The Manual Wheelchair as a Personal Mobility Device – Erik Kondo

A few days ago marked my 39th year as a wheelchair user. That means for about 2/3rds of my life I have been using a wheelchair as my primary method of mobility. But simply using a wheelchair for a long time doesn’t mean you understand the performance, optimization, and dynamics of wheelchairs. The way you learn about these issues is the same way people become experts with other types of mobility equipment such as bicycles, skateboards, scooters, motorcycles, cars, ATVs. etc. They use them. They modify them. They experiment with them. They repair them. They try different types. They research them. They use them in varied environments. They typically own and use multiple types for specific uses. They come up with unique ways to use them. They learn from others like them. They are constantly tinkering with them and thinking about how to improve them.

Unfortunately, this is not the case in the wheelchair world. Rather than being seen primarily as a mobility device, wheelchairs are seen as primarily medical devices. As such, the medical community has deemed themselves to be the “experts” on wheelchair use. Despite the fact that most of them don’t actually use wheelchairs. What little training they do have on actual wheelchair use is typically only related to hospital style wheelchairs in accessible settings. Much of their knowledge comes from flawed academic studies which derive their results from using able-bodied subjects to “research” wheelchair propulsion and seating.

Imagine going to a bicycle store as someone who has never ridden a bicycle, and getting fitted for a bicycle by a salesperson who doesn’t ride a bike. The bicycles in the store are all manufactured by companies whose employees don’t ride bikes. You are accompanied by your family members, who give you advice on which bicycle to buy despite also not being bike riders. The one bicycle rider that you know, has only ridden one style of bicycle in their entire life. And they don’t like bike riding, so they do it as little as possible. While this situation never happens when obtaining a bicycle, it happens all the time with wheelchair users.

Given that there are lots of different types of wheelchairs, in this blog, I am going to focus on one category – manual wheelchairs for active users. Mountain bikes have a lot in common with road bicycles. But an article on mountain biking is not referring to road biking. Therefore, despite having many issues in common, I am specifically NOT talking about power wheelchairs, postural wheelchairs, pediatric wheelchairs, standing wheelchairs, temporary use hospital wheelchairs, other specialty wheelchairs and their respective users. I am only referring to issues related to manual wheelchairs which are used by people with sufficient upper body strength and metal capacity to independently propel them.

While it may seem that I am talking just about ultra-light wheelchairs (K0005), I am not. Rough terrain and recreational wheelchairs are not K0005, yet they are manual wheelchairs for active users. While a K0005 is suitable for some active wheelchair use, it is not best suited for ALL active wheelchair use. Getting back to the bicycle analogy, it is clear that the “best” bike is not just the lightest bike. The “best” bike is the one that performs optimally in certain situations and environments.

The reason I keep using the wheelchair/bicycle analogy is because a manual wheelchair is mechanically very similar to a gearless/chainless bicycle. The same materials and methods used to manufacture bicycles can be used to manufacture wheelchairs. A bicycle is essentially a two wheeled chair that is leg powered. Any person/company that can build a bicycle can also build a manual wheelchair. In fact, I believe it is much easier to make a manual wheelchair than a bicycle.

Manual wheelchairs and bicycles are personal mobility devices. One is arm powered. The other is leg powered. Bicycles are the most widely used, affordable, and functional personal mobility devices in existence worldwide. They exist in a huge variety of styles and prices. They are easy to find parts for and to get serviced. Their price point follows the Bell Curve with relatively few very cheap bicycles, many mid-priced bicycles, and few very high priced bicycles. Bicyclist skills also follow the Bell Curve. Most bicyclists have moderate skills, few are very poor bicyclists, and few are very skilled bicyclists.

On the other hand, wheelchairs follow the inverted Bell Curve (Well Curve) where there are very many extremely low priced wheelchairs (worldwide) and many high priced wheelchairs (in wealthy countries only) and few in the mid-price range. Most manual wheelchair users have acquired relatively low level skills, few have moderate skills, and very few have high skills.

If manual wheelchairs were treated like personal mobility devices similar to bicycles, millions of wheelchair users around the world would have access to affordable and functional wheelchairs. They would be able to get them repaired quickly and inexpensively. They would no longer be the least active demographic in society. They would be competent in basic wheelchair skills and have a relatively higher level of mobility. They would have access to a wide variety of true experts to help them advance their personal performance and knowledge.

But manual wheelchairs are only seen as medical devices and the results are dismal for wheelchair users as a whole, and particularly for those in low resource countries.