By:  Lisa Hilborn

Fostering a love for movement is especially important for young and/or newly injured individuals who use wheelchairs, as it can nurture a lifetime of physical activity for a population that may have limited movement opportunities. Pushing a wheelchair that is not specifically configured to oneself is extremely inefficient. It would be parallel to walking in a sumo suit or playing tennis in goulashes; it certainly does not foster a love for movement.

There are a variety of considerations when configuring a wheelchair that go far beyond seat width and backrest height. Factors that must be carefully contemplated include the use of a rigid or adjustable frame, seating bucket, strapping, sports played, and use of technological advancements.

Considering the vast evolution of wheelchairs during the past decade and a half, the development of sport wheelchairs is in its infancy. Even the stigma that has so often surrounded “the wheelchair” is disappearing with the integration of modern technology and customization.

Configuration of Sport Wheelchairs

There is a multiplicity of factors to consider when adjusting a wheelchair relative to the demands of a sport and, even beyond that, a specific position within the sport.  For example, similar to stand-up basketball, a “guard” benefits from a shorter, more agile wheelchair, whereas height would be a key factor for the “center.” Centers require a seat-to-floor measurement of up to 21 inches thus towering over the typical 16- to 19-inch seat-to-floor heights of everyday wheelchairs. On a somewhat similar note, a tennis wheelchair is designed to be nimble.  Its lightweight and highly cambered design enables the user to glide effortlessly across the court, changing direction with a tilt of the head, shift of the shoulders, or light brush against the wheel.

On the other end of the spectrum, quad rugby is a hard-hitting, fast-paced game. As such, the wheelchairs are heavy and low to the ground, with thick tubing that resembles tanks.  Every component of a rugby chair is designed to rock the opponent or render them immobile.  Regardless of its configuration a wheelchair with an adjustable frame is heavier and more prone to continual maintenance and repair than a rigid frame but provides the novice user a greater degree of adjustability in seating position.

Appropriate Use of Seating Bucket

Individuals who lack sitting balance and/or compete in high-contact sports, such as quad rugby, may increase stability and thus enhance functional ability by adding seating bucket.

Seating bucket, or “dump,” is created through drawing the knees closer to the chest by raising the front of the seat sling and “dumping,” or dropping, the bottom of the seat sling.  In essence, the athlete sits in a negatively angled seat sling that reduces the distance one’s trunk falls before making contact with the knees. Seating bucket also increases the stability of a chair during high-contact activities such as quad rugby, as the center of gravity is closer to the ground.

Sitting in bucket for an extended period  of time can be detrimental to the health of one’s skin as the majority of weight is born by the Ischial Tuberosites. To protect against skin breakdown, it is important to reconfigure the buttocks by frequently engaging in pressure relief, proning, or sitting in an everyday chair.

Effective Strapping

Strapping one’s core, legs and feet to the chair is an effective way to enhance balance and become “one with the chair.” In effect, the chair becomes a mere extension of one’s body, allowing the user to effortlessly change direction through enabling the body and the chair to work in unison.

Without the use of strapping, an aggressive turn will render paralyzed legs counterproductive as they fall in the direction of the momentum. An athlete utilizing effective strapping is able to manipulate the chair by counterbalancing his or her weight and fully using his or her hands to play the sport. Examples are to shoot a basketball, stroke a tennis ball or push aggressively to check an opponent.  An additional advantage of effective strapping is that the chair serves to protect atrophied legs during contact or a fall. In general, more strapping is necessary for people with higher lesion levels and/or complete injuries.

Application of Innovative Technology

If the past 15 years are any indication of the progress in store, we are legitimately in the infancy of wheelchair development. Advancements such as stronger, lighter frames made from titanium, increased customization, increased sport specificity, and benefits from advancements used in other applications indicate that the possibilities are endless. The development of dual wheelie bars, for example, is a customization that provides the basketball player with greater stability to tilt laterally and block a shot taken behind them.  This technological development has enhanced athletic strategy tremendously and has provided a more dynamic platform from which to progress.

Snowboard bindings, aka “ratchet straps,” have all but replaced the metal buckle and Velcro strap. The use of conventional metal buckles and Velcro straps may prove dangerous to an athlete who lacks the ability to feel the buckle rubbing against the skin, or may give way if overly saturated with moisture or sweat. The use of ratchet straps has become vital in a variety of sporting arenas. Specific to wheelchair basketball, for example, ratchet straps ensure that one’s core is maintained in an exact position within the chair, in the interest of precisely replicating a shot.

The integration of carbon fiber spokes, borrowed from the cycling world, has enabled athletes to optimize performance with wheels that are lightweight, strong, and more durable. These wheels have particularly impacted basketball and tennis wheelchairs, rendering the chairs lighter and more responsive. In addition, carbon fiber spokes allow athletes to tilt with smaller possibility of collapse commonly associated with metal rims. The integration of rubber-coated push rims is designed to mitigate overuse injuries – especially for those with tetraplegia – and serve as another tool to maximize performance.

With the never-ending desire to improve an athlete’s function in a wheelchair, the cutting-edge design of yesterday will be rendered obsolete with tomorrow’s innovation. Thus, each individual athlete’s skill level will be maximized and wheelchair sports will be catapulted to endless heights.

Funding

Specification, customization and use of innovative technologies specific to sport wheelchairs increase their expense to the point that it becomes difficult to entice insurance companies or Medicare to pay for them.  Nonprofits such as the Challenged Athletes Foundation and the Christopher and Dana Reeve Foundation are strong alternate funding sources.