Power Wheelchairs

Many People Living with ALS ( or clients) find that a power wheelchair provides a means of independent mobility when they are no longer able to walk long distances. Before selecting a power wheelchair it is important to consider what type of chair will meet the client's long-term power mobility needs. The following is a brief overview of some of the features to consider when choosing a power wheelchair.

Mid-Wheel or Rear-Wheel Drive

One of the recent innovations in power mobility has been the development of mid-wheel drive wheelchairs. In the past, most power wheelchairs had rear-wheel drive which meant the wheelchair needed considerable room to turn.

Now mid-wheel drive chairs are also available. These can turn on a dime, which allow wheelchair users to get around tight corners and turn in small rooms.

Controller

It is important to choose a controller that will meet the client's needs over time. Most people living with ALS are initially able to use a joystick to drive a power wheelchair, provided the user can reach the joystick as well as operate the on/off switches. Typically, a joystick that has the switches closer to the user will work better for the client.

A swing away joystick bracket should be considered if the user will be needing to get the wheelchair close to a table or desk.

Some people with ALS lack the hand and arm strength to use a joystick, so choose an alternate array consists of several switches embedded in the headrest. Touching different parts of the array will steer the chair in different directions.

Some clients find it easier to drive with a proportional head control. This type of control uses one switch (often placed by the cheek) that acts as the gearshift, with the headrest acting as the accelerator. By turning his head the person with ALS is able to switch the direction he is driving. Extending his head back into the headrest will control how far he travels in that direction.

Some wheelchairs can be operated with a single switch and a scanner. This means it is possible to drive a wheelchair with a finger tap or even a toe tap.

Power Tilt, Recline, and Elevating Leg rests

Many power wheelchairs come with optional power tilt, recline, and elevating leg rests. The recline feature allows the wheelchair back to be moved forward and back in isolation from the seat. Tilt refers to moving the wheelchair back and seat together as a single unit.

If the client is planning to use the chair throughout the progression of the ALS it is very important that the wheelchair have tilt. This will add considerably to the cost of the chair, however it will be worth it. As the client's trunk muscles weaken, tilting the wheelchair slightly will allow the person with ALS to sit comfortably. Recline and power elevating leg rests are nice to have features, but are not as crucial as the tilt.

When ordering tilt, recline or power elevating leg rests, one should ensure these systems can be operated through the joystick or whatever control the client is going to use. This will probably increase the cost of the chair, but will often save the person living with ALS much frustration down the road.

Points to discuss with your Vendor and Therapist

Your occupational or physical therapist, as well as your local medical equipment vendor, can assist you when selecting which power wheelchair might be best for you. Here are some of the questions you should consider before making a final decision.

• Where will I be using the wheelchair? Will it be used indoors or outdoors? If the wheelchair is to be used outdoors, will there be rough or uneven ground? (A person with ALS who is living on an acreage may want a wheelchair with good curb climbing ability.)
• What is the turning radius of the wheelchair? Will this work in my home?
• Does the wheelchair have a weight limit?
• Does the chair accommodate a tilt system?
• Will the chair accommodate other types of controls (e.g. head control or single switch)?
• Can I mount a seating system on the wheelchair?

If you are considering purchasing a second hand chair, it is advisable to find out if you will be able to modify the chair at a later date. (e.g. ask if the electronics are current enough to allow for alternate controls.)

Funding Sources

Power wheelchairs vary greatly in prices. A basic rear-wheel drive, joystick- controlled wheelchair will cost about $4000 to $7000. A mid-wheel drive wheelchair with after-market tilt will probably be around $12,000. Alternate controls (e.g. head control) will increase the cost even more.

The Alberta Aids to Daily Living (AADL) program has limited funds available for basic power wheelchairs. Many private insurance plans will also provide partial or full funding for power mobility. Service clubs and community organizations are often willing to raise money for power wheelchairs.

Researching all of the available power wheelchair options can be a time-consuming process, but many people living with ALS would agree that using a power wheelchair makes a huge impact on their quality of life.

For more information

• Pride Mobility
• Invacare
• Sunrise Medical
• Wheelchair Discussions

This information has been prepared for the ALS Society of Alberta by Anne Chapman-Heinemeyer, OT. For more information on the ALS Society of Alberta's Equipment Program, please call Jeremy Wojtkiw at (403) 228-3857 (Extension 104) or e-mail at jeremy@alsab.ca. Phone toll free in Alberta at 1 (888) 309-1111.