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The Right Fit

By Marcia Lukas
July 24, 2022

If you’ve made the decision to start using a wheelchair, getting the right fit is very important.

When I first started using a standard scooter and wheelchair, I was still able to stand and walk. But when my MS progressed, I found myself spending more time sitting – it became necessary for me to use a customized chair and seat cushion to prevent pressure sores and feel comfortable.

Your wheelchair journey may start with your primary care provider or neurologist. Explain your situation as specifically as possible. If you spend some time standing or walking, your healthcare provider may suggest a standard scooter or wheelchair. If you find you’re spending more time in your wheelchair and are using it as your primary source of mobility, you might need a customized wheelchair. In this instance, ask your provider to refer you to a physical therapist to get a seating evaluation.

During the seating evaluation, the physical therapist will be able to evaluate your specific needs. This often starts with a seating map. This sensor allows the therapist to see exactly how you sit, your posture, and where your pressure points are. Posture impacts these pressure points. Leaning over to one side more than the other may place more pressure on that side, making it more susceptible to a pressure sore.

Once your pressure points are identified, the proper cushion can be determined. My therapist and I chose a Rojo cushion because it has many separate air pockets, which respond to my pressure points, allowing air to be increased, decreased or even removed in certain areas. My right side is weaker, which likely contributed to past pressure sores I’ve experienced. So, with that in mind, the therapist customized the cushion to alleviate pressure and also fashioned a foam wedge to keep me propped up.

The proper cushion is only half the process. The other half is finding the best wheelchair for your needs. Fortunately, there are many different, helpful options. For example, if you are unable to consistently move to relieve pressure on your own, you may want to talk with a physical therapist about wheelchairs with tilt and/or recline features.

Also consider how you will use the wheelchair. Will you be in it all day? Do you need it for travel? Can it fit through doorways at home? What kind of a vehicle will you need to transport it?

Once you have the perfect chair and cushion, there are more customizable options available.

Even seemingly small adjustments can make a big difference in your comfort. My therapist guided me to adding side guards alongside my knees, keeping my legs from flopping open. A lateral torso guard and a contoured seatback help to place my back and trunk into a more comfortable posture. Cushioned gel pads on my armrests prevent skin irritation, and I was fitted with a contoured headrest that would support my neck while leaning back for pressure relief. Lastly straps would be fabricated to keep my ankles from rolling over and my feet from falling off the footrests.

It’s also important to have a medical supply company that does more than drop off your new chair. When mine arrived, it took a few weeks before things felt just right. Armrests were lowered and the seatback was adjusted so the contours hit in just the right places. I was fortunate the technician came to my house to make the changes.

Another important consideration is cost. This is something to be quite honest about with your therapist. Wheelchairs can be very expensive and most insurance companies will only pay for a new one every five years. Given that MS can be progressive, it is important to realistically anticipate your needs now and what you may need in the future. If your arms are becoming weaker, it might be time to seriously consider an electric wheelchair, rather than a manual one. Your goal should be a wheelchair that helps to keep you healthy and comfortable, but also lets you get out, living the fullest life possible.

There are so many advancements in wheelchairs and other devices that help us to maintain our lives. Having proper wheelchair seating is not just a matter of comfort, but an important part of maintaining your good health, both physically and mentally, and to live our best lives with MS.

The National Multiple Sclerosis Society is proud to be a source of information on multiple sclerosis related topics. Unless otherwise indicated, the information provided is based on professional advice, published experience, and expert opinion. However, the information does not constitute medical or legal advice. For specific medical advice, consult a qualified physician. For specific legal advice, consult a qualified attorney.

Marcia Lukas

Marcia is a retired homemaker and a married mother of two grown children. She has had primary progressive MS for more than 35 years and as a recent blogger, strives to show people that wheelchair users are just like everybody else.

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