1. Know Your Range of Knee Motion 

The range of knee motion is probably one of the most critical measurements in the legrest prescription process. Over-stretched legs are not only uncomfortable but can also lead to poor posture over time. 

Reference article: The Fundamental Importance of Knee Range of Motion

Reference article: The Fundamental Importance of Knee Range of Motion

• Within Normal Limits (WNL): If knee flexion falls within normal limits, most legrest options should be suitable.
• Fixed Knee Contracture Over 90 Degrees: When knee angles are fixed at over 90 degrees, proper support usually requires specific alignment between seat depth and a customized legrest.
• Limited Knee Flexion or Fixed Knee Contracture: For users with limited knee flexion or fixed contractures, it’s important to choose a legrest that supports the exact angle needed.

1. 1. Tool-adjustable legrests and manual elevating legrests are the most commonly used options.  
   2. Users with high muscle tone over the knees will benefit from tool-adjustable legrests, as these allow for a stable, fixed position. 
   3. If different limitations exist in each knee, sperated legrests with an independent angle-adjusting function are often the better choice. 

2. Consider Your Transfer Method

If you frequently transfer into and out of your wheelchair from its side, it’s essential to choose a legrest that won’t obstruct your movement. Central legrests provide clearance on both sides of the legs, which can be a game-changer for users with limited hand mobility to have smooth transfers.  

For those who prefer transferring from the front of the wheelchair, swing away legrests can clear the leg space entirely. However, if a user lacks sufficient hand function to swing the legrest away, consider legrests that allow the footplate to lower to the ground. Paired with anterior tilt or low seat height, this setup enables users to step out of the wheelchair directly from the front.  

3. Choose the Right Footplates

Don’t overlook the footplate design when selecting a legrest. Not all footplates are compatible with every legrest, so be sure to consult with your dealer or therapist to ensure the right match.  

The central mount footboard is ideal for compact space or indoor if it can be positioned at an angle close to 90 degrees.

For users without any leg deformities, either a one-piece or two-piece footplate is suitable. However, if there is a leg length discrepancy, two-piece footplates are recommended to accommodate different footplate heights on each side.

Adjustable footplate is ideal for individuals with foot deformities, as it can be tilted forward and backward, and the lateral angle can also be adjusted. 

Special mention should be made of Amputee Legrests, which typically feature shortened support and angle adjustability. Some models also provide lateral support to help keep the residual limb stable. 

4. Think About Leg Elevation Needs

If you have a positioning wheelchair and you have no deformities in your lower extremities, consider whether manual or powered elevating legrests are better suited to your needs and abilities.  

To enhance circulation in the lower limbs, a tilt-in-space wheelchair equipped with elevating legrests can be highly effective. The key principle is to position the legs higher than the head, which promotes better blood flow. 

Pro Tip:  Biomechanical length compensation allows the legrest to adjust in length as the angle changes, reducing strain on the joints. It’s especially important for users who cannot reposition themselves in their wheelchair.

5. Consult Your Therapist for Special Positioning

For individuals with severe deformities in the pelvis, trunk, and lower extremities, a specialized positioning setup is necessary to ensure sitting stability, comfort, and driving efficiency. A therapist’s assessment plays a crucial role in selecting the most suitable legrests to support proper posture. 

Conclusion 

Choosing the right legrest for your wheelchair is essential for maximizing both comfort and functionality. By taking into account factors such as your range of knee motion, transfer methods, footplate design, leg elevation needs, and specific sitting posture, you can make an informed decision tailored to your individual requirements. If you have further questions about selecting legrests, consulting a qualified therapist and your dealer for professional guidance is key to making the right choice. 

Tzuyu Lin, PT, Product Manager

Tzuyu Lin is a physiotherapist and Product Manager at KARMA headquarters. She began her career at the Rehabilitation Engineering Lab at National Taiwan University, focusing on exoskeleton studies, and later gained five years of physiotherapy experience at an orthopedics clinic.

Since joining KARMA in 2021 as a Product Specialist, Tzuyu has focused on custom adaptations and complex rehab technology. Now part of the product management team, she co-developed the KARMA Flexx Adapt wheelchair.

Keep Reading

Which Leg Rest Should You Choose?

How Do the Footplates Contribute to a Comfortable Sitting Position?

