Assisting a person who uses a manual wheelchair requires proper technique to ensure the safety and comfort of both the occupant and the pusher. Mastering the mechanics of pushing helps prevent unnecessary strain on the pusher while providing a smooth, secure ride for the occupant. This knowledge is essential for caregivers, family members, and anyone tasked with moving a wheelchair. The goal is to move the chair efficiently while prioritizing clear communication and adherence to safety protocols.
Essential Preparation Before Moving
Before moving a wheelchair, the pusher must perform a series of checks and establish clear communication with the occupant. First, confirm that the wheel locks (brakes) are fully released. A partially engaged brake causes drag, increasing effort and creating a trip hazard. Next, ensure the occupant’s feet are positioned securely on the footrests, preventing them from dragging on the ground or being caught under the casters.
The pre-movement check also involves scanning the chair for any loose items, such as blankets or clothing, that could interfere with the wheels. Adjust the push handles to a comfortable height, ideally around waist level, to maintain a straight back and leverage the body’s larger muscle groups. Finally, establish simple verbal cues, such as “ready to move” or “slowing down,” so the occupant is never surprised by sudden changes in speed or direction.
Standard Pushing and Turning Techniques
When moving the wheelchair on flat ground, proper body mechanics prevent pusher fatigue and injury. Stand close to the chair, gripping both push handles firmly with a straight back and slightly bent knees. The power for pushing should originate from the legs and hips, not the lower back, utilizing a weight-shift motion to propel the chair forward.
Maintain a steady, consistent speed and avoid sudden accelerations or stops, which can be jarring for the occupant. For wide turns, guide the chair in the desired direction, ensuring a broad arc to prevent the rear wheels from clipping objects. When a tighter maneuver is necessary, such as a 90-degree turn, apply slightly more forward pressure to the handle on the side you wish to turn toward while slowing the opposite wheel. This differential force pivots the chair smoothly around its axis.
For an even sharper pivot, pull back on one handle while simultaneously pushing forward on the other, rotating the chair in place. Throughout any movement, keep your elbows slightly bent and close to your body to maximize control and leverage. This technique allows for precise adjustments without undue strain on the shoulders or arms.
Managing Obstacles and Inclines
Navigating changes in terrain requires specialized techniques to maintain stability and prevent tipping. When approaching an uphill ramp or incline, push the chair forward using a straight approach, leaning your body weight slightly into the push handles and using your leg muscles for power. If the incline is steep, a firm, continuous push is better than short, jerky efforts, which can prevent the chair from rolling backward between pushes.
Descending a ramp requires turning the chair around and backing down the slope for maximum control. Position your body between the chair and the top of the ramp, using your body weight as a natural brake to slow the descent. Walk slowly backward with a wide stance, allowing the large rear wheels to contact the ground first while maintaining a firm grip on the handles to regulate speed.
To ascend a small curb or step, the front casters must be lifted using the chair’s tipping lever, a small bar located near the rear axle. Step down on this lever while simultaneously pulling back and down on the push handles to gently raise the front wheels. Once the casters clear the curb, roll the large rear wheels up and over the barrier by shifting your body weight forward and pushing.
Descending a curb is done backward: back the rear wheels to the edge, then slowly lower them to the pavement while keeping the front casters raised with the tipping lever. To manage a standard doorway, approach the door, open it wide, and use your foot or shoulder to hold the door open while guiding the chair through.