Osteogenesis Imperfecta Physical Therapy for Kids

Wheelchairs

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Many parents with children with OI choose to buy a wheelchair for their child. Some children will use their wheelchair for their primary mode of mobility. Some children will use a wheelchair while recovering from a fracture or surgery. Some need one for long distance mobility - like a day at the amusement park!

This section is designed to help parents and therapists learn about wheelchair and positioning options.

There are many companies all around the world that make wheelchairs for kids. This link can give you an outline of many chair out there.

usatechguide.org

On this site you can click on wheelchair reviews and then click pediatric manuel or power wheelchairs. They list many different chairs and reviews on some of them. You can can compare the specs for each wheelchair, see what they look like, and link to the manufacturer.

Is my child too young for a power chair?

Wheelchair seating for children - what to consider


SEATING CONSIDERATIONS:

Pediatric chairs can fit very small children so that the child can sit with their hips, knees and ankles at 90 degrees. Do not allow the chair to be adjusted in any other way!!! If your child's body does not go into a 90 degree position at the hip, knee or ankle joints, get as close as possible. You will need to work with a PT to help you improve your child's joint mobility. Their hips of course should not be in a frog position. They should be sitting aligned with their hips, knees and ankles straight in a row - NOT with their knees far apart. If their knees naturally flop apart you can get a seat cushion to help position the thighs in. If THAT doesn't work, you can get blocks placed on the side of the cushion to keep them in. If they develop a deformity there, it will be very hard for them to stand.

While waiting for the wheelchair vendor to help improve her child's leg position, one parent that I know designed an ingenious design. She used a swim noodle and covered it with fabric. See photo below. If you want more detials on this, please contact me.



To find a wheelchair that would fit your child, you will need to know the seat depth and seat width that your child would need:

Seat Depth:

How deep the chair is. With your child sitting, it is the part that will sit on the seat - measure from the back of the buttock to behind their knees.

Seat Width:

How wide the seat of the wheelchair must be. With you child sitting at a 90/90/90 position, measure the width of their hips - from one side to the other.


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OVERVIEW OF A FEW OF THE MOST POPULAR MANUAL WHEELCHAIRS

Click on links for more information on each chair.

INVACARE

- invacare.com 800-333-6900

- Makes the Comet for kids

- Smallest seat depth available in pediatric chairs adjusts from 7-13 inches
*smallest seat depth*
or with a long frame the depth adjusts 9 - 16 inches

- Seat width adjusts between 10 to 16 inches

- 21 color choices

- Growth system - can adjust the wheelchair to grow as your child grows.

****Can get a nice stroller handle that you can push with one hand ***





SUNRISE MEDICAL WHEELCHAIRS

Makes:

Zippie

Zippie2

Zippie GS

Quickie Kidz

Quickie GPV

Check out each style. There is really something for everyone.

The GPV is really sporty and comes as small as 12X12 for the kids that want a sporty little chair that is really light weight

The GS - stands for growth system - this one adjusts to grow with your child in width as well as length and height within this same chair. It is heavier than the other chairs.

Seat depth 10 to 20 inches

Seat width 10 to 18 inches

Cool light-up casters (cost extra)

Many color choices

*******Comes with stroller handle




Sunrise Medical - sunrisemedical.com







Makes the Quickie Zippie







The GS - stands for growth system - this one adjusts to grow with your child in width as well as length and height







seat depth 10 to 20 inches







seat width 10 to 18 inches







cool light-up casters (cost extra)







many color choices







*comes with stroller handle















Etac - www.etac.net







Makes the Sting for kids







eight color choices







rigid frame - no elevating legrests







stroller-like push handles are adjustable in height but I was told that the knob to attach them does not hold up well.







COOL spoke guard! Several different designs















TiLite -







Not as much growth options







Stroller handles







Seat depth 10 -18 inches







Seat width 12 -18 inches







Only weighs 13.7 pounds!!!! Lightest chair listed here







Has upolstery color choices















Colours - colourswheelchair.com







Anaheim, CA 800-892-8998















Make Little Dipper, Chump and Krypto







Has a very cool website - blasting music!







Makes cool looking wheelchairs for super heros!















Otto Bock - OttoBock.com.en







Voyager is their chair for kids.















































ADDITIONAL NOTES:















1. Pediatric wheelchairs can come with standard configuration - large wheel in back and small pivoting wheels in the front, or reverse configuration - large wheel in the front and small pivoting wheels in the back. The reverse configuration is good for small kids so that they can reach the wheel easily to propel themselves. HOWEVER, it is very difficult to control the steering! Since the wheels in the back pivot it is very difficult for the chair to go straight for the child when self-propelling OR for the helper when they push the chair. We tried this on our loaner chair since we thought it would be easier for a 20 month old to propel. She could push it and steer all around the room when we tried it. However, when we went to a long striaght hall, both my daughter and I had a hard time getting it to go straight where we wanted. SO - reverse configuration sounds great, but TRY IT before you choose it! If you choose it and then don’t like it, the vendor can reconfigure the chair to standard configuration without any new parts.















