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What is Wheelchair Check?
Who is it for?
International
Why joining international collaboration
How to join
Evaluation use tool
Research
Background
Privacy Statement
Acknowledgement
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Wheelchair Check
HVV
Completing the Wheelchair Check will help you understand potential issues with sitting and driving in your wheelchair, such as pain, fatigue, and lack of support. The questionnaire also offers advice on resolving these problems, whether you use a manual, power-assisted or electric wheelchair.
Once you've completed the questionnaire, you can download a summary PDF using the download button. This PDF compiles all relevant information about your wheelchair in one place, which you can use for yourself, your wheelchair advisor, or therapist. You can easily share this PDF, along with other necessary forms (such as wheelchair application), via email or post. Collaborating and discussing solutions for any sitting or driving issues is essential, considering both the advantages and disadvantages, to make informed decisions. ©
What is your age?
What is your biological sex?
Male
Female
Prefer not to answer
What medical condition do you have?
Spinal Cord Injury (Paraplegia)
Spinal Cord Injury (Tetraplegia)
Spina Bifida
Multiple Sclerosis
Guillain-Barre Syndrome
Stroke/Traumatic Brain Injury
Leg Amputation
Congenital Brain Injury/Cerebral Palsy
Muscle Diseases
Ehlers-Danlos Syndrome
Annet
How many years have you been using a wheelchair?
Fill this in if you have been using a wheelchair for less than a year:
0-3 months
4-6 months
7-9 months
10-12 months
What type of wheelchair do you mainly use?
Note: Manual Wheelchair; including electrically supported systems (hand rims, joystick)
Electric Wheelchair
Manual Wheelchair
Foot-propelled Wheelchair
Push wheelchair (pushed by others)
For which wheelchair are you completing this screening tool?
Note: Manual Wheelchair; including electrically supported systems (hand rims, joystick)
Electric Wheelchair
Manual Wheelchair
Electric Wheelchair for sports
Manual Wheelchair for sports
Foot-propelled Wheelchair
Push wheelchair (pushed by others)
How many hours do you use this wheelchair per day?
on average
Which sport?
What is the brand of your wheelchair?
For example: Quickie Argon, RGK, Wolturnus, Kuschall
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How many years have you been using this wheelchair?
How many years have you been using this wheelchair?
Fill this in if you have been using this wheelchair for less than a year:
0-3 months
4-6 months
7-9 months
10-12 months
What is the approximate weight of the wheelchair including the seat cushion?
<15 kg
15-20 kg
20-25 kg
>25 kg
No idea
Consult a professional about the weight of your hand-rim wheelchair if you experience overuse symptoms, such as sore shoulders. Additionally, consider the weight when lifting the wheelchair in and out of a car, this is also important for caregivers.
How do you drive your electric wheelchair:
With a hand-controlled joystick
With a chin-controlled joystick
With a head-controlled joystick
How do you move your manual wheelchair
With both hands using the hand rims
With both hands using electrically-supported hand rims
With either or both legs (taking steps) and/or one hand using the hand rims
With hand joystick
Are you able to use your foot/feet from heel to toes when taking steps?
Yes
No, I can only take steps with the front part of the foot and or toes
Lower the seat height. Discuss the pros and cons of lowering the seat height with professionals.
Do you slide forward unintentionally with your buttock when taking steps?
No, I stay in place with my buttocks (against the backrest)
Yes, I slide forwards with my buttocks
Have the stepping and sitting position checked by professionals and discuss the pros and cons of possible changes.
How would you rate your wheelchair skills?
For example, proper wheelchair driving/propulsion, turning and maneuvering, going up and down a curb or a ramp, wheelies, etc.
Excellent
Good
Reasonable
Moderate
Poor
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Substandard wheelchair skills?
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Room for improvement/ substandard wheelchair skills
Do you need wheelchair skills training?
Yes
No
I would like training but I don’t think this is physically possible
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Do you want to have wheelchair skills training?
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wheelchair training
Contact professional trainers in a rehabilitation centre.
How would you rate the driving characteristics of your wheelchair?
This is about the wheelchair itself; how easy can you move it.
Driving= propelling in the hand-rim wheelchair or driving an electric wheelchair
Excellent
Good
Reasonable
Moderate
Poor
Contact the wheelchair supplier to improve the driving set up.
Rolling characteristics
Does the wheelchair move forward and backwards easily and smoothly when rolling (or taking steps)
Yes
No
Does the wheelchair move forward and backwards easily and smoothly when maneuvering (e.g. turning it)?
Yes
No
Does the wheelchair deviate from course when driving it straight ahead?
