The Importance of the Perfect Fitting Wheelchair

December 9, 2015
Choosing the perfect fitting wheelchair

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Mobility aids are an essential element of disability health care and play a key role in the lives of millions of patients and across the globe. Wheelchairs help patients move from place to place independently, reducing the strain on caregivers and improving the confidence and security of patients. However, with more than 90% of patients complaining of seating discomfort or pain in a recent study, the importance of choosing the perfect fitting wheelchair should not be underestimated.

Whether you’re looking for a manual wheelchair, or are seeking a more heavy-duty power chair, there are a number of factors that you should take into account when selecting a wheelchair. Keep reading to view our comprehensive guide to finding the perfect fitting wheelchair.

A Guide to Finding the Perfect Fitting Wheelchair


Image by Daniel Hoherd (Flickr)

Most wheelchair users spend much of their time seated and carry out a range of daily functions from the safety of their wheelchairs. Hence, the perfect fitting wheelchair should be comfortable and provide proper structural support and alignment for the trunk, pelvis and lower extremities throughout the day. Regardless of which type or model of wheelchair you’re aiming for, the perfect fitting wheelchair should provide a snug fit and have adequate adjustability.

Seat Width

Wheelchair width

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Seat width is one of the key factors to take into account when picking out a mobility aid. To obtain the best wheelchair fit, make sure that your hips fit snugly in the seat. Most of our models feature 16-20″ seats, but we also provide pediatric and bariatric wheelchairs with seat widths ranging anywhere from 14-40”.

Over time, seats which are too wide for users can cause discomfort and even lead to conditions such as pelvic obliquity and scoliosis. On the other hand, seats that are too narrow can cause rotational deformities and increase pressure on the lateral thighs and lower limbs. As a rule, the perfect fitting wheelchair should be just wide enough to accommodate your hips and buttocks without cutting off ventilation or impairing wheelchair transfer.

We carry a number of wheelchair accessories that are designed to improve your user experience while on the move. If you suffer from back pain or need additional therapeutic support, take a close look at our seat cushions, backrests, position belts, and oxygen tank holders.

Seat Depth

Seat depth

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Seat depth is another factor to weigh when choosing a wheelchair. This measurement is determined by the distance between the back of the buttocks and the back of your knee. As a rule, your seat should be 2” shorter than the distance between your shoulder and the handrims, and 4” shorter than the distance between your knee and the footrest, but this can vary slightly from person to person.

Be sure to avoid deep-seated wheelchairs, as they can cause kyphosis and pelvic tilt, and impede easy transfers, reduce maneuverability, and heighten the risk of skin breakdown or pressure sores. Wheelchair seats that are too shallow can cause hip external rotation and abduction and increase pressure on IT’s, which only goes to show the importance of choosing the perfect fitting wheelchair. In the long run, poor posture can contribute to back and knee pain and significantly reduce the quality of life of full-time wheelchair users.

Seat Height

Wheelchair seat height

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Next, consider seat height. It’s crucial that your wheelchair is raised at least two inches off the ground, with ample room between the floor and the chair’s footrests providing good propulsion efficiency and a smooth ride. Some patients may prefer to set their seat low and close to the ground but risk serious injury to the feet and ankles in doing so. If the seat is raised too high, however, wheelchairs users will lose control and may have difficulty maneuvering their chair. Height-wise, the perfect fitting wheelchair should make for easy transfers onto beds and other surfaces, and may be adjusted for use at a table or desk.

Leg Rest Length and Footplate Height

leg rest height

When choosing the perfect fitting wheelchair, make sure that the leg rests and foot plates are the appropriate size and length. The amount of time and pressure applied on these wheelchair components varies widely from user to user, as patients with higher mobility levels may remove leg rests in order to propel themselves with their feet.

Nevertheless, for the best wheelchair fit, make sure that your feet fit comfortably on the footplates without rotating sideways and your thighs and knees remain low on the cushioned surface. Avoid raising your knees above hip level, as sitting in this position for long periods of time will cause back pain and increase hip abduction pressure and stress on sitting bones.

Back Width and Height

Wheelchair back width and height

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The width of the back of the wheelchair is similar to that of the seat, but can differ from it if you use a secondary positioning support such as a backrest or pad. With a host of seating and back options available to suit the therapeutic needs of patients suffering from pain, kyphosis or scoliosis, it’s a good idea to choose a wheelchair that can accommodate backrests and other secondary supports.

Getting the back height right is crucial to avoiding additional kyphotic pressure and reducing strain on the torso. For the proper wheelchair fit, make sure that your back is pressed against the back pad and your chest is perpendicular to your thighs, which will give you both propulsion efficiency and adequate trunk support. The perfect fitting wheelchair should also be wide enough to allow postural readjustments without inhibiting movement.

Choosing the Perfect Fitting Wheelchair: Armrest Height

Armrest height

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For the perfect wheelchair fit, the patient’s elbows should lie below shoulder level when resting on the arm supports, with the upper and lower arms forming a right angle. Armrest height is a very important factor, as a low armrest setting can lead to shoulder subluxation while a high setting can cause joint pain, kyphosis or put stress the sitting bones. Remember to keep your shoulders relaxed, your forearms placed on the arm supports, and your back against the cushion.

Manual Wheelchairs and Power Wheelchairs


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To obtain the best wheelchair fit, make sure you talk to a trained professional or therapist and go over your options before settling on a specific model. If you’re recovering from an injury or require an upgrade on your current model, talk to one our experts to get the full benefit of their knowledge and expertise on the latest technologies and industry trends.

When it comes to choosing the perfect fitting wheelchair, age and strength are important factors to take into consideration, as not all wheelchair users can propel themselves across different surfaces and inclines.

Manual wheelchairs provide physical support for the disabled and elderly while also allowing patients to rely on their upper body strength to maneuver around independently. Fitted with folding mechanisms, handgrips, height adjustment devices and a range of other accessories, self-propelled wheelchairs are the ideal solution for active users with high aerobic endurance and come in a number of different models and designs to suit individual needs and preferences.

manual wheelchair

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The Quickie 2 Family is a great all-around manual wheelchair and can be easily adjusted to accommodate your needs. The Quickie Xtender Power Assist, a lightweight powered manual wheelchair, provides the perfect middle-option between self-propelled chairs and high-end power wheelchairs.

Motorized wheelchairs are a great option for those who need extra support and power while on the move. Mid-wheel drive power chairs are designed to provide a comfortable and safe ride, with great performance and control offering users speed and incredible movability over a range of surfaces. For more information, make sure you read our previous post on motorized mobility aids.

Discharge Planning

If you’re planning to leave hospital soon or need to be transferred home, Macdonald’s will work with you, your caregivers and family contacts to provide the perfect mobility solution for you.

For more information about wheelchairs, contact Evan. He’ll be happy to assist you with all your questions.


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