Wheelchairs

Manual wheelchairs should be selected following assessment of mobility goals, propulsion ability, posture, skin risk, transfers, cognition, endurance, body measurements, environment, car transport and carer manual-handling capacity. A basic folding wheelchair may not be suitable for full-day use or complex seating needs.

Overview

This note covers:

• Self-propelled manual wheelchairs
• Attendant-propelled manual wheelchairs
• Transit wheelchairs
• Folding transport wheelchairs
• Manual wheelchair power-assist add-ons

Powered wheelchairs and powered mobility scooters are covered separately in:

• Powered Mobility Devices

Purpose

A manual wheelchair may:

• Support mobility when walking is unsafe or limited
• Increase access to appointments and community activities
• Reduce fatigue and falls risk over longer distances
• Support mobility during recovery or functional decline
• Allow independent mobility through self-propulsion
• Allow a carer or attendant to assist with mobility
• Provide a seated mobility option that can be folded for vehicle transport

Main Types

Self-Propelled Wheelchair

A self-propelled wheelchair has large rear wheels with handrims that the user can push.

It may also have push handles and attendant brakes.

Choose When

• The user wants to propel independently
• Upper-limb strength and endurance are adequate
• Hand function and coordination are adequate
• The user can brake, turn and control speed
• The environment provides sufficient space
• Rear-wheel access is not blocked by posture or armrests
• The user can complete pressure relief or has an appropriate plan
• The chair will be used for more than brief attendant-assisted outings

Benefits

• Supports independent mobility
• Allows the user to control speed and direction
• Large rear wheels usually manage small surface changes better than transit wheels
• Rear wheels may be quick-release for car transport
• Can be pushed by an attendant when required

Limitations

• Wider and usually heavier than a transit chair
• Requires upper-limb effort
• Repetitive propulsion may contribute to shoulder or wrist strain
• Requires adequate cognition and visual-perceptual ability
• Large rear wheels take more car-boot space
• Poor fit reduces propulsion efficiency
• A lightweight transport-style chair may not suit full-time independent propulsion

Attendant-Propelled Wheelchair

An attendant-propelled wheelchair is primarily pushed by another person.

It usually has smaller rear wheels and push handles.

Choose When

• The user cannot propel safely or effectively
• Community outings are carer-assisted
• Compact folding and lower lifting weight are priorities
• Use is intermittent or for shorter trips
• An attendant can safely push, brake and manage slopes
• The user can sit safely in the available seating system

Benefits

• Often lighter and narrower than a self-propelled chair
• Smaller rear wheels may reduce folded size
• Easier to load into some vehicles
• Attendant brakes may assist on slopes
• Suitable for appointments and short outings

Limitations

• User has limited independent mobility
• Attendant is required
• Small rear wheels may perform poorly on uneven surfaces
• The attendant must manage ramps, slopes and kerbs
• May not provide adequate postural or pressure support
• Compact transport chairs can become uncomfortable during prolonged sitting

Transit Wheelchair

“Transit wheelchair” is commonly used for a compact attendant-propelled wheelchair with small rear wheels.

A transit chair is intended mainly for transporting a seated person with an attendant. It is not the same as a wheelchair approved as a vehicle seat for occupied transport.

Choose When

• Use is occasional
• Trips are short
• The chair must fit into a car boot
• An attendant is always available
• The environment is mainly indoors or on smooth outdoor surfaces
• Low chair weight is a major priority

Benefits

• Compact
• Often lightweight
• Narrower overall width
• Easy to store
• Easier to lift than many self-propelled chairs

Limitations

• Cannot usually be independently propelled
• Small wheels are less suitable for rough surfaces
• Ride may be less comfortable
• Limited adjustability
• Not usually appropriate for prolonged daily use
• The term “transit” does not automatically mean crash-tested for occupied vehicle transport

Self-Propelled vs Attendant-Propelled vs Transit

How to Choose the Wheelchair Type

Choose Self-Propelled When

• Independent mobility is a goal
• The user can reach and push both handrims
• Upper-limb strength and endurance are sufficient
• The user can brake and turn safely
• The wheelchair will be used regularly
• The user can learn efficient propulsion
• Larger rear wheels will fit the home and vehicle

