Wheelchair Fitting

Original Editor - Your name will be added here if you created the original content for this page.

Top Contributors - Naomi O'Reilly, Simisola Ajeyalemi, Kim Jackson, Tarina van der Stockt, Shaimaa Eldib, Rucha Gadgil, Amrita Patro, Olajumoke Ogunleye and Robin Tacchetti  

Introduction

A properly fitted wheelchair provides comfortable seating and good back support, improving posture ultimately optimizing function. It has been estimated that 80-90% of individuals are not properly fitted in their current wheelchair as their bodies and needs change over time. Improperly fitting wheelchairs can lead to medical problems such as skin breakdown from pressure and rubbing, blood clots from poorly fitting seats and posture issues from misalignments. A wheelchair that does not fit properly may lead to pressure ulcers, poor posture, reduced balance, difficulty propelling the wheelchair, and difficulty with transfers.

The ideal sitting position for most people in a wheelchair follows the 90-90-90 rule; 90° bend in the hips. 90° bend in the knees and 90° bend in the ankle.

Measures of Wheel Chair Fitting

Wheelchair fitting focuses on five measurements.

1. Seat width: It is measured from the widest aspect of the user’s buttocks, hips or thigh. It should be wide enough to avoid pressure on the hips. You should be able to place your hands vertically between your hip and the armrest with slight contact between both. Average adult size is 18 inches.
2. Seat depth: It is measured from the user’s posterior buttock, along the lateral thigh to the popliteal fold with your palm horizontal to the seat. Usually, a space of about 2 inches is preserved to avoid pressure from the front edge of the seat against the popliteal space. You should be able to fit 3-4 fingers between the front edge of the seat and the back of your knee. Average adult size is 16 inches.
3. Seat height: It is determined by the height of the individual and if the wheelchair is self-propelled. When using the feet to propel. the seat height should allow for them to reach the floor with their heel. Those using footrests have higher seat heights. It is measured from the user’s heel to the popliteal fold. The bottom of the footrest is 2 inches from the floor. Average adult size is 19.5 to 20.5 inches
4. Armrest height: Should allow user sit erect, with level shoulders when bearing weight on the forearms as they rest on the armrest. It is determined by measuring the distance between the seat of the chair and olecranon and adding one inch. Average adult size is 9 inches above the chair seat.
5. Height of the back of the chair: The inferior angles of the scapula should be approx. 1 finger-breadth above the back when the user sits with erect posture. It is determined by measuring the distance between the seat of the chair to the patient’s axilla, and subtracting four inches. Average adult size is 16 – 16.5 inches

Resources

References