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  • Help me pick out my first manual chair

    Hey there,

    Newbie here to SCI and this awesome community. I'm looking to get my first manual chair soon, and hoping to find some advice from the been-there done-that geniuses on this forum that can help me avoid making the common mistakes we all make when entering new terrain. :-)

    A little about me: I'm a 6' 160lb 41-year-old male, injured last June in a climbing accident. I've got a C5/C6 incomplete Asia B diagnosis with triceps and wrists, but no fingers and no core below the chest. I did my inpatient rehab at Spaulding in Boston, and continue there with my outpatient care for the time being. I'm working with the PT team there on my wheelchair needs. But it's been tricky: they advised me to get a power chair while I was still an inpatient, and my Medicaid insurance program has been batting me around for the last nine months with appeals so I still don't even have that.

    My PT's plan was and is to submit a follow-up insurance request for a manual chair once I've got the power chair in hand. But frankly, given Medicaid pressures over the last year, I don't expect them to grant me a manual chair. So I think my best course of action is going to be paying for one out-of-pocket and hoping that the power chair comes through as planned. The good news is that I have a loaner power chair, as well as a loaner manual chair (a Quickie GPV Competition that sadly doesn't really fit me ) courtesy of Numotion.

    A couple of considerations for my situation:
    1) I don't think I'm going to get in the habit of transferring to a car, and will instead get a minivan with a ramp to help protect my shoulders.
    2) My PT has advised me that I should get power assist wheels. After doing some research, I really like the look of the Twions. Hopefully their FDA woes don't complicate things.
    3) Also, I've been largely out of action for the last several months due to a pressure sore that I stupidly gave myself and the subsequent surgery it required. Now that I'm getting back into action, I decided to go big and get a Stricker handcycle. In fact, I've already ordered that intending to use it with the loaner chair until such time as I get my own! But of course, if I dropped the coin on the handcycle I'm pretty damn ready to do it for the wheelchair too. Needless to say, I want to make sure I get a chair that will work well with the handcycle. This is my ticket being really active again like I was prior to the injury.
    4) Finally, prior to my injury I spent most of my free time in the mountains and I'd like to get back there one way or another. So hopefully I can find a chair that can take a lickin' and keep on tickin'!

    So my big question is: What are all the things that I need to be thinking about in order to make sure I get the right chair this first time around? I'm not getting any younger, and arguably the most productive upcoming years of my life are gonna be the next four or five. So I really want to do the best I can to put myself in the right chair. At the very least, I want to know what is important to think about when working with my colleagues at Spaulding to plan out what chair I should get. While an inpatient, I actually went through this process but didn't know what the heck does doing. They ended up saying I'll get a Quickie, but damned if I even know what model nevermind why they thought it was the right one for me. This time around, I want to make sure that I'm deep in the details and getting something that's exactly right.

    Things I think I know:
    • I've heard a few people say nasty things about Quickie, and a lot of people say nice things about TiLite. Maybe that's the brand for me? But what model?
    • I suspect I'd be stupid not to get an adjustable chair this first time around.
    • The chair needs to be reinforced properly so that I can use power assist wheels.
    • The cushion is a crucial but wholly separate discussion. I'm not getting another pressure sore!
    • Obviously, my PT's gotta make sure we get all the right measurements.
    • Once I think I found the right solution, I should try like hell to demo it.


    What else am I missing? And, importantly, what do I need to know and be thinking about with regard to all my measurements?

    Thanks so much for any help! And sorry for the long-winded post. Appreciate your patience!

    - Emmett
    Last edited by ejl10; 05-30-2019, 11:08 PM.
    C5/6 complete (maybe) circa June 2018

  • #2
    Sounds like you're thinking along excellent lines. I'm not in the US so don't understand insurance etc.

    I just wanted to make sure you know, re the twions, that the newest e-motions are generally better for people with an upper body impairment; they're more adjustable, more fine tuneable etc. Are they available in the US, currently? Here in Europe they're very new while the twions have been out for quite a while. You might want to try and get a demo of both, at least, before ordering twions because the new e-motions may work better for you.

    Comment


    • #3
      First I'd stay away from the bike until your butt is completely healed. Emphasis on the completely. On this forum you will find a bias toward Tilites. I have a 35 year old Quickie folder and it works great for me. My only advice is to get a chair as adjustable as possible. Then fiddle with it. I even like aluminum chairs, because I can cut them and have them welded to fit me.
      I looked at powered wheels, but because I use a car, I got a Smart Drive. But I'm a para so I can put it on and off myself, but its difficult for a quad.
      Don't let them stick you in a power chair. I got the power assist, but can feel myself getting fat from it.

      Comment


      • #4
        I have a heavy duty TiLite. It is almost infinitely adjustable within its setup range. Most of the modern sport chairs will likely work. Find the ones that work best with the Twion if there is an issue.