Choose Attendant-Propelled When

• The user cannot self-propel
• An attendant is consistently available
• The chair is mainly used for appointments or outings
• A lighter and narrower chair is needed
• Car transport is frequent
• The attendant can manage the chair safely

Choose a Transit Chair When

• Use is brief and occasional
• Compact transport is the main priority
• The user will always be pushed
• Surfaces are smooth
• The person does not require complex posture or pressure management
• The chair fits the person and vehicle

Consider a More Configurable Manual Wheelchair When

• The person uses the wheelchair for much of the day
• Postural support is required
• Pressure injury risk is moderate or high
• Seat dimensions need customisation
• The person foot-propels
• Wheel position must be adjusted for efficient propulsion
• The person has asymmetry, contracture or changing tone
• A power-assist system is planned
• The basic folding chair does not support function or comfort

Consider Powered Mobility Instead When

• Manual propulsion is not sustainable
• Shoulder or hand pain limits propulsion
• Community distances exceed the person’s endurance
• The attendant cannot safely push
• Independent mobility is required but manual propulsion is not possible
• Power-assist does not meet the person’s needs

See Powered Mobility Devices.

Occupational Therapy Assessment

Person

Assess:

• Mobility goals
• Walking ability
• Falls history
• Sitting tolerance
• Posture and pelvic position
• Trunk control
• Upper-limb strength
• Shoulder and hand pain
• Grip and coordination
• Lower-limb position
• Foot propulsion
• Sensation
• Skin integrity
• Pressure injury history
• Continence
• Cognition
• Vision and perception
• Fatigue
• Body weight
• Height
• Relevant body dimensions
• Ability to complete pressure relief
• Ability to operate brakes
• Ability to fold or dismantle the chair

Activity

Assess:

• Frequency of use
• Duration of sitting
• Indoor or outdoor use
• Independent or attendant propulsion
• Transfers
• Toileting
• Eating at tables
• Community access
• Shopping
• Appointments
• Vehicle transport
• Storage
• Carrying personal items
• Slopes, ramps and kerbs

Environment

Measure and assess:

• Doorways
• Hallways
• Bathroom access
• Turning spaces
• Lift dimensions
• Ramps
• Thresholds
• Floor surfaces
• Path surfaces
• Gradient and cross-fall
• Vehicle boot opening
• Boot width, depth and height
• Lifting height into the vehicle
• Storage space
• Charging location if power-assist is used

Wheelchair Measurements

Measure the person in a stable, supported sitting position. Use the cushion intended for the wheelchair when checking final fit.

Seat Width

Measure across the widest part of the hips or thighs.

Allow enough clearance for:

• Clothing
• Hand access
• Transfers
• Cushion fit
• Hip movement

Avoid excessive width.

A seat that is too wide may:

• Reduce pelvic support
• Increase leaning
• Make self-propulsion less efficient
• Increase overall chair width
• Make doorway access harder
• Allow the cushion to move

A seat that is too narrow may:

• Cause pressure at the hips or thighs
• Restrict clothing
• Increase skin risk
• Make transfers difficult
• Prevent correct cushion fit

Seat Depth

Measure from the back of the pelvis to the back of the knee.

Allow clearance behind the knees.

A seat that is too deep may:

• Press behind the knees
• Encourage sliding
• Prevent contact with the backrest
• Affect circulation
• Make transfers harder

A seat that is too shallow may:

• Reduce thigh support
• Increase pressure under the pelvis
• Reduce stability

Seat-to-Floor Height

Consider:

• Foot contact
• Footplate clearance
• Foot propulsion
• Transfers
• Table access
• Cushion height
• Overall wheelchair height
• Car transfer method

A seat that is too high may:

• Prevent foot contact
• Reduce transfer safety
• Make foot propulsion impossible

A seat that is too low may:

• Increase hip and knee flexion
• Make standing transfers difficult
• Reduce caster clearance
• Increase pressure through the feet or thighs

Backrest Height

Consider:

• Trunk control
• Shoulder movement
• Self-propulsion
• Postural support
• Comfort
• Head support needs

A high backrest can improve support but may restrict shoulder movement during propulsion.

