Tilt, Recline, Leg Lifts
Tilt and recline and power leg lifts are features you will need. Tilt angles the chair backward for periods of
pressure relief and also makes it much easier to get you scooted back in the chair so you are seated comfortably.
Recline lowers the backrest and when used with the leg lifts can let you lie back in your chair with your feet up.
Recline won't get you flat but when used with tilt it may. Standard power leg lifts are fine for adjusting
your legs while sitting up, but when you lie back in your chair and raise the footrests, the footrests are
suddenly too short! Your knees have to bend or you need a big pillow to get your heels above the footrests. Very
inconvenient and hard to get comfortable! The solution is to order "articulating" leg rests. These lengthen as
they lift so that your legs aren't scrunched even with the legs all the way up. Comfortable for elevating your
feet to reduce swelling or just catching a nap! All this is necessary for comfort, preventing pressure sores,
naps, dentist visits, and any woozy spells if you are prone to fainting.
The ROHO comes with a hand pump and patch kit. New cushions have Smart Check for determining the proper inflation
for a specific user. It is essentially a glorified tire pressure gauge but it something users have wanted for
years! It saves a lot of the trial and error adjustments of older cushions.
Rear, Mid, or Front Wheel Drive
For anyone without the Smart Check, here is how to set up a ROHO air cushion. I suggest pumping the cushion up fairly full, then leaving the valve open for about 15 minutes. It won't deflate completely, just remove excess
air. Then get into your chair and sit on it. It will still feel rock hard and need to be deflated more! You are
not supposed to sit ON the cushion, but rather to sink down and sit IN it. Have a helper put their hand, palm
down, under the bones of your butt to help check the inflation. They should be able to wiggle their fingers just
a little without feeling them bottom out on the metal of the seat pan. You will have to open the valve while you
are sitting on the ROHO to force more air out—and you will probably be surprised at how much air has to be pushed out before the cushion is comfortable. If you find you have let out too much air and are bottoming out,
just use the pump to add more. That can be done even while you are sitting on the cushion. It will probably take a couple of tries to get it inflated/deflated to where it is comfortable, but once you do it won't need adjusting for months. All this fussing around to get the pressure right is necessary and well worth the effort!
The big decision with a power chair is the type of drive; rear, mid, or front wheel drive. There are pros and cons
to each type of drive. Ideally, you would have the opportunity to try each type in your home and outdoors on the
terrain you are likely to encounter. That is a joke. Few vendors have a demo chair of each type for you to try.
Most will be more likely to have one or no demo chairs. There are some differences between drives that can help
determine what should work best for you.
- A rear wheel drive is good for
outdoor use off sidewalks. The push provided by the rear wheel drive can get it up and over most smaller
obstacles allowing it to travel well over lawns, light snow, rough ground and trails as well as up driveway
curbs. It handles higher speed smoothly, making it the best choice if you want a chair that will travel any
distance efficiently and quickly. Indoors, a rear wheel drive has a somewhat larger turning radius but works
well. It moves smoothly without the lurching that is synonymous with mid-wheel drive. It steers and turns corners
intuitively making it easy to drive.
A problem with mid-wheel drive that never seems to be mentioned by the manufacturers but does come up in
discussions by mid-wheel drive owners is called Caster Jerk. This is not the typical flutter of any caster. It is
a jerk or lurch to the side.
Any wheelchair has some caster jerking as the casters swivel 180 degrees from forward to backward. There is
resistance to the swivel until it reaches 90 degrees and then it finishes the swivel quickly causing a little
jerk in direction. The movement is slight and soon ignored.
With a mid-wheel drive, however, there are four casters attempting to change direction 180 degrees. The jerk is
accentuated and can be a problematic lurch to the side. This is minor and easily accommodated to in average size
rooms where the casters have enough distance to travel to move more smoothly through the swivel. This can be
adjusted with steering control settings or may require moving the entire seat on the base. It cannot be
In small spaces, it becomes a significant problem if it is necessary to back up, turn, and pull forward again to
position the chair correctly. When there isn't enough space/distance for the casters to swivel smoothly, they
jerk the chair quite powerfully to one side. The leg rests and foot plates bash walls, scratch furniture, and
inflict great pain on any ankles that get in the way! The jerk occurs even after the joystick is released and
even if you attempt to steer to the opposite side. Perhaps the most frustrating aspect of caster jerk is that
once you are in a tight space you can't adjust the position of the chair without repeated jerks. Times when
you are likely to encounter jerking include maneuvering in a small bathroom to position the chair accurately
beside the toilet or at the sink, at a computer desk where you need to be centered and straight on, in a van
where you need to face forward in alignment with the tie downs, in doctors and dentists exam rooms, restaurants
and buildings with small entries.
If the jerking problem isn't severe, most users become accustomed to, and they love their mid-wheelchairs, but
will admit jerking does occur and is annoying. People for whom the mid-wheel drive is their first chair accept
the problem as part of wheelchair life.
- The drive most often recommended for
those whose main use will be indoors is the mid-wheel drive. It has the smallest turning radius so it can turn in
an area slightly larger than the chair itself. Outdoors a mid-wheel drive chair can get hung up on uneven, soft,
or snow covered ground or on badly cracked sidewalks or streets. If the front or rear casters are on top of a
high spot, it can leave the chair resting on the other set of casters with the drive wheels off the ground and
spinning uselessly. Climbing any curb cut out that is not fairly level and gradual can cause this and require a
ramp. Driveway curbs fit this category but unlike sidewalk curb cuts, are wide enough to be climbed by driving up
at an angle.
- Front wheel drive is not as common.
It is the best for climbing over obstacles as high as two inches or more such as curbs and does so without taking
the bump at high speed. It can handle snow, gravel, and rough terrain but tends to fish tail at higher speeds so
has lower speed built in.