Choosing a Wheelchair: A Guide for Optimal Independence.

Choosing a Wheelchair: A Guide for Optimal Independence

Karp G. Sebastopol; CA 95472, O'Reilly & Associates, 1998, paperback, 180 pp, illus, $9.95.

An endorsement for this book by Barry Corbet, Editor of New Mobility Magazine, reads: "I love the idea of putting knowledge often possessed only by professionals into the hands of new consumers." The author, a wheelchair user himself, admirably succeeds in doing just that. He has translated the very complex and sometimes overwhelming process of choosing a wheelchair into an understandable and easy-to-read format.

One of a series of patient-centered guides, this book was written to help consumers become informed decision makers in the wheelchair selection process. It is geared primarily toward the independent adult wheelchair user, but much of the information is applicable to other populations.

The first chapter provides a brief overview of the growth and evolution of the wheelchair industry. Chapters 2 through 5 introduce the reader to the process of selecting a chair as a whole. These chapters discuss the advantages and disadvantages of large versus small manufacturers, funding sources, the selection process, and the consumer's role in that process. These chapters stress the need for consumers to be their own advocate, particularly with funding sources, and the importance of being prepared for consultation appointments. The discussion of the selection process emphasizes a team approach, with physical therapists, occupational therapists, and experienced specialists in durable medical equipment as integral members of the team.

Chapters 6 through 8 discuss the options to consider when choosing between a manual and a power wheelchair. Chapter 6 explores factors to consider in determining whether a power wheelchair or a manual wheelchair, or a combination of both, would be appropriate. A discussion about scooters, an option for some, is also included. Chapter 7 considers the options available to users of manual wheelchairs, such as a rigid versus a folding frame; the size and type of wheels; and the placement and angle of wheels, hand rims, and wheel locks. Chapter 8, "Power Chair Decisions," discusses aspects of the decision that are unique to power wheelchairs, including choosing front-, rear-, or mid-wheel drive; direct drive versus belt drive; control systems; batteries; speed; and safety.

Chapters 9 through 14 describe and compare components that are common to both manual and power wheelchairs, including seat cushions; seats and backs; footrests, tires, casters, and suspension systems; tilt/recline systems and positioning systems; and armrests, clothing guards, and accessories.

In chapter 15, the author discusses the essentials of wheelchair maintenance and offers tips about what to look for to avoid problems. Wheeling style and technique are discussed in chapter 16. The principle of mindfulness and its application to wheelchair use is introduced in an interesting part of the chapter called "Zen Wheeling." According to the author, wheeling with mindfulness helps to preserve energy, reduce stress, and prevent accidents. The author espouses a slower and more relaxed wheeling style to save energy and reduce cumulative strain on the upper extremities. He also stresses the importance of using "wheelies" to get over obstacles.

In the last part of the book, 2 checklists summarize features and options for both manual and power wheelchairs. A bibliography containing 9 references and short lists of publications, Internet resources, and equipment manufacturers are also included. The publications listed are geared toward adult wheelchair users or cover general-interest topics on disability. The Internet resources include Web sites focusing on general product listings or discussion groups.

I found this book to be a good introduction to wheelchair selection, particularly for people who are using wheelchairs for the first time. It offers a good mix of basic medical and practical information using a style and language appropriate for the average consumer. Through his writing, the author also provides some emotional support and, at times, offers a perspective that only another wheelchair user could share.

The advantages and disadvantages of different types of wheelchairs and seating components are clearly stated, and no single feature or product is unfairly promoted or emphasized over another. Although a few specific manufacturers' products are pictured or mentioned for illustration purposes, the author wisely keeps this to a minimum. Rather, he focuses on features common to most systems, which will prevent the book from becoming outdated too quickly.

This book would be a good addition to resource libraries for patients and their families. Physical therapist students or therapists new to the field of seating and mobility may also find this useful as an introductory text.

Gretchen Meyer, PT IPMR/Easter Seal Rehabilitation Center Peoria, Ill

Ms Meyer is Area Supervisor at the Easter Seal Rehabilitation Center and Adjunct Clinical Instructor in the physical therapy program at Bradley University. She specializes in the provision of adaptive equipment and wheeled mobility systems for both children and adults.