Armrest Height

Armrests should support the forearms without elevating the shoulders.

Incorrect height may contribute to:

• Shoulder elevation
• Trunk leaning
• Reduced pressure distribution
• Difficulty at tables
• Transfer obstruction

Footrest Length

Adjust so that:

• Feet are supported
• Thighs remain supported
• Footplates clear the ground
• Knees and hips are positioned appropriately
• Footplates do not interfere with transfers

Footrests that are too low may reduce ground clearance.

Footrests that are too high may increase thigh pressure.

Safe Working Load

Confirm:

• User weight is below the manufacturer’s safe working load
• Cushion and accessories are compatible
• Weight distribution is appropriate
• The chair remains stable
• The safe working load is not treated as the recommended user size

A person may be below the safe working load but still be too wide, tall or poorly supported by the chair.

Chair Weight and Transport Weight

Check all relevant weights:

• Total chair weight
• Frame weight
• Heaviest component
• Weight after removing leg rests
• Weight after removing quick-release rear wheels
• Power-assist unit weight
• Battery weight
• Combined lift required

The lightest advertised weight may refer to the frame without removable components.

Folding and Dismantling

Check:

• Cross-folding mechanism
• Folding backrest
• Removable leg rests
• Swing-away leg rests
• Quick-release rear wheels
• Removable cushion
• Anti-tippers
• Folding footplates
• Power-assist removal
• Whether parts can be safely reattached

Product Examples

Product specifications can change. Confirm the exact model and variant before prescription.

Aspire Socialite Attendant-Propelled

Example specifications:

• Seat width: 450 mm
• Seat depth: 430 mm
• Total width: 595 mm
• Unit weight: 8.9 kg
• Frame weight: 8.1 kg
• Safe working load: 115 kg
• Backrest height: 410 mm
• Attendant brakes with parking lock
• Removable leg rests
• Folding backrest

May Suit

• Short trips
• Appointments
• Carer-assisted outings
• Users needing a light folding chair
• Vehicles with limited lifting capacity

Main Considerations

• Fixed seat size
• Limited adjustability
• User cannot independently self-propel
• Confirm comfort and posture for intended sitting duration

Aspire Socialite Self-Propelled

Example specifications:

• Seat width: 450 mm
• Seat depth: 430 mm
• Total width: 675 mm
• Total length: 1030 mm
• Unit weight: 13 kg
• Safe working load: 115 kg
• Backrest height: 410 mm
• Large rear wheels
• Folding frame and backrest
• Removable leg rests

May Suit

• A user who can independently propel
• Mixed user and attendant propulsion
• Short outings and appointments
• A person needing a lightweight folding self-propelled chair

Main Considerations

• Wider and heavier than the attendant version
• Fixed 450 mm seat width
• Confirm rear-wheel access
• Confirm shoulder endurance
• Large wheels affect boot space

Aspire Lite Wheelchair

The Aspire Lite is a lightweight folding manual wheelchair available in different propulsion configurations and sizes, depending on the current range.

May Suit

• Intermittent use
• Community outings
• Users or carers prioritising portability
• Situations requiring a basic folding chair

Check the Exact Variant

• Self-propelled or attendant-propelled
• Seat width
• Safe working load
• Total weight
• Frame weight
• Rear-wheel release
• Folded dimensions
• Leg-rest removal
• Brake type

Do not rely on the product family name alone because specifications may differ between variants.

Aspire VIDA MG

The VIDA MG uses a magnesium frame and is available in attendant- and self-propelled variants with 400 mm and 450 mm seat widths.