No
Yes
With the following questions about maintenance and set up we hope to find the possible reason(s).
Maintenance wheelchair
Do the large wheels sit firmly in the axle ?
(i.e., when pulling on the wheels, they stay firmly connected)
Yes
No
Beware, this is very dangerous. Have this repaired immediately.
Is there a wobble in one of the wheels (or broken spokes)?
No
Yes
This can make the wheelchair less able to turn or drive properly and can lead to overuse injuries. Therefore, have it repaired immediately.
Do all four wheels (i.e. large wheels and front caster wheels) rotate smoothly in their axles?
Yes
No
This can make the wheelchair less able to turn or drive properly and can lead to overuse injuries. Therefore, check to see if it’s dirty (e.g. hair or dirt) around the axles, and also check the ball bearings in the wheels for wear.
Do the stem bolts (maneuvering bolts) of both front wheels (i.e. casters) turn properly?
Yes
No
This can make the wheelchair less able to turn or drive properly and can lead to overuse injuries. Therefore, check the ball bearings of the stem bolt for dirt or wear.
Are the stem bolts (maneuvering bolts) of both front wheels (i.e. casters) vertical?
Yes
No
This can be a possible cause for left-right deviation and/or difficulty turning. Therefore, have the stem bolts adjusted, if possible.
Is the tire pressure optimal (i.e. hard) in all of the wheels?
Yes
No
This can make the wheelchair less able to turn or drive and can lead to overuse injuries. Therefore, inflate the tires until it is difficult to press them with your thumb (refer to the maximum allowed BAR on the sides of the tires).
Are any of the tires worn down or do they wear out quickly with normal use?
No
Yes
Wear can be caused by the wheels turning inward or outward (i.e. the wheels are not exactly parallel when driving the wheelchair (or when hand biking). Therefore, check to see if the wheels are parallel.
Do the brakes hold firm (i.e. don’t slip) during activities such as transfers (or on a slope)
Yes
No
This can lead to dangerous situations. Therefore, inflate the tires and/or have the brakes adjusted.
Wheelchair driving adjustments
Is your wheelchair properly adjusted for daily use (e.g. it doesn’t start to tip over making you almost fall out)?
Yes
No, the wheelchair tips forward too easily (e.g. when leaning forwards)
No, the wheelchair tips backwards too easily (e.g. when leaning backwards)
No, the wheelchair tips to the side too easily (e.g. when leaning sideways)
Please, consult your wheelchair supplier to check the wheelbase. If necessary, place the large wheels more to the front or the backrest more to the rear. If necessary. move the front fork or the position of the front wheels. Discuss the pros and cons of any changes with your wheelchair supplier
A possible solution is to move the large wheels backwards or move the backrest more forward. Discuss the advantages and disadvantages with your wheelchair supplier.
Have the height of the seat checked and check how you sit in relation to the wheels (e.g. you should be able to touch the axles with your hand). Discuss the pros and cons of any changes with your wheelchair supplier.
Does the wheelchair tip back easily when applying force to the hand rims?
No, the wheelchair doesn’t tip back easily and rides smoothly: optimal weight distribution over the wheels
Yes, the wheelchair does tip back easily when applying force to the hand rims; too much weight behind the large wheels
Yes, the wheelchair rides and turns with difficulty and the front wheels do not tip back easily: too much weight on the front wheels
A possible solution is to move the position of the large wheels backwards or move the backrest more forward. Discuss the advantages and disadvantages with your wheelchair supplier.
Have the wheelbase checked and, if necessary, place the large wheels more to the front or the backrest more to the rear. Discuss the pros and cons of any changes with your wheelchair supplier.
Can you operate the hand rims with your arms with ease when rolling?
Yes
No, I have to grab the hand rims too far back (or forward)
No, I can hardly use the hand rims because I sit (too) high above the wheels
No, I have to lift my arms (and shoulders) too high when using the hand rims because I’m sitting too low between the wheels
No, my sitting position and/or trunk/shoulder position is not comfortable for rolling
No, I can’t get a good grip on the hand rims (they’re too slippery or damaged or the shape of the hand rims isn’t right)
No, I don’t have enough power
Have the front/rear adjustment of the wheels checked. Changes affect tilt sensitivity. Discuss the pros and cons of any changes with your wheelchair supplier.
Have both the wheel adjustment of the large wheels and the seat height checked (wheels higher/seat height lower). Discuss the pros and cons of any changes with your wheelchair supplier.
Have both the wheel adjustment and the seat height checked (wheels lower/seat height higher). Discuss the pros and cons of any changes with your wheelchair supplier.
