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SCI Forum


Manual Wheelchair Guide

By Elisa Smith, PT, DPT, NCS and Holly Wakefield, PT, DPT, NCS, Rehabilitation Medicine, Harborview Medical Center.

Presented on April 12, 2016 at the University of Washington Medical Center.

Your wheelchair must meet the needs and demands of your life. The best path to getting the right manual wheelchair is to learn as much as possible about wheelchair features and design so you can advocate for yourself. In this forum, Harborview rehab physical therapists Elisa Smith and Holly Wakefield discuss manual wheelchair design concepts and explore a range of customizing options, including preparing your wheelchair for handling snow, picking more comfortable handrims, and matching your wheelchair to your ability to walk part of the time. This forum video will help you navigate the maze of old and new products on the market and empower you to advocate for the wheelchair you need.


Presentation time: 60 minutes. After watching, please complete our two-minute survey!

You can also watch this video on YouTube.

For a complete list of our streaming videos, go to http://sci.washington.edu/info/forums/forum_videos.asp.


  1. Dieruf K, Ewer L, Boninger D. The natural-fit handrim: factors related to improvement in symptoms and function in wheelchair users. J Spinal Cord Med. 2008;31:578–585.
  2. Edelle C. Field-Fote. Spinal Cord Injury Rehabilitation. F A Davis Company; 2009.
  3. Hastings JD, Fanucchi ER, Burns SP. Wheelchair configuration and postural alignment in persons with spinal cord injury. Arch Phys Med Rehabil. 2003;84(4):528-534.
  4. Hastings JD. Tips for choosing the right wheelchair. NW Regional SCI System Forum. Available at http://sci.washington.edu/info/forums/reports/wheelchair_choosing.asp. Accessed April 8, 2016.
  5. Mason BS, van der Woude LH, Goosey-Tolfrey VL. The ergonomics of wheelchair configuration for optimal performance in the wheelchair court sports. Sports Med. 2013;43(1):23-38.
  6. Mason BS, Van Der Woude LH, Tolfrey K, Lenton JP, Goosey-Tolfrey VL. Effects of wheel and hand-rim size on submaximal propulsion in wheelchair athletes. Med Sci Sports Exerc. 2012;44(1):126-134.
  7. Medola FO, Fortulan CA, Purquerio BM, et al. A new design for an old concept of wheelchair pushrim. Disabil Rehabil Assist Technol. 2012;7: 234–241.
  8. Odderson SR,  Jaffe KM, Sleicher CA, Price R, Kropp RJ. Gel wheelchair cushions: a potential cold weather hazard. Arch Phys Med Rehabil. 1991;72:1017-1029.
  9. Perks BA, Mackintosh R, Stewart CP, et al. A survey of marginal wheelchair users. J Rehabil Res Dev. 1994;31:297–302.
  10. RESNA Position on the Application of Ultralight Manual Wheelchairs. Arlington, VA: Rehabilitation Engineering and Assistive Technology Society of North America; 2012. Available at: https://www.resna.org/sites/default/files/legacy/resources/position-papers/UltraLightweightManualWheelchairs.pdf. Accessed March 29, 2016.
  11. Richter WM, Rodriguez R, Woods KR, et al. Reduced finger and wrist flexor activity during propulsion with a new flexible handrim. Arch Phys Med Rehabil. 2006;87:1643–1647.
  12. Ripat JD, Brown CL, Ethan,s KD. Barriers to wheelchair use in the winter. Arch Phys Med Rehabil. 2015;96:1117-1122.
  13. Ripat JD, Colatruglio A. Exploring winter community participation among wheelchair users: an online focus group. Occup Ther Health Care. 2016;30:95-106.
  14. Sauret C, Bascou J, de Saint Remy N, Pillet H, Vaslin P, Lavaste F. Assessment of field rolling resistance of manual wheelchairs. J Rehabil Res Dev. 2012;49(1):63-74.
  15. Smith EC. Get a grip: Handrims.  Northwest Regional Spinal Cord Injury System Newsletter. Available at: http://sci.washington.edu/tips/#handrims. Accessed: April 2, 2016.
  16. van der Linden ML, Valent L, Veeger HE, et al. The effect of wheelchair handrim tube diameter on propulsion efficiency and force application (tube diameter and efficiency in wheelchairs). IEEE Trans Rehabil Eng. 1996;4:123–132.
  17. van der Woude LH, Bouw A, van Wegen J, van As H, Veeger D, de Groot S. Seat height: Effects on submaximal hand rim wheelchair performance during spinal cord injury rehabilitation. J Rehabil Med. 2009;41(3):143-149. 
  18. van der Woude LH, Formanoy M, de Groot S. Hand rim configuration: effects on physical strain and technique in unimpaired subjects? Med Eng Phys. 2003;25:765–774.

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