Ready… Set… Go! Exploring the World of Pediatric Ultra Lightweight Manual Wheelchairs
Wheelchairs have evolved immensely over time, but especially over the past 20 years. The most recent surge in technological advances for manual wheelchairs began in the 1990's and has continued with the implementation of lighter weight material being utilized in manufacturing and the ability to truly customize a wheelchair for each individual.
Part of what has driven these changes has been the data gathered through research studies on the importance of proper wheelchair set-up for not only efficiency, but also for the client's overall health. A fantastic resource on the topic was published by the Rehabilitation Engineering Association of North America (RESNA) in 2012 that detailed research and clinical application of ultra lightweight manual wheelchairs to assist practitioners with selecting the best wheelchair for their clients. Click the link to read "RESNA Position on the Application of Ultralight Manual Wheelchairs".
Initially, the focus on the development and implementation of ultralight weight manual wheelchairs was on adult clients. Yet, in recent years, clinicians, manufacturers, and suppliers have broadened the scope of ultralight weight manual wheelchairs to include pediatric clients. When it comes to selecting and justifying an ultralight weight manual wheelchair for a pediatric client many of the same principles apply as to when selecting one for an adult. However, there are additional variables brought into the mix when working with a child.
While each child develops at his or her own rate, in general babies without developmental delays or disabilities begin to become mobile (crawling, creeping, and walking) around 6-12 months. It is important to give a child with gross motor delays the opportunity to explore his environment in order to promote learning and growth in all areas of development. The idea of a little one propelling his own manual wheelchair may seem a bit much, but there are alternative mobility options available to promote mobility such as the Scooot from Firefly at a young age.
In my career I have worked with children as young as 18 months old who have successfully propelled an ultralight weight manual wheelchair. Our friend, Lily, from Utah received her first Zippie Zone when she was two years old and as you can see from this video Lily has been dancing her way through life since.
The younger a child is able to independently explore their environment increases the child's opportunity for learning while decreasing the likelihood of the child developing learned helplessness.
Similar to choosing an independent manual wheelchair for an adult, the weight of the material, adjustability, customization, configuration, and proper set-up are all important when working with a child.
Depending on the size of the child, some wheelchairs may weigh more than the child. Be sure to not only look at the weight of the frame, but also pay attention to the weight of the seating system and accessories. If it's clinically appropriate consider a lightweight cushion and back that are designed for a child such as the JAY® Zip™ Cushion and Backs. You'd be surprised how fast an ounce here and there can add up.
Proper configuration and set-up are also key pieces of the puzzle. Ensuring that the rear wheels are appropriately positioned and the center of gravity is adjusted to the child's sweet spot (as far forward as possible, but not too tippy) will have a tremendous impact on the child's ability to propel the wheelchair and decrease the impact of propulsion on the child's body. For more information on these topics please refer to our post "Moving Forward with Center of Gravity".
Understanding the amount of growth and how to grow a wheelchair is also essential when selecting the best option for a pediatric client. Be sure to talk with your manufacturer's representative to fully understand a wheelchair's growth capabilities.
One of the primary goals of getting a child an ultralight weight wheelchair is to get him or her as active as possible in all areas of life. While we want to encourage the child to propel himself independently as much as possible, the reality is the child may need some assistance from a caregiver at times. The addition of something as simple as push handles to a pediatric ultralight weight wheelchair may make a huge difference in the lives of a child's caregivers.
The ability to transport the wheelchair in the community via a parent's personal vehicle, on public transportation, and/or school bus is vital. When thinking about transporting the wheelchair in a personal vehicle the family should consider how the wheelchair breaks down (quick release wheels, removable seating, fold down back, folding frame, etc.), the number of steps that go into breaking the wheelchair down and reassembling the wheelchair, and the weight of the components. I always encourage parents to bring the vehicle they are planning to transport the equipment in to the appointment, so they can get experience the process. If the plan is to transport the child in his wheelchair, it is absolutely essential for the caregivers and school team to understand all of the steps that go into properly securing the wheelchair and restraining the child in the vehicle.
Last, but not least, give the child the opportunity to express himself through the selection of colors. Nowadays clients not only have the ability to choose the color of the wheelchair frame, but on some brands they can also choose the color of a back shell and fabric bands on cushions. It's amazing how a splash of color can impact a user's overall satisfaction with his wheelchair.
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Always remember at the end of the day, your client is your number one priority!
Posted by: Date: 12/14/2014 12:00:00 AM
Filed under: Angie