coordinator for the Motion Analysis Center, a three-dimensional motion analysis lab where she also runs a pediatric and adult seating and positioning clinic. She has been active in DME prescription for the past 18 years. Rosen is on the Board of Directors of the Rehabilitation Engineering and Assistive Technology Society of North America. She has lectured and written articles on wheelchairs, seating and positioning, and standing.
Jarrod Rowles is an ATP/SMS and CRTS with Numotion in Central Florida. He has worked extensively with children and adults who have complex diagnoses and seating needs, and has been involved in complex mobility provision for more than 7 years. For more information, contact [email protected]