26 msfocusmagazine.org Symptom Management Wheelchairs Keep You Moving A common response to a diagnosis of multiple sclerosis is the question, “Will I need to be in a wheelchair?” The answer is very often “no.” Studies have shown that, absent of any treatment, only about one-third of people with MS require a wheelchair or mobility aid after 20 years with MS. However, for a certain amount of the MS population, a wheelchair is necessary for mobility. For some it is temporary, for others it is more long-term. But “wheelchair” doesn’t have to be a dirty word. Indeed, like anyothermobilityaid, it can be the source of continuing independence. The matters that must be addressed – aside from the cost – are fitting, safety, and accessorizing. Fitting When it comes to fitting, there are a number of considerations that must be taken into account, such as posture, size, and weight. Posture is very important for both comfort and proper measurement. If your posture is poor, it will result in discomfort. It may also put you at risk for pressure ulcers, pain, soreness, muscle imbalances and contractures. Measurements must be made to determine the appropriate size. To ensure a proper, comfortable fit for the wheelchair, you will need to determine seat width, depth, and height; backrest width and height; and the positioning of the armrests. The seat should be a little bit wider than your widest point, should end 1 to 2 inches before the back of your knees, and there should be a few inches from the wheelchair’s footplates to the floor. To provide maximum support, the backrest should be slightly wider than your torso, and, ifyou have trouble sitting upright, the backrest should be higher than usual. The armrests should allow you to comfortably rest your forearm and can either be desk- or full- length. Full-length would provide you needed support to push yourself up to a standing position. Desk-length arms are shorter and allow you to get closer to the edge of a table. The weight of the wheelchair must also be taken into account. For manual wheelchairs, a heavier chair means exerting more force to move, which might be a problem if muscle weakness and fatigue are common symptoms for you. There can be as much as a 15 pound difference between a standard and lightweight manual wheelchair. A steel-framed chair can weigh up to 50 pounds. A lightweight chair typically weighs between 28 and 36 pounds and can be more easily stored in a vehicle trunk.