Busting Myths about the Leg Rests on a Wheelchair

If you frequently transfer into and out of your wheelchair from its side, it’s essential to choose a legrest that won’t obstruct your movement. Central legrests provide clearance on both sides of the legs, which can be a game-changer for users with limited hand mobility to have smooth transfers.  

Independence and freedom

The wheelchair is the most popular assistive device, and it’s easy to see why. A wheelchair can give back the feeling of independence and freedom to someone who might have previously felt dependent and restricted. A wheelchair can provide mobility to someone to help them get around, no matter how short or far the distance. A wheelchair can assist a wide range of mobility levels, lifestyles, backgrounds, and environment, making it the most versatile assistive device on the market. 

Having access to a wheelchair allows the user to travel independently wherever they want, whenever they need. The control they have over their own life will also improve self-confidence and allow users to take control of their own lives. 

Improves health

A wheelchair that fits properly can reduce secondary injuries such as scoliosis and pressure sores as a result of an ill-fitting wheelchair. With the proper wheelchair and supports, the wheelchair user can better propel and participate in more physical activities, thus improving their health. Choosing the right wheelchair not only means that the chair fits correctly, but it is also suitable for the user’s lifestyle. For example, if the user plans to use their wheelchair as their main form of transformation, if possible, the user can select a power wheelchair. This will relieve some of the physical effort that comes from propelling a wheelchair for long periods of time. 

Being able to move around comfortably will improve the user’s mental health by being able to take control of their own life and enjoying the freedom that comes along with having your own mobility device. 

Active member of the community

Wheelchairs are incredibly versatile and can be use used by men, women, young, or old. All of these roles are vital in an active community. In order to access the community, whether it be to go to work or attend school, a wheelchair can be used to provide access to these and other various activities. Without access to friends, family and peers, life can become lonely, so it’s important to have a way to access the company of others. 

No matter what wheelchair you decide to choose, there are benefits that go beyond recovery or rehabilitation. The United Nations Convention on the Rights of Persons with Disabilities (UNCRPD) states that having a personal mobility device is a human right. A personal mobility device should have the ability to move in a matter and at the time of one’s own choice. Acquiring a wheelchair is not only a choice, but a human right. If you need help choosing the right wheelchair for you, KARMA Medical are always here to help.

Postural supports

Posture supports allow the user to sit in their wheelchair comfortably for longer. The postural supports can be bespoke for each user to increase stability and mobility. Increased stability is imperative to avoid long term injury. 

This is why selecting the right wheelchair is so important for each user. A therapist or doctor will provide the user with the accessories they need in order to sit comfortably and securely. 

Adjustable headrests

Power wheelchairs are typically already equipped with headrests, however, headrests can be added to manual wheelchairs should the user require additional head and support. For example, KARMA Medical’s Adjustable Headrest can be configured to the requirements of the user. Headrests not only reduce strain on the neck and shoulders, they also help maintain the user’s posture for a stable sitting position. Sitting comfortably will improve the user’s mobility and prevent long term injuries.

Tray table

A tray table may not seem like an obvious mobility aid, however it does assist in making it easier to navigate daily life. For example, if the user is planning to eat outdoors with their peers, outdoor seating is not always accommodating for wheelchair users. A tray table removes these obstacles, allowing any wheelchair to participate in everyday activities. Not only can a tray table be used to enjoy meals, but it can be used as a work surface for a laptop etc. 

A tray table is also great for elderly wheelchair users who may not be comfortable moving in and out of their wheelchairs at meal times or for other various activities. They can be used on both manual and power wheelchairs, which is great for all wheelchair users. 

Wheelchair bags

Wheelchair storage or a wheelchair bag may seem like an obvious accessory, but it’s also one of the most useful. There are a variety of wheelchair storage solutions to choose from, for example, backpacks, net bags, armrest bags, and tote bags. The backpack and tote bags can hang on the push handles of the wheelchair to provide plenty of additional storage when out and about. 

Wheelchair bags are a great place to store medical equipment and other necessities instead of keeping them on your lap. This will ensure that the belongings are safe and that the user’s mobility isn’t affected with the additional things.

All KARMA Medical wheelchair accessories are designed for comfort and support to assist not only the user but caregivers to improve mobility. There are accessories for both power and manual wheelchairs for not only support, but also to make daily life easier.

