Hospital Minero-Museo de Medicina Laboral located in Real del Monte, Hidalgo, Mexico.]] A wheelchair is a wheeled mobility device in which the user sits. The device is propelled either manually (by turning the wheels by the hand) or via various automated systems. Wheelchairs are used by people for whom walking is difficult or impossible due to illness (physiological or physical), injury, or disability. People with both sitting and walking disability often need to use a wheelbench. The earliest record of the wheelchair in England dates from the 1670s, and in continental Europe this technology dates back to the German Renaissance. Image:Wheelchair button.JPG|
A basic standard manual wheelchair incorporates a seat and back, two small front (caster) wheels and two large wheels, one on each side, and a foot rest.
Wheelchairs are often variations on this basic design, but there are many types of wheelchairs, and they are often highly customised for the individual user's needs. The seat size (width and depth), seat-to-floor height, footrests/leg rests, front caster outriggers, adjustable backrests, controls, and many other features can be customized on, or added to, many basic models, while some users, often those with specialised needs, may have wheelchairs custom-built.
Various optional accessories are available, such as anti-tip bars or wheels, safety belts, adjustable backrests, tilt and/or recline features, extra support for limbs or neck, mounts or carrying devices for crutches, walkers or oxygen tanks, drink holders, and clothing protectors.
The electric wheelchair shown on the right is fitted with Mecanum wheels (sometimes known as Ilon wheels) which give it complete freedom of movement. It can be driven forwards, backwards, sideways, and diagonally, and also turned round on the spot or turned around while moving, all operated from a simple joystick.
Manual or self-propelled wheelchairs are propelled by the occupant, usually by using large rear wheels, from 20-26 inches in average diameter, and resembling those of bicycle wheels. The user moves the chair by pushing on the handrims, which are made of circular tubing attached to the outside of the large wheels. The handrims have a diameter that is slightly less than that of the rear wheels. Skilled users can control speed and turning and often learn to balance the chair on its rear wheels - do a "wheelie". The wheelie is not just for show - a rider who can control the chair in this manner can climb and descend curbs and move over small obstacles.
One-arm drive enables a user to guide and propel a wheelchair from one side. Two handrims, one smaller than the other, are located on one side of the chair, left or right. On most models the outer, or smaller rim, is connected to the opposite wheel by a folding axle. When both handrims are grasped together, the chair may be propelled forward or backward in a straight line. When either handrim is moved independently, the chair will turn left or right in response to the handrim used. Another alternative is a lever-drive chair that propels the chair forwards by using a lever that is pumped back and forth. Some chairs are also configured to allow the occupant to propel using one or both feet instead of using the rims.
Attendant-propelled chairs are designed to be propelled by an attendant using the handles, and thus the back wheels are rimless and often smaller. These chairs are often used as 'transfer chairs' to move a patient when a better alternative is unavailable, possibly within a hospital, as a temporary option, or in areas where a user's standard chair is unavailable. These chairs are commonly seen in airports. Special airplane transfer chairs are available on most airlines, designed to fit narrow airplane aisles and transfer a wheelchair-using passenger to and from their seat on the plane.
Wheelbase chairs are wheeled platforms with specially-molded seating systems interfaced with them for users with a more complicated posture. A molded seating system involves taking a cast of a person's best achievable seated position and the either carving the shape from memory foam or forming a plastic mesh around it. This seat is then covered, framed, and attached to a wheelbase.
Light weight and high cost are related in the manual wheelchairs market. At the low-cost end, heavy, tubular steel chairs with sling seats and little adaptability dominate. Users may be temporarily disabled, or using such a chair as a loaner, or simply unable to afford better. Heavy unmodified manual chairs are common as "loaners" at large facilities such as airports, amusement parks and shopping centers. In a higher price range, and more commonly used by persons with long-term disabilities, are major manufacturer lightweight chairs with more options. The high end of the market contains ultra-light models, extensive seating options and accessories, all-terrain features, and so forth.