        My TiLite uses an axle pin that is 3/8" shorter than all other pins I have used in the last 37 years due to a non-standard hub diameter. Ordered a proper axle mount (threaded sleeve) and they sent me what I already had.

        My experience with sales reps suggests doing lots of your own research is best.

        Comment


        • #5
          Just curious, if your funding is Medicaid, how do you have enough funds to privately purchase a handcycle and a light-weight manual chair and power assist system?

          (KLD)
          The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

          Comment


          • #6
            I had the exact same thought reading the OP.

            Originally posted by SCI-Nurse View Post
            Just curious, if your funding is Medicaid, how do you have enough funds to privately purchase a handcycle and a light-weight manual chair and power assist system?

            (KLD)
            "I have great faith in fools; self-confidence my friends call it." - Edgar Allen Poe

            "If you only know your side of an issue, you know nothing." -John Stuart Mill, On Liberty

            Comment


            • #7
              Unless you are set on titanium construction, there isn't any single best manufacturer in the "mainstream" ultralight rigid frame market.

              A couple of years ago, it appeared that TiLite was going to dominate everyone. In recent years, they've become a victim of their own success and have struggled to maintain their identity since being acquired by Permobil.

              Quickie has incrementally improved their products in recent years. They may not be particularly innovative, but their lineup is pretty solid and a good value.

              IMO, the two companies who have been responsible for much of the disruption and innovation in this space have been Motion Composites and Ki Mobility.

              While most people tend to be fixated on its weight, the Apex Carbon isn't really that much lighter than titanium or 7000 series aluminum. Nonetheless, I think it is a model that everyone needs to consider. Its greatest advantage is the stiffness of it's frame. It is a nicely engineered chair.

              While I haven't had any hands on experience yet, the Ki Mobility ethos is a modular design that looks like it could be precisely dialed in for the less experienced user.

              Everybody talks about vibration dampening, but they rarely talk about it in the most-significant context--keeping the feet solidly on the footplate going over surface irregularities. Both of these models are able to do that.

              While both companies are relative newcomers to the market, they have been responsive to feedback from the market and employee a number of individuals who played significant roles in the success of TiLite and Quickie.

              Comment


              • #8
                Originally posted by SCI_OTR View Post

                IMO, the two companies who have been responsible for much of the disruption and innovation in this space have been Motion Composites and Ki Mobility.

                While I haven't had any hands on experience yet, the Ki Mobility ethos is a modular design that looks like it could be precisely dialed in for the less experienced user.

                Everybody talks about vibration dampening, but they rarely talk about it in the most-significant context--keeping the feet solidly on the footplate going over surface irregularities. Both of these models are able to do that.

                While both companies are relative newcomers to the market, they have been responsive to feedback from the market and employee a number of individuals who played significant roles in the success of TiLite and Quickie.
                I was very enthused by the Ki Mobility ethos until I read the specs with the weight. It is a lot heavier than ZR and I am small, so loading and unloading is the major strain on my shoulders. I hate how my feet jiggle of the foot plate when I go over those yellow bumps for blind people.

                Comment


                • #9
                  Originally posted by Tetracyclone View Post
                  I was very enthused by the Ki Mobility ethos until I read the specs with the weight. It is a lot heavier than ZR and I am small, so loading and unloading is the major strain on my shoulders. I hate how my feet jiggle of the foot plate when I go over those yellow bumps for blind people.
                  The Ki Mobility Ethos has considerably more parts than the virtually almost-all-welded ZR/TR, which accounts for the weight difference.
                  stephen@bike-on.com

                  Comment


                  • #10
                    Originally posted by EmilyL View Post
                    Sounds like you're thinking along excellent lines. I'm not in the US so don't understand insurance etc.

                    I just wanted to make sure you know, re the twions, that the newest e-motions are generally better for people with an upper body impairment; they're more adjustable, more fine tuneable etc. Are they available in the US, currently? Here in Europe they're very new while the twions have been out for quite a while. You might want to try and get a demo of both, at least, before ordering twions because the new e-motions may work better for you.
                    That's fantastic to know. I hadn't heard about the new e-motion wheels, but will definitely look into them before I make any move!
                    C5/6 complete (maybe) circa June 2018

                    Comment


                    • #11
                      Originally posted by baldfatdad View Post
                      First I'd stay away from the bike until your butt is completely healed. Emphasis on the completely. On this forum you will find a bias toward Tilites. I have a 35 year old Quickie folder and it works great for me. My only advice is to get a chair as adjustable as possible. Then fiddle with it. I even like aluminum chairs, because I can cut them and have them welded to fit me.
                      I looked at powered wheels, but because I use a car, I got a Smart Drive. But I'm a para so I can put it on and off myself, but its difficult for a quad.
                      Don't let them stick you in a power chair. I got the power assist, but can feel myself getting fat from it.