Example specifications:

Features include:

• Folding frame
• Hinged backrest
• Detachable leg rests
• Attendant brakes
• Anti-tippers
• Quick-release wheels

May Suit

• Frequent vehicle transport
• Users requiring a lighter frame
• Choice between 400 mm and 450 mm seat widths
• Attendant or independent propulsion

Main Considerations

• Confirm total weight and minimum transport weight
• Confirm the 113 kg safe working load
• Magnesium construction does not remove the need for safe lifting technique
• Self-propelled variants remain wider and heavier

Redgum Opal 18-inch Transit Wheelchair

Example specifications:

• Seat width: 460 mm
• Seat depth: 400 mm
• Seat height: 500 mm
• Overall width: 550 mm
• Folded width: 250 mm
• Product weight: 9.4 kg
• Maximum user weight: 136 kg
• 300 mm rear wheels
• 200 mm front wheels
• Attendant brakes
• Detachable swing-away leg rests

May Suit

• Short attendant-assisted outings
• Narrow doorways
• Smooth indoor and outdoor surfaces
• Car-boot transport
• Users fitting a 460 mm seat

Main Considerations

• No independent propulsion
• Small rear wheels
• Fixed seat dimensions
• Confirm 500 mm seat height supports transfers
• Assess comfort for intended sitting duration

Product Comparison

The lightest chair is not automatically the most suitable. Seat fit, stability, posture, transfers and surface performance remain central.

Power-Assist Add-Ons

Power assist adds motorised assistance to a compatible manual wheelchair.

It does not automatically convert every manual wheelchair into a safe powered mobility device.

Main Types

Rear Push-Assist Unit

A powered wheel attaches behind or under the wheelchair and assists forward movement.

Examples include SmartDrive-style systems.

May suit:

• Independent manual wheelchair users
• Reduced propulsion endurance
• Shoulder pain or overuse risk
• Longer community distances
• Slopes and carpet

Consider:

• Wheelchair compatibility
• User control method
• Stopping and braking
• Attachment clearance
• Unit and battery weight
• Removal for transport
• Training
• Indoor manoeuvrability

Power-Assist Wheels

Powered wheels replace the standard rear wheels and amplify the user’s push.

Examples include Alber e-motion-style systems.

May suit:

• Users who can push but need reduced effort
• Users who want to retain pushrim control
• Bilateral propulsion
• Slopes and longer distances

Consider:

• Each wheel’s weight
• Lifting into the vehicle
• Wheel removal
• Charging
• Handrim control
• Chair width
• Cost
• Compatibility

Attendant Power Assist

A powered unit assists the attendant to push the wheelchair.

May suit:

• Heavy users
• Slopes
• Carer fatigue
• Reduced attendant strength
• Longer assisted distances

Consider:

• Attendant control and braking
• Safe use on slopes
• Attachment to the wheelchair
• Battery and unit weight
• Storage
• Car boot loading
• Whether the base wheelchair remains suitable

Front Attachment or Handcycle-Style Add-On

A powered front attachment connects to the wheelchair and lifts or unloads the front castors.

May suit:

• Independent community mobility
• Longer distances
• Selected outdoor surfaces

Consider:

• Turning radius
• Braking
• road and path use
• transfer into the device
• attachment method
• transport
• total length
• local regulations
• training

Benefits of Power Assist

• Reduced propulsion effort
• Increased distance
• Reduced attendant effort
• Improved access on slopes
• Potential reduction in repetitive upper-limb loading
• Retention of a manual wheelchair base
• Easier transport than some powered wheelchairs

Limitations of Power Assist

• Added weight
• Battery charging
• Device compatibility
• Increased maintenance
• More complex control
• Potential for unintended movement
• Greater stopping distance
• Reduced portability
• Lithium-battery transport requirements
• Cost
• Need for training and review

Power-Assist Assessment

Assess:

• Manual wheelchair suitability
• Frame compatibility
• User or attendant control
• Cognition
• Vision and perception
• Reaction time
• Braking
• slopes
• kerbs
• indoor use
• outdoor use
• transfer method
• battery management
• charging
• vehicle transport
• ability to lift components
• backup mobility plan

Loading a Wheelchair Into a Car Boot

Assess the vehicle, chair and person completing the lift. A folding chair can still be unsafe to lift if it is heavy, awkward, held away from the body or lifted over a high boot lip.