Have your sitting posture checked. Discuss the pros and cons of any changes with your wheelchair supplier.
Look into other types of hand rims.
Have the driving setup checked, look into training or alternative solutions.
Seat dimensions
Is the width of the wheelchair seat ( and cushion) optimal?
Note: With a stable body weight, less than 1cm (.5 inch) is the optimum space between each hip and the side of the wheelchair. Some wheelchair suppliers add additional space for clothes which can cause your pelvis to shift to one side.
Yes, there is 0-1 cm of space between each of my hips and its side of my wheelchair seat.
No, there is more than 1 cm of space between one or both of my hips and the side(s) of my wheelchair seat
No, I sit too tightly against the side(s) of my wheelchair seat, which can cause pressure on my hip(s) and/or thigh(s)
Have this checked by a professional
Is the seat (and cushion) length optimal?
Note: for each of the below questions it is assumed that your buttocks are positioned against the back rest of the wheelchair
Yes, I have 2-5 cm (1-2 inches) between the back of my knees and the front of my wheelchair seat.
No, the seat length is too short with more than 5 cm (2 inches) between the back of my knees and the front of the seat.
No, the seat length is too large with no space between the back of the knees and the front of the seat.
No, I am not even able to sit with my buttocks against the back rest because of the (too) large seat depth
Have this checked by a professional
Is the seat cushion’s firmness optimal for your buttocks and thighs?
Note: If the seat cushion is too hard it can cause pressure sores on the skin covering the sitting bones and/or tailbone. If the cushion is too soft it can cause instability. It is optimal when the firmness is just right allowing for comfort, safety, proper support and balance
Yes, the firmness of the cushion appears safe, comfortable, supportive and balanced
No, the firmness of the cushion is too hard
No, the firmness of the cushion is too soft
Have this checked by a professional
Complaints with cushion?
Is the position of your thighs right in the wheelchair?
When looking from the side; e.g. with a tray placed on the lap
Select all that apply:
Yes, both my thighs are horizontal, or my knees are slightly higher than my my thighs
No, my knees are lower than my thighs (a lap tray would slide forwards)
No, my knees (tend to) fall to the side(s) due to inadequate support from the cushion below my thigh(s) or a footplate that is too high
No, my buttocks (tend to) slide forwards (e.g. making reposition neccesary)
Have this checked by a professional
Is the seat height optimal?
Note: e.g., an optimal height so the wheelchair can fit below a table or steering wheel and enables transfers from the wheelchair to the bed or toilet. Also, getting from sitting to standing (for those who can).
Select all that apply:
Yes, with the seat height all transfers and activities can be performed without problems
No, due to a low seat height I have problems with transfers or other activities.
No, due to a high seat height I have problems with transfers or other activities.
No, due to the seat height I can not take steps well with the wheelchair (for those who can use their leg(s))
Have this checked by a professional
Is/are the height and position of the footplate(s) correct?
Note: The footplate should be >5 cm above the ground. The angle, length, and position of the footplates determine optimal foot support. The position may also interfere with activities, e.g., negotiating curbs, making transfers, or optimal sitting/driving.
Select all that apply:
Yes, the footplate(s) give(s) optimal support to my feet and this does not interfere with activities
No, my feet are not well supported (e.g. they tend to slide, fall off)
No, the position of the footplate(s) interferes with my activities (e.g. negotiating curbs, transfers, driving or sitting)
Have this checked by a professional
Is the backrest comfortable and at an optimal height?
Note: the backrest height also depends on the physical ability. In an electric wheelchair (when lying is an option), the needs may differ from a hand-rim wheelchair. Driving applies to both electric and hand-rim wheelchairs.
Select all that apply:
Yes, the backrest does not interfere with sitting, driving or other activities in the wheelchair
No, the backrest is not comfortable
No, the (upper part of the) backrest pushes my trunk forwards
No, the backrest is too high and doesn't provide enough freedom for my shoulders to properly drive/propel or do activities
No, the backrest is too low and does not give my back enough support to sit comfortably
Have this checked by a professional
Is the height, shape, and position of the armrests optimal?
Note: The armrests are generally used for your forearms/elbows to lean on. They can also help lift your buttocks for pressure relief, slide forward, or stand up.
Select all that apply:
Yes, the armrests give support to the arms and do not interfere with activities
No, the armrests are too high or too low to properly support my forearms/elbows or to lift my buttocks
No, the armrests are too wide (e.g. interfere with grabbing the handrims when rolling)
No, the armrests are too long (e.g. interfere when handbiking)
I don't use armrests
Have this checked by a professional
Sitting-/driving problems
Do you find
sitting
in the wheelchair, in general,
tiring
?