2. DO GET A SEAT CUSHION!!! Some insurance companies want justification for a good seat cushion. DO NOT allow your child to sit on the sling seat or on a bed pillow. This will make their hips roll in (internally rotate) and lead to deformity. A good seat cushion can helpyour child sit with legs straight, not in a frog position.















3. When your wheelchair is delivered to you make sure it fits correctly!!! Make sure their legs are aligned properly. It should be very easy for them to steer and should not seem like it will tip if they go flying around a sharp corner (or if a big brother is going for a speed record on a sharp course while pushing them). The large wheel can be set at an angle so that it angles out from top to bottom (camber). This may make the wheel easier for them to reach at the top and make the chair wider at the base to prevent tipping. The placement of the large wheel can be adjusted up/down and front/back to make the height of the chair different (may want your child same height as peers or lower to the ground so they can transfer out easier...). The seat height can also be adjusted to where you want it for those same reasons. Demand that the chair work perfectly! They are made with these adjustments so they can be custom adapted for your child!!!















4. I recommend that before you go to order your wheelchair, print out the order form from the internet and ask the rep. or vendor what all the options are. If you see something on the order form that they don’t mention, ASK them about it!! I wish that I would have insisted on the tray. It costs extra and some insurances don’t find it medically necessary, but it is worth a try...























PLEASE ADD TO THIS INFORMATION IF YOU HAVE LEARNED FROM EXPERIENCE! WE ALL LEARN FORM EACH OTHER!!! chair listed here







Has upolstery color choices















Colours - colourswheelchair.com







Anaheim, CA 800-892-8998















Make Little Dipper, Chump and Krypto







Has a very cool website - blasting music!







Makes cool looking wheelchairs for super heros!















Otto Bock - OttoBock.com.en







Voyager is their chair for kids.















































ADDITIONAL NOTES:















1. Pediatric wheelchairs can come with standard configuration - large wheel in back and small pivoting wheels in the front, or reverse configuration - large wheel in the front and small pivoting wheels in the back. The reverse configuration is good for small kids so that they can reach the wheel easily to propel themselves. HOWEVER, it is very difficult to control the steering! Since the wheels in the back pivot it is very difficult for the chair to go straight for the child when self-propelling OR for the helper when they push the chair. We tried this on our loaner chair since we thought it would be easier for a 20 month old to propel. She could push it and steer all around the room when we tried it. However, when we went to a long striaght hall, both my daughter and I had a hard time getting it to go straight where we wanted. SO - reverse configuration sounds great, but TRY IT before you choose it! If you choose it and then don’t like it, the vendor can reconfigure the chair to standard configuration without any new parts.















2. DO GET A SEAT CUSHION!!! Some insurance companies want justification for a good seat cushion. DO NOT allow your child to sit on the sling seat or on a bed pillow. This will make their hips roll in (internally rotate) and lead to deformity. A good seat cushion can helpyour child sit with legs straight, not in a frog position.















3. When your wheelchair is delivered to you make sure it fits correctly!!! Make sure their legs are aligned properly. It should be very easy for them to steer and should not seem like it will tip if they go flying around a sharp corner (or if a big brother is going for a speed record on a sharp course while pushing them). The large wheel can be set at an angle so that it angles out from top to bottom (camber). This may make the wheel easier for them to reach at the top and make the chair wider at the base to prevent tipping. The placement of the large wheel can be adjusted up/down and front/back to make the height of the chair different (may want your child same height as peers or lower to the ground so they can transfer out easier...). The seat height can also be adjusted to where you want it for those same reasons. Demand that the chair work perfectly! They are made with these adjustments so they can be custom adapted for your child!!!















4. I recommend that before you go to order your wheelchair, print out the order form from the internet and ask the rep. or vendor what all the options are. If you see something on the order form that they don’t mention, ASK them about it!! I wish that I would have insisted on the tray. It costs extra and some insurances don’t find it medically necessary, but it is worth a try...























PLEASE ADD TO THIS INFORMATION IF YOU HAVE LEARNED FROM EXPERIENCE! WE ALL LEARN FORM EACH OTHER!!!

Case Study - Craig Gets Mobile!

Case Study - Craig Gets Mobile!

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