Before Selecting the Wheelchair

Measure:

• Boot opening width
• Boot opening height
• Boot floor depth
• Boot lip height
• Load height from the ground
• Space around wheel arches
• Available space after groceries or mobility aids
• Rear-seat folding options

Check:

• Folded wheelchair dimensions
• Chair weight
• Frame weight
• Heaviest removable component
• Whether leg rests must be removed
• Whether rear wheels must be removed
• Whether the chair can stand upright
• Whether the boot floor is level
• Whether a loading aid is required

Before Lifting

1. Park on a level surface.
2. Apply the vehicle parking brake.
3. Clear the boot.
4. Apply the wheelchair brakes where appropriate.
5. Remove the cushion.
6. Remove leg rests.
7. Remove quick-release rear wheels when required.
8. Fold the backrest.
9. Fold the frame.
10. Secure loose parts.

Lifting Principles

• Move close to the wheelchair
• Use a stable stance
• Hold secure frame points
• Keep the load close to the body
• Avoid twisting
• Turn with the feet
• Avoid lifting by removable armrests or footrests
• Use two people when required
• Use a ramp, hoist or boot-loading device when manual lifting is unsafe

Sliding or Tilting Into the Boot

Some chairs may be loaded by:

• Tilting the chair onto the boot edge
• Sliding it on a protective mat
• Loading the frame first
• Loading wheels and leg rests separately

Only use a method that has been assessed as safe for the chair, vehicle and person.

Unloading

• Prevent the chair from unfolding unexpectedly
• Keep fingers clear of folding joints
• Lower rather than drop the chair
• Reattach wheels and leg rests correctly
• Confirm quick-release axles are locked
• Open the frame fully
• Check brakes before use

Manual-Handling Risks

• Back strain
• Shoulder strain
• Finger entrapment
• Dropping the chair
• Damage to vehicle or wheelchair
• Uncontrolled unfolding
• Lifting heavy powered wheels
• Handling lithium batteries
• Repeated lifting over a high boot lip

Alternatives When Boot Loading Is Unsafe

• Lighter wheelchair
• Attendant-propelled version
• Quick-release wheels
• Smaller transit chair
• Vehicle boot hoist
• Wheelchair loading ramp
• Sliding board or loading tray
• Different vehicle
• Wheelchair-accessible transport
• Powered mobility device designed for vehicle loading
• Two-person handling plan

Transfers

Assess:

• Standing transfer
• Pivot transfer
• Slide-board transfer
• Hoist transfer
• Armrest removal
• Leg-rest removal
• Footplate movement
• Brake access
• Seat height
• Cushion stability
• Carer space

How to Use

Before Use

• Check tyres and castors
• Check brakes
• Check leg rests
• Check quick-release wheels
• Check folding locks
• Check cushion position
• Check anti-tippers
• Remove loose objects
• Confirm the user is positioned safely

Self-Propulsion

• Sit with the pelvis supported
• Place hands on the handrims
• Use smooth, controlled pushes
• Avoid trapping fingers between handrim and wheel
• Slow before turns and slopes
• Use gloves when clinically appropriate
• Avoid excessive speed
• Follow training for ramps and kerbs

Attendant Propulsion

• Use both push handles
• Keep the wheelchair close
• Slow before turns
• Use attendant brakes appropriately
• Approach thresholds straight
• Avoid sudden tipping
• Use kerb-climbing features only as trained
• Do not descend steep slopes without assessment

Applying Brakes

• Stop the wheelchair
• Apply both brakes
• Confirm the chair is stable
• Use parking brakes for transfers
• Do not use parking brakes as the only method to slow a moving chair unless designed for this purpose

Safety Issues

• Apply brakes for transfers
• Swing away or remove footplates before standing transfers
• Keep hands away from wheels and folding joints
• Do not exceed the safe working load
• Do not hang heavy bags from push handles
• Use anti-tippers when prescribed
• Do not use damaged tyres, castors or brakes
• Avoid steep slopes
• Do not leave the person unattended on a slope
• Do not use a standard manual wheelchair as a vehicle seat unless it is approved and secured for occupied transport
• Do not lift the wheelchair by removable components
• Do not propel a transit chair without an attendant
• Review after falls, near misses, pain or skin changes

Pressure and Posture

A wheelchair cushion may be required.

