CLINICA L P ER S P E CT IV E - CE U AR TI C L E
WHY WE NEED TO CONSIDER THE DRIVE WHEEL ON A POWER WHEELCHAIR Written by: RACHEL FABINIAK, PT, DPT
NRRTS would like to thank Permobil for sponsoring this article.
C LI NICA L P E R S P E CTIV E - C E U A RTI CLE Did you ever wonder why some power wheelchairs can easily drive over rough terrain while others get stuck? Or why for some individuals, the inside of every door frame is destroyed from the wheelchair running into it? There are many variables on a power wheelchair which can impact the maneuverability, driving technique and even the comfort of the individual. For this article, we will discuss how the configuration of the drive wheel can impact more than just the look of the power wheelchair. First, we must start at the very beginning. The drive wheel on a power wheelchair is the larger wheel and is connected to the motors. The drive wheel location has a significant impact on how the power wheelchair drives and maneuvers in different environments. There are three main types of drive wheel configurations: front, mid drive and rear-wheel drive (see Figure 1). This article will explore drive wheel configuration pros and cons, selection considerations and how to teach an individual to drive each specific configuration. The drive wheel is in many cases the first consideration when prescribing a power wheelchair, but do we ask the right questions to really determine which option is best? Then, once the chair is delivered, do we work on the specific driving skills required for that configuration? Or, do we just have our standard driving instructions that we quickly run through? Confidence for an individual driving a power wheelchair was independently associated with less difficulty with activity, participation, increased life space and greater wheelchair skills (Mortenson, 2015). We must remember that each individual will need specific training based on their cognition, learning style, experience and environment of use. The research available on drive wheel configuration is limited and dated. Previously, we had built a good understanding through other industries of the
impact of drive wheel placement. This article may validate your current practice. This information may also challenge you to improve the way in which you work through the procurement of Complex Rehab Technology (CRT) for individuals with mobility impairments. A study by Ward, et al. in 2010 that examined the satisfaction of power wheelchair prescription for individuals with amyotrophic lateral sclerosis found that when an experienced therapist was involved in the prescription process, 87% of the individuals thought no changes were needed. This study also reported 69% of individuals test trialed more than one wheelchair. An individual may be able to use more than one drive wheel configuration and a comparison trial can help make a final determination.
MANEUVERABILITY: In order to determine which drive wheel configuration would be best for an individual, we have to understand how each configuration drives. The drive wheel is attached to the motors and
Drive Wheel Configuration
FIGURE 1-A
36
DIRECTIONS 2020.5
Front-Wheel Drive
FIGURE 1-B
Mid-Wheel Drive
FIGURE 1-C
Rear-Wheel Drive