                      Thanks so much for the reminder to not rush into the bike. It's been an awfully long road already dealing with this pressure sore, and I definitely don't want it to recur. I got the bike now primarily because bike-on was running low and I didn't want to miss my chance before the end of summer.
                      Great advice about adjustability. I've read that several times here, and it's top of mind. My biggest worry is about anything that isn't adjustable, like frame measurements. I want to make sure I get those right! But of course, to your point some metals like aluminum can still be adjusted.
                      As far as power wheels are concerned, I'm pretty sold on the idea especially since I don't transfer to a car. But I'll be damned if I get stuck in a power chair all the time! It'll be good for working at home at a standing desk, and just generally getting me standing on a regular basis, but it's not something I want to be my only vehicle. After 11 months of being pretty sedative, I'm eager to become active again
                      C5/6 complete (maybe) circa June 2018

                      Comment


                      • #12
                        Originally posted by ejl10 View Post
                        That's fantastic to know. I hadn't heard about the new e-motion wheels, but will definitely look into them before I make any move!
                        I've been waiting for the new e-motion wheels to get FDA clearance for years. Just like the Community Use package with the Twions, the issue seems to be the Bluetooth capabilities. Hopefully, they will both receive clearance soon.

                        Comment


                        • #13
                          Originally posted by KevinH View Post
                          I have a heavy duty TiLite. It is almost infinitely adjustable within its setup range. Most of the modern sport chairs will likely work. Find the ones that work best with the Twion if there is an issue.

                          My TiLite uses an axle pin that is 3/8" shorter than all other pins I have used in the last 37 years due to a non-standard hub diameter. Ordered a proper axle mount (threaded sleeve) and they sent me what I already had.

                          My experience with sales reps suggests doing lots of your own research is best.
                          Great to hear about the TiLite adjustability. That's absolutely what I like to hear since I'm pretty sure I'm not gonna get the adjustments right on the first go. But a bummer to hear about that axle pin - seems like nonstandard equipment is always a real hassle. And I couldn't agree more about sales reps in general. Occasionally they're knowledgeable and helpful, but more often than not they leave you with incomplete information.
                          C5/6 complete (maybe) circa June 2018

                          Comment


                          • #14
                            Originally posted by SCI-Nurse View Post
                            Just curious, if your funding is Medicaid, how do you have enough funds to privately purchase a handcycle and a light-weight manual chair and power assist system?

                            (KLD)
                            Short answer is that I'm damn lucky. Here in Massachusetts, the Medicaid Mass Health program serves as a backstop to private insurance for folks with disabilities, and given that we're an expansion state it's reasonably generous. As luck would have it, that just happens to be where my power chair is coming through. Frankly, I don't have a whole lot of understanding about how the program is set up, but I'm glad it's there. As far as my funds go, I was fortunate to have some friends run fundraising activities with others in the climbing community on my behalf while I was still unconscious after the accident. I'm trying to spend that money on things that really make sense to get me active again. Seems like that's what everyone in the community wanted for me.
                            C5/6 complete (maybe) circa June 2018

                            Comment


                            • #15
                              Originally posted by SCI_OTR View Post
                              Unless you are set on titanium construction, there isn't any single best manufacturer in the "mainstream" ultralight rigid frame market.

                              A couple of years ago, it appeared that TiLite was going to dominate everyone. In recent years, they've become a victim of their own success and have struggled to maintain their identity since being acquired by Permobil.

                              Quickie has incrementally improved their products in recent years. They may not be particularly innovative, but their lineup is pretty solid and a good value.

                              IMO, the two companies who have been responsible for much of the disruption and innovation in this space have been Motion Composites and Ki Mobility.

                              While most people tend to be fixated on its weight, the Apex Carbon isn't really that much lighter than titanium or 7000 series aluminum. Nonetheless, I think it is a model that everyone needs to consider. Its greatest advantage is the stiffness of it's frame. It is a nicely engineered chair.

                              While I haven't had any hands on experience yet, the Ki Mobility ethos is a modular design that looks like it could be precisely dialed in for the less experienced user.

                              Everybody talks about vibration dampening, but they rarely talk about it in the most-significant context--keeping the feet solidly on the footplate going over surface irregularities. Both of these models are able to do that.

                              While both companies are relative newcomers to the market, they have been responsive to feedback from the market and employee a number of individuals who played significant roles in the success of TiLite and Quickie.
                              Really interesting to hear this. I haven't given too much thought to other materials like carbon fiber, but it's certainly worth the curiosity. I've always assumed that carbon fiber doesn't lend itself as well as the adjustability, but perhaps with the right set up that isn't so much of an issue. I've certainly heard rumors about struggles with dampening, so it's good to hear your counterpoint. I'll look into these other brands, thanks for the tip!
                              C5/6 complete (maybe) circa June 2018

                              Comment

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