See:

• Cushions
• Pressure Injury Prevention and Management

Assess:

• Pelvic position
• Sliding
• Leaning
• Foot support
• Arm support
• Sitting duration
• Pressure relief
• Skin checks
• Cushion fit
• Backrest support

A basic sling seat can contribute to pelvic collapse or postural asymmetry when the chair is too wide or seating support is inadequate.

Trial Checklist

• [ ] Correct propulsion type
• [ ] Correct seat width
• [ ] Correct seat depth
• [ ] Correct seat height
• [ ] Correct footrest length
• [ ] Armrests support the user
• [ ] Cushion fits
• [ ] Safe working load is suitable
• [ ] Brakes are accessible
• [ ] Transfers are safe
• [ ] User can propel when applicable
• [ ] Attendant can push and brake
• [ ] Doorways are accessible
• [ ] Turning space is adequate
• [ ] Outdoor route is suitable
• [ ] Chair folds correctly
• [ ] Car boot dimensions are adequate
• [ ] Lifting weight is manageable
• [ ] Removable components are manageable
• [ ] Power-assist compatibility is confirmed when applicable
• [ ] Skin response is acceptable

Cleaning and Maintenance

Check:

• Tyre pressure
• Tyre wear
• Castor wear
• Wheel bearings
• Spokes
• Handrims
• Brakes
• Quick-release axles
• Folding mechanism
• Upholstery
• Armrests
• Leg rests
• Footplates
• Anti-tippers
• Frame damage
• Cushion
• Power-assist attachment
• Battery and charger

Follow the manufacturer’s servicing schedule.

Review Triggers

• Weight change
• New pain
• Shoulder or wrist symptoms
• New pressure area
• Falls or tipping
• Reduced propulsion
• Increased attendant effort
• Change in transfers
• Change in posture
• New car
• New home
• Wheelchair damage
• Brake failure
• Power-assist addition
• Increased daily sitting
• Functional decline

Client and Carer Instructions

Before Use

• Check brakes and wheels.
• Check leg rests and footplates.
• Check the cushion.
• Confirm removable wheels are locked.
• Keep bags light and balanced.

During Use

• Use brakes for transfers.
• Keep hands and clothing clear of wheels.
• Slow down on slopes and turns.
• Keep feet supported.
• Report pain, numbness or skin changes.

Stop Using and Seek Review When

• Brakes do not hold
• A wheel is loose
• The chair pulls to one side
• The frame is damaged
• The user develops skin redness
• Transfers become unsafe
• The chair no longer fits
• The chair cannot be loaded safely into the vehicle

Related Notes

• Powered Mobility Devices
• Cushions
• Pressure Injury Prevention and Management
• Wheelchair Accessories
• Vehicle Access and Wheelchair Loading
• Transfer Equipment

References

• Aidacare. Aspire Socialite Folding Wheelchair – Attendant Propelled: https://www.aidacare.com.au/products/wheelchairs/manual-wheelchairs/manual-folding-wheelchairs/aspire-socialite-folding-wheelchair-attendant-propelled/
• Aidacare. Aspire Socialite Folding Wheelchair – Self Propelled: https://www.aidacare.com.au/products/wheelchairs/manual-wheelchairs/manual-folding-wheelchairs/aspire-socialite-folding-wheelchair-self-propelled/
• Aidacare. Aspire Lite Wheelchair: https://www.aidacare.com.au/products/wheelchairs/manual-wheelchairs/manual-folding-wheelchairs/aspire-lite-wheelchair/
• Aidacare. Aspire VIDA MG Wheelchair: https://www.aidacare.com.au/products/wheelchairs/manual-wheelchairs/manual-folding-wheelchairs/aspire-vida-mg-wheelchair/
• Respirico. Redgum Opal Aluminium 18-inch Transit Wheelchair: https://respirico.com.au/shop/mobility/wheelchairs/transit-wheelchairs/redgum-opal-aluminium-18-transit-wheelchair/
• Sunrise Medical Australia. Wheelchair Assessment Measuring Guide: https://www.sunrisemedical.com.au/education-in-motion/resources/wheelchair-measuring-guide
• Permobil. Essential Measurements for Manual Wheelchair Selection: https://hub.permobil.com/blog/manual-wheelchair-selection
• Relevant manufacturer manuals, Australian Standards and organisational procedures