Never
Sometimes (occasionally)
Regularly (about half of the time)
Most of the time
Always (i.e. daily)
Have a wheelchair consultant/professional check whether your complaints can be reduced by a better sitting or driving position in the wheelchair.
Do you find
driving
in the wheelchair, in general,
tiring
Driving= propelling in the hand-rim wheelchair or driving an electric wheelchair
Never
Sometimes (occasionally)
Regularly (half of the time)
Most of the time
Always (i.e. daily)
Have a wheelchair consultant/professional check whether your complaints can be reduced by a better sitting or driving position in the wheelchair.
Do you find
sitting
in your wheelchair, in general,
painful
?
Never
Sometimes (occasionally)
Regularly (half of the time)
Most of the time
Always (i.e. daily)
Have a wheelchair consultant/professional check whether your complaints can be reduced by a better sitting or driving position in the wheelchair.
Please indicate below where you have pain while sitting and how severe the pain is (pain score).
Indicate all that apply.
No pain
Mild pain
Moderate pain
Serious pain
Severe pain
Excruciating pain
Neck/head
Back at height of shoulder blades
Middle of back
Lower back
Side of chest/ribs
Side (loins)
Sitting bones
Tailbone/sacrum
Other
What is the other location?
please state
Do you find
driving
in your wheelchair, in general,
painful
?
Driving= propelling in the hand-rim wheelchair or driving an electric wheelchair
Never
Sometimes (occasionally)
Regularly (half of the time)
Most of the time
Always (i.e. daily)
Have a wheelchair consultant/professional check whether your complaints can be reduced by a better sitting or driving position in the wheelchair.
Please indicate below where you have pain while driving and how severe the pain is (pain score).
Indicate all that apply
No pain
Mild pain
Moderate pain
Serious pain
Severe pain
Excruciating pain
Fingers/wrist left
Fingers/wrist right
Elbow left
Elbow right
Shoulder left
Shoulder right
Neck
Back
Other
What is the other location?
please state
Do you currently have a bedsore (i.e. pressure ulcer or decubitus) or have you had one in the last three months ?
No
Yes, but fully healed
Yes, and not yet healed
Immediately have your wheelchair and sit cushion checked.
What is/was the location and severity of your bedsore (decubitus)?
Please circle the appropriate category for the relevant location. If it occurred multiple times, please circle the worst case.
Category 1: Intact skin; redness does not disappear (I.e., become white) when pushed over a bony prominence
Category 2: Superficial open wound with a red/pink bottom. This category also includes an intact blister (filled with fluid) or a ruptured one.
Category 3: Loss of an entire layer of skin. Subcutaneous fat may be visible, but bone, tendon, and muscles are not. Wound tissue may be present.
Category 4: Loss of an entire layer of skin where bone, tendons, or muscle is visible. Liquified wound tissue or an old scab may be present.
Category 1
Category 2
Category 3
Category 4
Heel
Ankle
Hip
Buttock
Tailbone
Other ...
What is the other location?
please state
What is the brand of your seat cushion?
For example, Roho, Vicair, and Jay or unknown
What is the condition of your seat cushion (and cover)?
Cushion and cover in good condition
Only the cover is in mediocre condition (significant signs of wear and tear/dirty)
Cushion and cover in mediocre condition (significant signs of wear and tear/ dirty)
Seat cushion is leaking, empty or worn out
I don’t know
I don't have a seat cushion
Get this taken care of immediately as the risk of skin damage/bedsores is high.
Get this taken care of immediately as the risk of skin damage/bedsores is possible.
Get cover replaced.
Are you well informed about the importance of your seat cushion and how it works?
Yes
Somewhat
No
Get informed about how it works.
Is your sitting position stable?
Stable (I can sit for hours without problems)
Fairly stable (after a few hours I start shifting more and more in the wheelchair)
Not stable (I start shifting immediately after I get into the wheelchair)
Have a consultant/professional check whether your complaints can be reduced by a better sitting or driving position in the wheelchair.
Are you stable in your wheelchair when reaching forward, for example, to get a carton of milk?
Yes, I’m stable
No, I tend to fall forward
No, I tend to fall sideways
No, I tend to fall both forwards and sideways
Have a consultant/professional check whether your complaints can be reduced by a better sitting position in the wheelchair.
Are you stable in your wheelchair when driving it?
