Contributed by Malcolm Turnbull
There are some amazing new assistive technologies available in today’s marketplace. One of the most sought-after innovation are power assist options for manual wheelchairs. Read on to find out Malcolm Turnbull’s take on the various ways you can power your manual wheelchair, and the health and lifestyle benefits they offer.
Over the past several years the number of options for power assist add-ons to manual wheelchairs has grown rapidly. One reason for this is that research has shown that a high percentage of long term wheelchair users will experience upper extremity injuries. This includes shoulder pain, elbow pain and Carpal Tunnel syndrome.
To summarise the recommendations/guidelines, the main cause of upper limb pain is repetitive strain injury – in other words over use. Some of the recommendations to help prevent pain include:
- having an ultra-lightweight wheelchair that is custom made to fit the individual and set up to the optimal configuration for the individual
- having the most efficient push technique
- having good transfer techniques
- doing strengthening and stretching exercises
- reducing the number of pushes in any given day, and
- considering transitioning into a power chair earlier instead of later
In addition to power assist options helping to reduce the number of pushes, and the force required to push, they are also a great lifestyle option. Whether for work or leisure, power assist options can open up opportunities to go further, to explore new places, to go to places that would otherwise be way to hard and to do all this with friends and family. If there are places local to your home that you like to go they can also reduce the need to lift chairs in and out of cars and the stress of finding carparks!
With that somewhat long introduction, let’s get into some of the options out there. I will list what I see as the pros and cons of three of the most common options. Others may have differing opinions so always do your own research and seek input from other users if you are interested in investing in a power assist add-on.
The SmartDrive burst onto the market 2012 and has progressed rapidly since then. The latest model is the MX2+ which features the PushTracker™ (a wrist band) which connects to the SmartDrive via BlueTooth™. The wristband then becomes the controller for the SmartDrive, being activated by taps on the wheelchair pushrim. As well as functioning as the controller, the wristband enables settings such as top speed to be customised, keeps a track of how many pushes the user has done and how far the SmartDrive has powered the wheelchair as well as other features. There is also a PushTracker App which allows for the firmware/Bluetooth firmware in the PushTracker and the SmartDrive to be updated wirelessly.
With the SmartDrive my wife and I have explored many places I would not have done without it, including in Sydney, Thailand, the mountains of Northern Italy, London and lots more.
- Requires the user to have fair level of wheelchair skills
- Requires the user to have good cognitive skills
- Does not provide brake assist when going down hills
- There can be disconnection problems in areas with high wireless activity
- Not good on gravel/sandy/muddy surfaces
- Require zero pushes to get mobile!
- Requires next to no hardware on rigid frame chairs, hardware is available for folding chairs
- Extremely powerful, will get up really steep hills
- At about 6kgs it is very portable, can be used domestically or internationally
- Can be programmed to the individual’s capability
- While on the wheelchair the user can choose to use it or not use it
- If the SmartDrive battery runs out you can push the chair until you can get to a charger
- Does not increase the overall length of the wheelchair so can be used anywhere the wheelchair can go
The devices have been popular in Europe for many years and have finally found their way to Australia. Three or four years ago you would have been hard pressed to source one here, now there are a dozen or more brands on the market. This is a category within a category, so if you are considering one of these then do some research into the features of the different manufacturers and models.
If you are not aware of this type of product, imagine half an electric push bike with a hand throttle and brakes that has a way of attaching to the front of the wheelchair (you can see mine in the picture at the top of this article). Once attached the handbike is elevated to lift the small front castors of the wheelchair off the ground, turning the wheelchair into a powered trike. I have one of these in my garage and when I am going anywhere within 5-10km of my home, and the weather is good, I use this which saves the wheelchair transfer into my car and the hassle of finding a car park. Because they easily detach I can take it off while in a restaurant/café and have fun watching people trying to work out what it is!
- Not easily transported independently, they tend to be quite big and heavy. May not fit into cars for transport
- If it does not have reverse it can be a challenge to manoeuvre
- Most of these devices require some sort of hardware be attached to the wheelchair which can add weight
- If you do get a flat battery you would have to find a way to get it home, pushing the wheelchair while it is attached would not be possible
- They do increase the overall length of the wheelchair so can be challenging indoors
- Zero pushes need to get mobile!
- Disc brakes for going downhill or when needing to slow down
- With the front castors raised the risk of falling out frontwards is minimal
- The larger front wheel goes over rougher terrain, however the front wheel can “slip” on steeper hills and slippery surfaces
- Easy on and off means it can be removed when going into shops or tighter areas
- With some pre-planning can be taken overseas or domestically
Power Assist Wheels
Power assist wheels are wheelchair wheels with an electric motor with the ability to program to the specific needs of the user. Some offer an optional device to change programming and monitor battery level/fault detection remotely. Power assist wheels will fit onto most wheelchairs but do require some modification. The user is still required to push the chair, but the force required is programmed to the individual and a greater distance per push is delivered, thus reducing stress on the upper limbs. As well as being programmed to suit the individual’s ability to push, they can be programmed to assist braking when going downhills. Each wheel can be programmed individually for those who have strength differences on the left and right sides.
- The wheels tend to be heavy, the most common brand being 11kgs per wheel. This makes independent transportation challenging
- Can increase overall width of the wheelchair by 2-4cm
- Once on the option to push without power assist is not there, although two power assist options can be programmed. The adaptors for the power assist wheels do not allow for the “normal” wheels to be put on
- Can be programmed to take away up to 80% of the force needed to propel the wheelchair
- Programable to the individual needs, and for people with differing strength on left and right
- Provides brake assist, especially useful when going downhills
- An “anti-rollback” feature stops the wheelchair from rolling backward between pushes when going up hills
- Option of remote programming and monitoring
- The need to push may have advantages for some people, maintaining range of movement and body movement training
Want to Find Out More?
If you’re interested to learn more about these options, I would encourage you to do some desktop research then go and test the options that interest you so you can get a feel for the equipment. Below are some useful links to help you with your research.
SmartDrive Product Information
Power Assist Wheels