Increases your independence

Wheelchair users can sometimes feel like a burden, which results in them in wanting to be more independent. To go wherever they want, whenever they want. Sometimes a manual wheelchair may feel restricting however, a folding power wheelchair or power wheelchairs in general can increase the feeling of independence because you don’t need to rely on anyone to assist you. 

A foldable power wheelchair can help you as part of your daily routine to complete tasks as well as socialize with friends and family without the help of a caregiver. 

Increases happiness

With increased independence, you (the wheelchair user) will feel happier after completing tasks and activities that would otherwise not have been possible without a folding power wheelchair. This will boost your mood and those around you.

Saves space

A folding power wheelchair can be easily stored. As the name suggests, it can be folded to be more compact and often accessories removed to save even more space. They are perfect for individuals who don’t have a lot of living space. A foldable wheelchair also makes the chair easier to fit in the trunk of a car. This makes travelling a breeze, and you can save money by not needing to purchase a specialized car.

Convenient, lightweight, and foldable

KARMA has a wide range of lightweight folding power wheelchairs such as KP-25.2 and the eFlexx which can be easily transported or stored away when not in use. Being foldable and with removable parts also makes it easier to be transported by a caregiver. A lightweight foldable power wheelchair is a great option for users looking for a wheelchair for everyday use. 

Increased comfort

KARMA wheelchairs have been carefully crafted with the wheelchair user in mind. We understand that there are a wide range of wheelchair users with individual needs, which is why KARMA wheelchairs can be modified with a wide range of accessories and adjustments to ensure the utmost comfort of the user. The user should not only be comfortable sitting in the chair, but also be able to comfortably control the wheelchair. 

Safe to use and travel

Amongst the wide range of KARMA folding power wheelchair, a lot of models have been safety crash tested in accordance with international standard ISO 7176-19, which means that the wheelchair can be used as a seat in a motor vehicle. KP-25.2 has been a long time favourite folding power wheelchair amongst KARMA customers for good reason! KP-25.2 has been crash test approved, as well as passing other KARMA safety tests such as the Drop Resistance Test and the Rough Road Test. 

KARMA Fit

When choosing a wheelchair, it’s important to consider all the needs of the user. This includes their body measurements, prognosis, lifestyle, and budget; this is what we call the KARMA Fit. If you are still unsure or have questions about which wheelchair to choose, you can contact your local KARMA dealer or contact HQ. 

Ultra lightweight adjustable manual wheelchair 

Ergo Lite weighs a total of just 8.6 KG which is perfect for travelling with an elderly wheelchair user. The Ergo Lite series has proven a firm favourite amongst KARMA customers with hundreds of positive reviews on Amazon as well as winning Thiis Magazine’s 2020 Retailers’ Choice Award. 

This ultra lightweight wheelchair can be easily folded for convenient storage in the trunk of a car or at home when not in use. The Ergo Lite 2 has the option for large rear wheels if the user prefers the option to self propel when out and about. This wheelchair also comes with handy removable swing away footrests to make transferring in and out of the chair safe and easy.

The Ergo Lite series wheelchairs have been crash tested in accordance with international safety standard ISO 7176-19, which means it is suitable to be used as a seat in a motor vehicle for transportation. No matter where or how you are travelling to your destination, the Ergo Lite is a great companion for your trip! 

Lightweight manual wheelchairs designed for everyday use

Choose comfort every day when travelling from a wide range of S-Ergo lightweight manual wheelchairs. This series of manual wheelchairs includes the S-Ergo 125 that is equipped with flip back armrests and removable footrests for safe and easy wheelchair transfers. The foldable frames make S-Ergo 125 a great companion when travelling for easy storage. The S-Ergo lightweight manual wheelchairs are all equipped with KARMA’s patented S-Ergo Seating System to provide basic pressure relief when sitting for long stretches of time. 

Adaptable on the go

The Flexx series is KARMA’s range of adaptable chairs for a wide range of users. Flexx has a complete range of accessories that can be used during rehabilitation and to increase comfort. Flexx is an ideal wheelchair for travelling for its lightweight and foldable frame. Not only this but the backrest angle, height, seat depth, and rear axle can all be adjusted. If the user needs adjustments to their wheelchair made whilst traveling, this can all be done on Flexx. 

