Page 29 - Mobility Management, March 2019

can use. Are you using a tension-adjustable back? It’s decent, it accommodates some things. But really, you should have a rigid back and maybe some contour supports. How much movement do you need to make, and how much support do you need to be able to make that movement?”
Some ultralight users get fatigued because their energy is being wasted. “You look at the wheelchair itself,” Sayre said. “A lot of those folding K0005s have a lot of flexing in the frame, so you lose a lot of energy. That person is wasting that energy.”
While consumers can tend to fixate on getting the very lightest-weight frame, Wenzel emphasized that proper fitting is much more critical to a good outcome. “You can have somebody in a heavier folding chair,” he said, “but if the fit is perfect, with the width, depth, seat inclination, center of gravity, back angle, [then] compared to somebody in a lighter-weight, rigid frame, but the angles are terrible, the seat width is too wide and too long, and there’s not enough inclination — the person in the heavier chair might be able to go longer and do more during a day because the setup is better. So it’s not just about the frame weight. You’ve got to consider all the other components of the chair and setup of the chair.”
Sayre, who is also a Certified Environmental Access Consultant, said she also looks for environmental causes of fatigue. “When I do home evaluations, the first thing I look at is the carpet. My suggestion is always to do a laminate or hardwood [floor]. With tile, you have grout lines and have to go over those.
“If they’re going to stick with carpeting, [I prefer] a very commer- cial carpeting because you don’t want that high or medium pile that makes [propelling] very difficult. I have carpet samples that I take for them to roll over. Sometimes you have to prove it to them. They don’t think it makes a difference until you show it to them.”
Wenzel also noted that fine-tuning an ultralightweight chair for the best outcomes is an ongoing process. “It’s critically important that it’s not a one-time set-it-and-forget-it,” he said. “You can get a wheelchair and have one or two years go by, then go back for an evaluation, and there could be changes in the wheelchair user, in width or depth. It’s important that consumers understand it’s not a set-it-and-forget-it.”
Consumers, he said, need to “stay in tune with your chair and in contact with your therapist and ATP, because if you’re experi- encing pain and fatigue, there may be an intervention with your chair that could be made to help you.”
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