The manual process of transporting a wheelchair user up a flight of stairs, often called “bumping,” is an inherently high-risk maneuver that requires proper training and a thorough assessment of the environment and equipment. This technique involves tilting a manual wheelchair back onto its large rear wheels and lifting it, step by step, while the user remains seated. Due to the significant risk of injury to both the user and the caregiver, this procedure should only be attempted after careful preparation and when safer alternatives are unavailable. The technique is exclusively suitable for standard manual wheelchairs and is never recommended for heavy power chairs or scooters due to their mass.
Essential Safety Assessment Before Attempting
Before beginning any ascent, a comprehensive safety assessment must confirm that the procedure is physically feasible and mechanically safe. The wheelchair itself must be structurally sound, with secure, non-removable push handles and functional tipping levers (anti-tippers). These levers may need to be temporarily repositioned or removed depending on the specific technique used.
The combined weight of the user and the manual chair must be assessed against the caregiver’s physical capability. The person assisting must have the necessary strength and be trained in proper lifting techniques, focusing on using the legs to protect the back. The condition of the staircase is equally important. Inspect the stairs for sufficient width and proper lighting, and ensure there are no slippery surfaces, broken steps, or wet treads, which would disqualify the stairs from use.
Communication with the wheelchair user is the final preparatory step, ensuring they are informed of the plan, comfortable with the maneuver, and aware of how they can best assist, such as by maintaining a specific posture or removing their feet from the footrests. The user should be securely positioned in the chair, ideally using a safety belt to prevent unwanted movement during the tilt and lift. Removing any detachable footrests or ensuring they are securely folded up also eliminates a potential tripping or snagging hazard on the stair edges.
Step-by-Step Technique for Ascending Stairs
The core technique for ascending stairs with a single caregiver involves precise positioning and controlled lifting, focusing on one step at a time. The caregiver first positions the wheelchair at the base of the stairs with the user facing away from the steps, so the rear of the chair is against the bottom riser. Standing behind the chair, the caregiver uses one foot to press down on the tipping lever, gently pulling back on the push handles. This tilts the chair back until it reaches its balance point, resting only on its large rear wheels.
The chair must be maintained in this backward-tilted position, ensuring the small front caster wheels are elevated and clear of the steps throughout the ascent. The caregiver then pulls the chair backward and upward, using their legs to lift the combined weight and roll the rear wheels onto the first step. The movement is a combination of pulling and lifting, not pushing, which helps the caregiver maintain control and leverage.
After the rear wheels are securely placed on the step, the caregiver repositions their feet on the next step up to prepare for the subsequent lift, while still maintaining the chair’s balance point. This sequence is repeated for each step, focusing on keeping the user level and minimizing jarring movements. Once the top landing is reached, the chair is rolled fully onto the flat surface. The caregiver then slowly lowers the front casters back to the ground by releasing the tilt.
Adapting the Technique for Two Caregivers
The use of two caregivers significantly increases the stability and safety of the maneuver, particularly for heavier users or prolonged ascents. This technique requires a designated leader, usually the caregiver positioned at the rear of the chair, who controls the tilt and issues verbal commands to ensure synchronization.
The primary caregiver stands behind the wheelchair, gripping the push handles. The second caregiver stands in front of the user, facing them and holding onto the stable, non-removable frame near the front or the lower crossbar. This person provides stabilization, helps guide the front of the chair, and assists with the upward lift. They must avoid holding onto removable components like footrests or armrests, as these can fail under load.
Coordination is achieved through clear, audible commands from the rear caregiver, such as “Ready, Lift, Up,” before each step. Both individuals must execute the lift simultaneously, using their legs to distribute the load and pull the chair up one step at a time. The rear caregiver maintains the backward tilt. The front caregiver assists in pushing up and back, helping to keep the front casters clear of the steps and the chair balanced.
Recognizing Limitations and Exploring Alternatives
There are absolute safety limits where manual wheelchair bumping should not be attempted, regardless of caregiver strength or training. This includes staircases with narrow, winding treads, such as spiral stairs, or steps that are excessively steep, wet, or damaged. The manual technique is also prohibited when moving a heavy power wheelchair or assisting a user who is medically unstable or unable to follow instructions.
When manual assistance is not safe or practical, several specialized, mechanical solutions offer safer long-term accessibility.
Mechanical Alternatives
- Portable ramps can be used for short runs of stairs or single steps, providing a temporary slope for easier movement.
- Installed stair lifts carry the user in a seat for multi-level homes.
- Inclined platform lifts transport the user while remaining in their wheelchair.
- Specialized stair-climbing wheelchairs use tracks or unique wheel designs to ascend and descend stairs mechanically.