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Philadelphia
Pediatric Specialty Care
Orthopaedics
Spinal Cord Injury
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Wheelchairs and Seating
A. Evaluation process
Much time goes into determining an appropriately fitting wheelchair and seating system.
A thorough clinical evaluation of an individual’s needs, environment, and functional strengths help determine an appropriate wheelchair.
A team approach is ideal when selecting an appropriate wheelchair and seating system. The team should consist of:
- patient
- patient’s family and caregivers
- physician
- therapist: OT, PT, ST
- vendor/manufacturer representative
- assistive Technology practitioner
B. Manual vs. power mobility
There are many things to consider when deciding which type of mobility meets your needs:
Some reasons to select manual mobility:
- You have sufficient upper body strength and overall endurance to propel a manual wheelchair all day over various surfaces.
- Reducing the weight or increasing the maneuverability of a wheelchair will enhance your independence.
- You are able to perform all your daily activities in a manual wheelchair.
- A manual wheelchair is smaller, lighter, and less expensive to maintain and repair.
- You are able to independently perform a weight shift
- You have no chronic pain in your arms or shoulders.
Some reasons to select powered mobility:
- You have insufficient endurance or functional ability to propel a manual wheelchair independently.
- Powered mobility would enable you to be more independent in your daily living, working, and recreational activities.
- You are unable to independently perform a weight shift.
- Your personal and public environments and modes of transportation accommodate a power chair
- Financial considerations.
C. Positioning in a wheelchair
- Proper positioning begins with proper-sized equipment.
- One of the primary goals of wheelchair positioning is achieving an aligned body posture, which is important to prevent orthopedic deformities and pressure ulcers.
- The spine should maintain its normal curvature and pelvis should be neutral.
- A posterior pelvic tilt should be avoided, although it is frequently used to increase trunk balance, particularly with patients with cervical and upper thoracic level injuries.
- The hips, knees and ankles should be flexed to about 90 degrees.
- Shoulders should be aligned with the rest of the trunk.
- Head and neck should be centered with respect to the rest of the body
- Positioning must be balanced with feeling secure in the wheelchair and allowing for function.
- The hips, knees and ankles should be flexed to about 90 degrees.
- Shoulders should be aligned with the rest of the trunk.
- Head and neck should be centered with respect to the rest of the body
- Positioning must be balanced with feeling secure in the wheelchair and allowing for function.
D. Other general suggestions
- When selecting a vendor for repairs, ask if they have experience with your brand and type of chair. Contact the chair manufacturer for a recommended vendor in your area.
- Ensure the vendor has a contract with your insurance company.
- You can also call your insurance company and ask what DME companies are ‘in-network’ for your plan. (In-network and out-of-network benefits are often different…there is typically better coverage from insurance with an in-network provider)
Back to SCI home
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Tampa, FL 33607 813.281.0300

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