Affordable travel companion

For a more affordable wheelchair option whilst travelling, wheelchair users can choose Agile. The Agile is the latest innovation from the SOMA wheelchair range. Agile is lightweight and highly configurable; perfect for travelling! The quick release rear wheels make it convenient to store along with its foldable frame. Agile has also been crash tested in accordance with international safety standard ISO 7176-19, which means it is suitable to be used as a seat in a motor vehicle for transportation.

Don’t forget to consider the needs of the user!

Make sure to take into consideration the needs of the user as well as the convenient features of the manual wheelchair! Not every user is suitable for every chair. If you’re not sure which chair to choose, you could also consider renting a KARMA wheelchair during your travels. This would give the user a chance to try out a new chair, and it could be convenient to pick up the chair at the destination if travelling with a wheelchair is inconvenient. If you are travelling with an elderly user, you can take a look at our previous blog, travelling with an elderly wheelchair user, for our top travel tips!

Over time, many older people lose their mobility and are forced to use a wheelchair in their day-to-day lives. There are a wide range of wheelchairs that the elderly can choose from with many different functions. This blog will guide you to choose the right wheelchair most suitable for the elderly.   

Types of wheelchairs for the elderly

There are many types of wheelchairs for the elderly that they can choose from depending on their needs. KARMA has a large range of wheelchair solutions, no matter if the user needs a lightweight wheelchair for an elderly user or a positioning chair that can facilitate certain movements. 

Wheelchair for home

Indoor wheelchairs should be lightweight and easy to use. When caring for an elderly person at home, it is also important that the wheelchair is can be easily manoeuvred around the home, e.g., around tight corners and through often narrow doorways. Choosing a compact wheelchair will make it easier to get around limited spaces. Ergo Lite 2 has the option to be equipped with transit wheels that reduce the overall size of the chair. 

Another useful feature for a home wheelchair is that it can be foldable. When the user isn’t using the chair, if it can be folded and stored out of the way or taken in the car. KARMA has a large range of folding wheelchairs that the elderly user can travel with or store in a small space. 

Positioning wheelchairs

Positioning wheelchairs allow the elderly user to sit in a different position to relieve pressure and, if needed, can facilitate the care of the elderly user if necessary. KARMA’s positioning wheelchairs can be tilted, reclined, or both. Learn more about the benefits of a reclining and tilting wheelchair in a previous blog. 

Best wheelchairs for the elderly, what to know before buying?

There are several factors that should be taken into account before deciding on a wheelchair for the elderly. Such things to consider are the weight, if it is foldable, or should it be a power chair. These are all important things to think about, as there are many wheelchairs out there to choose from for each user. Remember that most wheelchairs can also be customised with different adjustments and accessories to suit the user. 

Ergo Lite 2 can be easily lifted and stored in the trunk of a car.

Which wheelchair is better for the elderly, manual or power?

The decision between choosing a manual or power wheelchair largely depends on the mobility of the elderly user. If the elderly person has good mobility in the arms and torso and good balance, then it is possible for them to use a self propel manual wheelchair. If they do not have any mobility and need to travel regularly, then a power wheelchair is the way to go. 

The decision is usually made by the person who will be caring for the elderly user. If the elderly person has good decent balance but unable to self-propel the chair, they can opt for a wheelchair with transit wheels that can be pushed by a caregiver. This is a good option for day-to-day use together with the assistance of a caregiver. If the elderly user does not have someone who can help them, then a power wheelchair may be a better choice. 

What factors should you consider before buying a wheelchair for the elderly?

The most important factor is the degree of mobility the elderly user has. In the case of older people, it is essential to bear in mind that the level of mobility decreases in most cases. This is why it is advisable to choose a wheelchair that is adjustable to adapt to the progressive loss of mobility an elderly person may suffer. Mobility products adapted to your needs and comfort.

KARMA Medical has a wide range of products to meet the needs of a wide range of users. KARMA also have wheelchairs specifically aimed for elderly wheelchair users, including lightweight wheelchairs, positioning wheelchairs, power chairs, and scooters. 

KARMA Medical wheelchairs are extensively safety tested to meet various international standards. If you still need advice about which chair to choose, you can contact your local KARMA dealer or contact KARMA here. 

