In life there are unexpected traumas, tragedies and health issues that can cause a dramatic turn in how we live our lives. A terrible injury or illness could leave someone facing a change in how they navigate the world.
A wheelchair can be a useful tool to help someone continue being mobile as they heal or regain independence. Patients can choose from a variety of manual or automatic wheelchairs depending on their needs.
Regardless of which type of device patients choose, learning to use a wheelchair isn’t as simple as hopping in and going. Like a bicycle or rollerblading, using a wheelchair safely and effectively requires practice and skill.
But with a little time and effort, using the two-wheeled device can become like second nature, allowing patients to regain their autonomy and confidence. Tidewater Physical Therapy offers wheelchair safety training and tips to maximize independence.
Practice makes perfect
The daily act of living requires wheelchair bound patients to reach, bend and transfer in and out of a wheelchair. Like a well choreographed dance, these movements involve timing, balance, proper weight distribution and a confident center of gravity.
Before a patient ever tries to negotiate a wheelchair, he or she should practice bending, reaching and transferring in several combinations with the assistance of a healthcare professional, such as a physical therapist, to make sure they’re comfortable with the movements.
When reaching forward, never try to grab an object if you have to move forward in the seat or reach to the floor between your knees. Reaching and bending backward follows similar rules. Position the chair as closely as possible to the object you need. Reach back only as far as your arm will extend without changing your sitting position. If you can’t reach it that way, then you’ll need to come at it from another angle.
Proper positioning and technique while maneuvering a wheel chair is essential for safety. And it isn’t just how you move your body that’s important.
Using elements of the chair, such as the wheel locks and casters (small wheels in the front of the chair), can help with stability and balance while moving in a static chair. Keeping the casters facing away from the drive wheels will create the longest possible wheel base when reaching back. They should also be extended away from the drive wheels while reaching forward, but in that case you should also make sure to use the wheel locks for better traction and stability.
Out in the real world
Once you get the basics of using your wheelchair, then you should practice with a therapist in real-world settings so you can safely traverse streets, curbs, hallways, parking lots, ramps and rough terrain. You should also practice using your wheelchair at home, work and in the community.
For patients who will be using their wheelchairs for extended periods of time, don’t forget to adjust for comfort every so often. Patients should perform pressure reliefs regularly to avoid back discomfort and skin breakdown (which could lead to pressure sores).
Initially pressure reliefs should be performed every 15-20 minutes until skin develops a tolerance for prolonged sitting. To relieve pressure, patients can push up in the chair by placing their hands on either side of their body laterally in the seat or on the armrests and extend their elbows to push down and raise their bodies. Patients with less upper body strength can choose to simply shift their torso either forward or side to side, until the weight has been lifted from their lower back and buttocks.
You can’t safely maneuver a wheelchair if you’re achy and uncomfortable.
Know your capabilities and limitations
Perhaps the most critical thing to know about using a wheelchair is what you can and cannot do safely. It’s important that patients know their own capabilities and limitations. Using a different set of muscles and skills to propel yourself forward is challenging. In order to do it safely, you must be able to recognize when you need to ask for help.
For example, patients new to wheelchairs need to consider their abilities before attempting to tackle an incline or decline alone. A therapist can help you learn to safely negotiate these obstacles, but it may take time before you can independently glide up or down a ramp or curb.
And if things go wrong – which they may – it’s important to work with a therapist to learn how to fall safely. Although counterintuitive, there are ways to fall that will minimize risk and injury. The first thing to know is never reach out one hand with the elbow extended in an effort to “catch” yourself. It may seem like the natural response, but it puts you at risk for a muscle pull, sprain or break.
Instead, a therapist will take you through a series of practice maneuvers involving a chair fall where patients tuck their heads, while holding the wheels and blocking their legs. Patients must also know how to move their bodies depending on their injury or disability if their chair is overturned.
Knowing how to maneuver your body and the wheelchair in concert under any circumstance is key. That’s how you get back to living.