Driving= propelling in the hand-rim wheelchair or driving an electric wheelchair
Yes, I’m stable
No, I tend to fall forward
No, I tend to fall sideways
No, I tend to fall both forwards and sideways
Have a consultant/professional check whether your complaints can be reduced by a better sitting or driving position in the wheelchair.
Do you feel that you lack support in your wheelchair?
No
Yes
I don’t know
Have a consultant/professional check whether your complaints can be reduced by a better sitting or driving position in the wheelchair.
Where do you lack support?
Select all that apply
Under my thighs
Under my buttocks (i.e. sitting bones, tailbone)
At the top of my buttocks (from the back)
At my lower back
At the middle of my back
At my back at shoulder level
At my neck or head
At my pelvis
At my side(s) or at my loin(s)
At my chest
Do you feel that you have too much support/pressure in your wheelchair?
No
Yes
I don't know
Have a consultant/professional check whether your complaints can be reduced by a better sitting or driving position in the wheelchair.
Where do you experience
too much
support/pressure?
Select all that apply
Under my thighs
Under my buttocks (i.e. sitting bones, tailbone)
At the top of my buttocks (from the back)
At my lower back
At the middle of my back
At my back at shoulder level
At my neck or head
At my pelvis
At my side(s) or at my loin(s)
At my chest
How would you rate your sitting position in your wheelchair?
Excellent
Good
Reasonable
Moderate
Poor
Have your sitting position checked by a consultant/professional.
Do you feel that your wheelchair sitting position could be improved?
No
Yes
I don't know
What would you like to change?
Select all that apply:
To sit more upright
To be more relaxed when sitting
To have more support when sitting
To sit more compactly (more closely together)
To sit more stretched out (more elongated)
To sit more confidently
Other...
Describe other changes
How would you rate how easy it is to move around using your wheelchair in general?
Propelling the hand-rim wheelchair or driving an electric wheelchair
Very easy
Easy
Neutral
Hard
Very hard
Discuss this with a consultant or professional.
If possible, what would you like to change about your
manual
wheelchair?
Select all that apply:
That my sitting posture is more appropriate to sit and/or propel
That my wheelchair drives more smoothly
That my hands would have better contact or grip with the hand rims
That the hand rims are better positioned in relation to my arms/shoulders
Other...
Describe other changes
If possible, what would you like to change about your
electric
wheelchair?
Select all that apply:
That my sitting posture is more appropriate to sit and/or drive
That my joystick is better positioned in relation to my hands/arms/shoulders
That my chin control is better positioned in relation to my neck/head
That my armrest is better positioned
Other...
Describe other changes
Does your wheelchair meet your movement needs both indoors and outdoors?
Excellently
Well
Reasonably
Moderately
Poorly
Discuss this with a consultant or professional.
What would you like to change to improve your ability to move?
Select all that apply
My wheelchair needs to be adjusted
Another aid is needed for moving indoors. If possible, describe what you think is needed (e.g. wheelchair, etc.)
Another aid is needed for moving outdoors. If possible, describe what you think is needed (e.g. wheelchair, etc.)
I need to get stronger and fitter
have to become skilled and less afraid when driving my wheelchair
The environment where I live and/or work should be better adapted to wheelchair driving
Describe the type of aid needed
Note: another type of wheelchair or another mobility aid e.g. a walker
Get in contact with a consultant (i.e. occupational therapist).
Contact a physical therapist.
Contact a professional to train wheelchair skills.
Who funded the wheelchair?
More options are possible, select all that apply
Private
Government (public health system)
Insurance
Charity (donation, crowd-funding)
Other
Other:
Also, note here when the wheelchair is borrowed (e.g., when you are still in a rehabilitation center)
In which country do you live?
Have you filled out this screening tool more often?
For example to evaluate another wheelchair
No this is the first time
Yes this is the second time
Yes this is the third time
More often
I agree to the anonymous use of this data for research. The data will not be personally identifiable in any way
*
With the dataset we hope to gain beneficial insights into the satisfaction of wheelchair users with their wheelchair
Yes
No
No, I just wanted to check out this screening tool (e.g.health professionals or wheelchair advisors, researchers)
This field is hidden when viewing the form
This field is hidden when viewing the form
Is the seat height right in the sports wheelchair?
Yes with the seat height all transfers and activities can be performed without problems
No its not
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About
What is Wheelchair Check?
Who is it for?
International
Why joining international collaboration
How to join
Evaluation use tool
Research
Background
Privacy Statement
Acknowledgement
Check now
Chequea ya
Check jetzt
Check nu
Ta sjekken
Veic pārbaude
Fais le Check