Renting a wheelchair for travelling 

When families with elderly relatives go on holiday, sometimes renting a lightweight wheelchair is easier and more convenient than bringing their current wheelchair. Choosing to rent a lightweight wheelchair makes travelling much easier, especially if the rental is organised at the travel destination. Choosing to rent a wheelchair at the travel destination could save time and money if the user has to check the wheelchair on a plane. 

A lightweight wheelchair can have the option to have an attendant propelled (small rear wheels) or to be self-propelled by the user. The user and family can even choose a wheelchair with detachable leg rest if the user has difficulty transferring in and out of the wheelchair or the family are travelling by car and the chair needs to be extra compact. 

For users with elderly caregivers that want to travel either on a short holiday or grocery shopping, KARMA’s Ergo Lite is an overall great choice.

Renting a wheelchair for rehabilitation

The user is recovering from an accident and only needs a wheelchair during their rehabilitation, so renting a wheelchair for a short period of time is a great alternative to outright buying one. The user can save a lot of money, and it is potentially more friendly to the environment. Ideal candidates for renting a wheelchair for rehabilitation are typically those who have broken a leg or hip. 

If the injury occurred is a leg fracture or hip arthroplasty then the best wheelchair they can choose that will best facilitate their recovery is a wheelchair with detachable armrests and leg rests. KARMA’s Flexx series has an adjustable rear wheel axis that can be altered depending on the user’s upper body strength and confidence using a wheelchair. 

Rent to test a wheelchair before purchasing

People who have suffered from a stroke can sometimes be left with limited body movement. The case of someone who has little body strength will typically be told to look for a high back wheelchair. A high back wheelchair will typically come with extra functions like “Tilt-in-Space” and Recline that are designed to make the user more comfortable. These wheelchairs tend to be on the pricier side, so it’s understandable that families of the stroke patient may want to try and test the wheelchair before committing to purchasing.

High-back, reclining, and tilting wheelchairs are usually recommended for those who are in long-term recovery from a stroke. Source: KARMA Medical YouTube – VIP2 Tilt & Recline Wheelchair.

When is it time to purchase a wheelchair?

If the user needs a wheelchair for more than a few months then it could be more cost-effective to purchase a wheelchair. There are definitely advantages to purchasing a wheelchair. For example, the wheelchair belongs to you, and you can use it whenever you want. Your wheelchair will have been chosen and fitted for you based on your body measurements and condition. Some people might consider the money spent renting a wheelchair a waste if it could have been spent invested in their own wheelchair instead. 

If the wheelchair is rented, the user may be required to cover any damage caused to the wheelchair. However, if the user owns the wheelchair then there are no consequences for any damage caused. If the user no longer needs the wheelchair, or they change their mind, they can result, donate, or give the wheelchair to someone else. 

Where can you rent a wheelchair?

You can contact your local wheelchair supplier, and they will direct you to where you can rent a KARMA wheelchair. If you are not sure which wheelchair to choose, you can contact your local KARMA wheelchair dealer or contact us here. 

KARMA’s Ergo Lite 2 is available with small or large rear wheels.

The role of the rear wheel is to offer stability to the wheelchair, and also the ability for the user to self propel. In order to be able to manually self propel, the user must choose the large rear wheels. This offers the user independence as they don’t need to rely on another person to get around. Typically, more active wheelchair users will opt for the larger rear wheels. 

If the user has someone, for example a caregiver or family, who is going to push the wheelchair from behind all the time, then a smaller rear wheel is more suitable. Typically, elderly users will opt for a wheelchair with a smaller rear wheels as it makes the wheelchair more lightweight and ideal for day trips. 

+ Advantages of a large rear wheels

The user can propel the wheelchair themselves.

Large rear wheels have a larger surface area, so it’s easier to navigate rough terrain e.g., grass or uneven road.

The rear wheel can be detached for convenient transportation and storage

— Weaknesses of a large rear wheel

Heavier wheelchair, which means more effort is required to lift it

Requires more storage space

+ Advantages of a small rear wheels

Ideal for elderly caregivers because of the lighter weight

Easier to navigate in small spaces; apartment buildings, elevators, etc.

Smaller storage space needed

-Weaknesses of a small rear wheel

The user cannot propel themselves

Small wheels are not suitable for rougher terrain

A good example of a wheelchair that has the option of both small or large rear wheels is the Ergo Lite 2. If the user has someone who is going to push them when they are in the wheelchair, then the smaller rear wheels make for easier lifting and convenient storage. If the user is looking for more independence with the benefit of an ultra lightweight wheelchair, then the larger rear wheels are the ideal choice. Both options are still equipped with a foldable frame for handy portability. 

