To Power or Propel - That is The Question!

Should you buy a power-chair, power add-on or self-propel? What are the differences, benefits and drawbacks?

The Power of Power

The benefits of using a powerchair are that you can have a very comfortable long-term use chair with you all the time. A powerchair can become like a mini-home! You can use the chair to transport yourself and various things and people (not recommended) around without any loss of energy or your own power! You can adapt a powerchair to accommodate all kinds of needs and disabilities and carry and transport a wide variety of disability aids and supports! You can also add speed controls, off-road tyres, lights, security features and...well, you name it! You can also get a power chair which can act as your bed, armchair and personal kitchen transporter and help by means of various power add-ons.

Why You Might Choose Full Power

There are so many reasons to choose full power. Here are a few:

• To enable you to go to or stay in work 
• To help you manage a fatigue condition whilst rearing kids 
• To help you access your environment more fully 
• To be able to recline or tilt the chair when out 
• Because you are not able to push a chair and don't want to be pushed 
• To be able to use public transport (they don't have to take scooters) 
• Because you have to transport mobility equipment 
• Because you need to carry a large change bag for yourself or a child 
• For fun 
• To get off-grid 
• Because transferring has become too difficult 
• Because moving around your home has become too difficult*
• Because you want more out of life!

Any disability or condition could spark off an interest in using a powerchair. You could hire one or try one for a period of time to see if this type of mobility aid might help you. 

Drawbacks to The Full Power Option 

If a large power-chair is going to be your only mobility choice then you will need to work out what kind of life you can achieve using a powerchair and you will need time to get used to both the chair and the restrictions it presents. Moving into a big powerchair sometimes also means changing your entire lifestyle. It also means moving into the 'disabled' lifestyle if you are going to be using this option every day. Not everyone is ready for this option if they have been using a wheelchair part-time or if they have been used to the freedom of a self-propelled wheelchair and so many people choose the power add-on route before they get this far. So let's discuss this next. 

Power Add-Ons - A GoBetween?

Many people would consider power add-ons or wheelchair add ons to be as far as they want to venture into the powerchair world. For those with some level of upper body strength, a non-progressive condition or those wanting to hold on to the freedom of both worlds this option may seem tempting. But beware, the world of power add-ons is expensive and fraught with all kinds of unknown factors. Probably one of the best things you can do if you are going to consider using power add-ons is to get a mobility dealer to come and demonstrate several options before you buy. I also advise doing considerable research before you buy. 

There are different levels of power add-ons. Perhaps the 'lowest' level of power add-on is the u-drive system which is a cheap low-level power attachment rather like an attendant attachment. Next in line are power add-ons with hand control units and finally, there are power add-ons which just add power to your drive. Some of the above I have owned at some point and will review...but here is a basic summary:

1. U-Drive: Basic attachment type. Cheap, slow and doesn't go very far. Good for indoors and slow people without a large budget. 
2. Powered Wheels with a controller such as JWaCtive, SD motion and Alber e-fix. Great add-ons giving a lot of freedom. Very lightweight in comparison to a powerchair but not actually light. SD Motion is lighter and easier to push than Alber wheels which are heavy 
3. Powered wheels without a controller: Fantastic fun but you still need to be able to push and the wheels themselves are very, very heavy so not easy to transport. You will need basic wheelchair skills to use this type of add-on 
4. External power attachments without controllers: These are really for active wheelchair users with good upper body strength who are able to self-propel quite effectively already. Some models can be quite troublesome and they are very expensive 
5. Electric bike add-ons. This is the one type of power attachment I have very little knowledge of and would very much like to try more of. These attachments allow you to have considerable power and also use your manual chair as a basic manual chair once you get to your destination

So, in summary, add-ons can make a good go-between but don't always allow for the level of freedom we might desire. 

Invacare Action 3NG MWP (photo courtesy of https://www.invacare.it/it/action-3ng-rocking-chair-ma-60a3ngrcit)   Dragonfly 2 (photo courtesy of http://www.ebaystores.co.uk/Click4Mobility) 

A good way of thinking about what kind of add-on you might want to use is to visualise everything you currently do in a week and then add on three things you would like to do regularly but feel you can't achieve with your current set-up. Using a list and your imagination will create a future-scape in your head. Joining a group such as a Facebook group for wheelchair users and asking a lot of questions will help. Don't make impulsive buys just because you are feeling the pang of a loss of freedom. Plan ahead. Wheelchair mistakes are expensive and frustrating! 

Self-Propelling - The Shanks Pony of the Wheelchair World 

Self-propelling is hard work, takes time to learn and involves developing new skills and muscles. If you can do it to any extent however this type of skill is possibly one of the biggest freedoms in self-directed wheelchair use. If you have low upper body strength but want to propel in some circumstances there are lots of things that might help - depending on where your weakness lies. Some things to consider are:

• Buying a lightweight active wheelchair
• Losing weight 
• Camber 
• Excellent wheels 
• Carbon fibre chairs 
• Wheelchair levers 
• Handrim grips 
• Off-road kit (wheels and front attachment) 
• Mid-wheel drive (such as the new Action 3MWP) 

Using a heavy or ineffectively set wheelchair won't help you push. If your main issue is that you have not yet developed the muscle power to push effectively then I suggest you save money and visit a mobility store and get your legs fitted out properly. It does not matter if you are using the chair full-time, part-time or sometime soonish. A badly fitted chair with a poor centre of gravity is going to be tiring and restrictive. 

Losing weight both on your body and on the chair is a good idea in general. a very light chair means less weight for your shoulders to carry and less weight for your chair! If your disability means you are pilling on the pounds then it's a chicken and egg situation. If you want to lose weight and keep fit then it might be worth pushing through the pain to keep pedalling- I mean wheeling!

Camber is the angle at which the wheels are set from the chair. If you are fat or need a heavy-duty prescription this isn't going to be an option for you. Big chairs with decent camber tend to be too big to fit through normal doors. If you are thin and want to propel but have weak arms you will want to buy a chair with some variance available on the camber as this will help you propel. 

Handrim grips and wheelchair levers can help people who find it hard to control a chair on a downward slope. The levers can be pushed inward to stop or slow a person down so this is a great option for someone determined to push but with limited power or damage to their arms. Check the manufacturer website beforehand to make sure the lever type is suited to your condition. Levers distribute the power away from the wrists elbows and shoulders to your upper back - so try them beforehand if you have back issues or trunk spasms. 

An off-road kit with a mid-wheel which can be attached to any chair can be great fun and help with pushing if you want to explore the country outside of the beaten track. However, it is worth trying the set-up first as it's not suitable for every chair or person. Having said that they are relatively cheap as an option. If you don't like being tilted backwards or you fear the feeling of instability this attachment is not for you. 

Why you might want to continue pushing:

Pushing your own chair if you can do it probably allows for the greatest amount of freedom possible. This won't be the case if you can't push, your chair is heavy due to a prescription or you are weak and need a chair to retain power. If you can push it allows you to:

• Fold the chair up into a car 
• Get to more places 
• Access places without a ramp if you're able to transfer 
• Keep your options open. 

Some of us such as myself need the prescription aspect of specific chairs and so are stuck with the heavier models. Invacare have recently brought out the Action 3NG MWD and this chair is designed for those of us whom are stuck with such dinosaur prescriptions for various reasons but still want to push sometime. I have yet to try the chair but will review it when I can. 

I hope you found this article interesting and that you will leave your own thoughts, comment and questions below.