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The effect of a disability affecting the lower limbs is to isolate the individual from the
rest of the community. He can so easily become house-bound, room-bound or even bed-bound. The
self-propelling wheelchair, properly prescribed and well fitted, goes far to solve this problem.
Unfortunately there is often not enough critical thought given to its selection for the individual
patient. He usually has to sit in it all day and the size should be such that he is comfortable
and well supported. The length and width of the chair restricts or aids its manoeuvrability in the
home or at work. Narrow doorways may prevent the entry of a chair to a room. A wider doorway
through which it can pass may not allow ingress if the passage is too narrow to allow the chair
to turn. Making an extra wide doorway calculated with the measurements of the chair in mind may
be one way in which to overcome this problem.
If the chair user is able to stand by holding the chair arms then the footrests must be
folding or swivelling so as to allow clear floor space on which to stand in front of the chair. The
swivelling footrests will also help in reducing overall length of chair when space is tight when
considering accessibility to rooms from narrow passages. Arm rests may need to be removable
when the user needs to sit near the table or has to slide from one sitting area to another if he
cannot stand. To cope with this problem space may have to be allowed for the chair next to the
toilet pan. It is not always possible to make space available at the side of the pan and then the
toilet seat may need to be raised to the height of the chair seat so that the user may slide forward
from his chair to the toilet and sit on the pan back to front. The chair should be folding so that it
may be transported in a car. Solid tyres are more practical than pneumatic ones. All chair users
should be provided with a pick-up stick as so many persons have fallen out of their chairs when
trying to retrive from the floor something which has been dropped. Not all disabled people have
sufficient strength to propel themselves by pushing on the rims fixed to the large wheels and in
such cases indoor electrically propelled chairs may be supplied, powered by batteries which have
to be recharged overnight.
Outdoor chairs and carriages are also available, comprising hand-propelled push-pull
lever or rotary handle types and pedal tricycles which are all exposed to the weather, electrically
propelled enclosed carriages and petrol driven enclosed carriages. Recent legislation has
extended these official issues to include, in certain conditions, motor cars with hand controls
replacing foot controls.
Many handicapped people, once in a chair, can be largely independent but there are those
who need to be lifted into and out of their chairs because of weakness of the shoulder girdle
muscles and for these persons the supply of some kind of lifting hoist is as important as the
supply of the chair. This aid does not only help the handicapped persons to be lifted easily and
without the manhandling which is so often distressing to them but also takes the strenuous
physical effort out of the performance which has to be endured by the members of the household
caring for them. There are three main types of lifting appliances; those which are mobile, those
attached to ceilings and/or walls and those fixed to the bed. The mobile hoist has to be worked
by a helper and can be used in bedroom, toilet, bathroom and living room. The hoists attached to
ceilings and/or walls are limited as to the site at which they operate and also as to the type of
construction of the building. Those fixed to the bed are also limited to lifting a person from bed to
chair or to any other facility next to the bed. The hoists which are not mobile could be operated
by the handicapped person alone providing he has a certain amount of strength and grip in his
hands and arms. These lifts can be of the industrial block and tackle type geared to the correct
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