We’re here to help

If after reading this blog you’re still not sure which rear wheel wheelchair is the best for you, you can contact KARMA or your nearest wheelchair dealer today! 

What is the difference between a footrest and a leg rest? 

Choosing the correct footrest or leg rest is critical to finding the right level of comfort and support for you. A footrest consists of a stationary hanger and footplate for the user’s feet to rest whereas a leg rest will have a calf pad to support the lower leg as well as a footplate. 

Basic footrests are usually the standard for wheelchairs with additional functions such as swing-away footrests that make transferring in and out of the wheelchair easier and safer. Standard footrests are typically set at 90° however some hanger angles can be adjusted to be less than 90° to accommodate the needs of the user. 

VS

2 types of leg rest: elevating leg rest and articulating leg rest

The main purpose of these leg rests is to help redistribute the pressure on the user to help increase circulation, prevent swelling, and increase comfort. Legrests are not as common on a standard wheelchair and are most often found on a Tilt-in-Space or reclining wheelchair to provide additional leg support. Choosing between elevating leg rest and articulation leg rest can depend on your medical condition.

Elevating Leg Rest Designed for comfort and support

Elevated leg rests can be any angle e.g. 90° or 80°. These types of leg rest come with a calf pad to support the leg when it is elevated. This is great for users who want to be comfortable but can’t bend their knees due to an injury or other medical condition. The leg can be kept straight with zero effort from the user or even a caregiver. 

An elevated leg rest will always have the same elevation so it’s good for users who need their legs to be rested at the same angle at all times. The length of KARMA’s elevating leg rest can be adjusted to ensure that the leg remains straight and doesn’t bend as a result of the footplate. 

Articulating Leg Rest

Articulating leg rests extend as they are elevated which is good for users who occasionally need to bend their legs. This type of leg rest is often found in power wheelchairs 

Articulating leg rests are designed to allow freedom of movement which is particularly important for someone with high blood pressure or someone who needs them as part of their therapy to keep the legs moving. The automatic length adjustment means that the user can rest easy as the length does not need to be adjusted manually. This is great for caregivers who might find it difficult to continuously bend down.

Which leg rest is best for you?

This is very much dependent on how much movement of your legs is required. If you are not allowed to move your legs then you can choose an elevating leg rest. If you can (or are recommended to move your leg) then you can choose an articulating leg rest. 

Before you make a final decision, be sure to try before you buy. Remember to always do this together with a professional therapist to prevent unnecessary injuries. 

The wheelchair user has the wrong wheelchair

As a caregiver, you should have the right equipment to work with. If the wheelchair is not properly maintained, that could make your job as a caregiver more difficult. Here are some things to look out for to help you avoid secondary injuries. 

The wheelchair is not properly maintained e.g. flat tires, faulty brakes, loose wheels, damaged upholstery/frame

• Once per month, check the tires (especially if you find the wheelchair particularly hard to push, the tires could be flat).
• If you notice the brakes stop working, you should contact the wheelchair dealer as soon as possible as these faults could be putting not only the user but the caregiver at risk of unnecessary injury. KARMA pride itself on providing excellent aftercare service for our users. We require dealers to have basic knowledge about our products to sell them. 

Modifications or repairs to the chair were not conducted by authorized personnel 

• If modifications to the wheelchair were made to the wheelchair by unauthorized personnel e.g. to the frame, the user voids the warranty on that product from the manufacturer. This means if there are other problems in the future, the manufacturer will not fix them under the warranty. 

The user is in a wheelchair that is not suitable for them or their environment 

• If the user is suffering from pressure sores then it’s possible that they have been prescribed a wheelchair that is not suitable for them. KARMA has a wide range of wheelchairs to ensure that there is a chair to suit a wide range of users. We recommend that the wheelchair you have been prescribed to you by a doctor or therapist to avoid user injuries. 
• Finding a wheelchair that is suitable to a user’s dimensions or condition is just as important as finding a wheelchair that suits their lifestyle and environment. For a caregiver, this is is particularly important as you hope the user will be prescribed a wheelchair that will not only make their life better but could potentially make the caregiver’s life more convenient. For example, if the user is unable to regularly reposition themself, we would recommend a wheelchair with Tilt-in-Space or recline functions. These positioning wheelchairs can reposition the user with little effort from the caregiver. 
• KARMA has a philosophy called the KARMA FIT where we encourage wheelchair users to choose a wheelchair that meets their needs, body dimensions, budget, and lifestyle (aka their environment). 