Three general styles of electric powered chairs (EPWs) exist: rear, center, front wheel driven or four wheel driven. Each style has particular handling characteristics. EPWs are also divided by seat type; some models resemble manual chairs, with a sling-style seat and frame, whereas others have 'captain's chair' seating like that of an automobile. EPWs run the gamut from small and portable models, which can be folded or disassembled, to very large and heavy full-featured chairs (these are often called 'rehab' chairs).
EPWs may be designed specifically for indoor use, outdoor use, or both. They are generally prescribed for persons who have difficulty using a manual chair due to arm, hand, shoulder or more general disabling conditions, and do not have the leg strength to propel a manual chair with their feet. A person with full function of the arms and upper torso will generally be prescribed a manual chair, or find that their insurance will not cover an EPW.
The user typically controls speed and direction by operating a joystick on a controller. Many other input devices can be used if the user lacks coordination or the use of the hands or fingers, such as chin controls and puff/sip scanners for those with C2-3 spinal cord lesions or head injuries (the user blows into a tube located near the mouth, which powers the movement of the chair). This controller is the most delicate and usually the most expensive part of the chair. EPWs can offer various powered functions such as tilt, recline, leg elevation, seat elevation, and others useful or necessary to health and function.
EPWs use electric motors to move the wheels. They are usually powered by 4 or 5 amp deep-cycle rechargeable batteries, similar to those used to power outboard boat engines. These are available in wet or dry options; currently dry cell batteries are more popular. Many EPWs carry an on-board charger which can be plugged into a standard wall outlet; older or more portable models may have a separate charger unit.
A mobility scooter (see full article) is a motorized assist device similar to an EPW, but with a steering 'tiller' or bar instead of the joystick, and fewer medical support options. Mobility scooters are available without a prescription in some markets, and range from large, powerful models to lightweight folding ones intended for travel.
A bariatric wheelchair is one designed to support larger weights; most standard chairs are designed to support no more than 250 lbs. on average.
Pediatric wheelchairs are another available subset of wheelchairs.
Disabled (and, often, other participating) athletes use streamlined sport wheelchairs for disabled sports that require speed and agility, such as basketball, rugby, tennis and racing. Each wheelchair sport tends to use specific types of wheelchairs, and these no longer look like their everyday cousins. They are usually non-folding (in order to increase solidity), with a pronounced angle for the wheels (which provides stability during a sharp turn) and made of composite, lightweight materials. Sport wheelchairs are not generally for everyday use, and are often a 'second' chair specifically for sport use, although some users prefer the sport options for everyday.
An exciting new sport has been developed for powerchair users called powerchair football or power soccer. It is the only competitive team sport for powerchair users. The Federation Internationale de Powerchair Football Associations (FIPFA) governs the sport and is located in Paris, France with country affiliates around the world.
Three-wheeled wheelchairs are wheelchairs with the least wheels and are found in EPW technology.
Adapting the built environment to make it more accessible to wheelchair users is one of the key campaigns of disability rights movements and the Americans with Disabilities Act of 1990 (ADA). The most important principle is Universal design - that all people regardless of disability are entitled to equal access to all parts of society like public transportation and buildings. A wheelchair user is less disabled in an environment without stairs.
Sometimes it is necessary to add structures like ramps or elevators in order to permit people in wheelchairs (and those using crutches, canes, walkers and so forth, or those with unsupported walking disabilities) to use a particular building. Other important adaptations are powered doors; lowered fixtures such as sinks and water fountains; and toilets with adequate space and grab bars to allow the person to maneuver himself or herself out of the wheelchair onto the fixture. In the United States, most new construction for public use must be built to ADA standards of accessibility.
The construction of low floor trams and buses is being encouraged, whereas the use of paternosters in public buildings without any alternative method of transportation has been criticized due to the lack of access for wheelchair users. Modern street furniture design now incorporates better accessibility for people with disabilities.
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