Failure to charge the wheelchair battery

• Keeping the wheelchair battery healthy and fully charged will not only benefit the user but also the caregiver. KARMA wheelchairs will show red LED lights to indicate the battery level of the chair. To increase the lifespan of the wheelchair battery, we recommend not letting the battery die but charging it everyday to keep the battery levels up. 

When day to day tasks are difficult with a wheelchair 

The effort that is involved to push the weight of the wheelchair and the user

• If the caregiver has to push the user then we recommend choosing an ultra lightweight wheelchair to lessen the burden on the carer. If there is no chance of the user propelling themselves, choosing an attendant or transit wheelchair with smaller rear wheels will reduce the weight of the wheelchair even more. 
• In extreme circumstances, the user could consider getting a power wheelchair that eliminates the need to be pushed at all. 

Pushing the wheelchair long distances

• If it’s a daily struggle to push the user long distances, similar to having to push the user weight as well as the weight of the wheelchair, a simple solution is to get a power wheelchair. This takes all of the strain and pain away from the caregiver. 

Helping to transfer in and out of wheelchairs

• Some wheelchair users require to be transferred in and out of the wheelchair several times a day. If the user is heavy, this can cause musculoskeletal strain injuries to the caregiver from carrying out this repetitive action. We suggest getting a Tilt-in-Space or Reclining wheelchair (either power or manual) so that the user can rest in the wheelchair which will reduce the amount of transfers. 
• A positioning wheelchair can also make tasks like changing diapers or administering medication easier. The reclining wheelchair can also make bed transfers easier as it can be adjusted to be the same height/ angle as the bed. Even a wheelchair with basic swing away footrests and armrests can make wheelchair transfers safer.

When the environment is not wheelchair friendly

Soft floors e.g. carpet/uneven surfaces

• Depending on the needs of the user, they could possibly choose a wheelchair with large, self propelled rear wheels to make pushing the wheelchair easier when on carpet. The larger wheels cover a larger surface area, making it easier for caregivers to navigate. The only downside is if there are limitations to the space, which brings us only our next problem;

Tight spaces to navigate 

• Choosing a small transit wheelchair to use in the home is a great option but obviously not possible for everyone. The transit chair is narrow, with space saving armrests, and smaller rear wheels. Home adaptations can also be considered to accommodate larger wheelchairs e.g. widening doorways.  

Struggling to push the wheelchair up and down ramps 

• If the combined weight of the user and wheelchair are the problem, we suggest choosing a lightweight wheelchair to lighten the load. If the carer struggles to frequently push the wheelchair up and down ramps, the user might consider a power wheelchair or installing a stairlift. An attendant control can even be added for the safety and convenience of the caregiver. 

Not enough education/information about wheelchair accessibility 

• A good wheelchair seller and/or manufacturer should provide a user manual that not only explains the best practice of how to use their products to protect the safety of the user but also achieve the longest lifespan. These days, most wheelchair manufacturers will produce videos or blog posts with helpful information about how to use their products. 

When the caregiver is elderly

The wheelchair is too heavy

• KARMA therapists recommend that caregivers, especially elderly ones, should not repeatedly be carrying objects weighing more than 10KG, otherwise they risk suffering from back pain. Therefore we recommend choosing an ultra lightweight wheelchair like Ergo Lite that weighs just 8.5KG. 

The user has to go to frequent hospital visits

• If the user is frequently visiting the hospital then the caregiver can choose a wheelchair that is easy to transport. Either a lightweight wheelchair with attendant wheels or a self propel wheelchair with removable rear wheels to make transporting the chair in and out of a car easier. 

Finding the right wheelchair 

Finding the “right” wheelchair is not just exclusive to the user but also the caregiver. A caregivers job is not easy but if there are some wheelchair features and functions that can assist them then it is worth investigating. You can check out the full range of KARMA wheelchairs on the KARMA website.