Deep sand, grass, rutted dirt trails, gravel and even thick carpet can be tough for a person to negotiate with a wheelchair, and tiring for his or her shoulders.

This frustration drove Pat Dougherty and his twin brother, Mike, both engineers, to design the FreeWheel wheelchair attachment, according to spokeswoman Cindy Krieg. Pat, a patient with C6/7 partial quadriplegia with a head injury, wanted to play with his children outside, but the extra effort required to move his chair was making his shoulders pop, Krieg said. By taking the front casters out of the equation and adding a larger wheel in front, the brothers made the wheelchair more stable and able to glide across rough terrain.

"He and Mike went through a whole variety of designs," Krieg said. "Finally, they came up with the design and spent about two years making them in the garage." The two made enough for 100 people worldwide to test, and the feedback helped make the attachment lighter, easier to use and adaptable to different footrests, she said.

"As you’re wheeling, momentum is your friend," she said. With the FreeWheel’s longer wheelbase, the chair can glide farther with each push, she said.

Cindi Petito, OTR/L, ATP, CAPS, founder of Seating Solutions and Lottus Designs in Florida, said the added wheel is great for people who experience different terrains. Petito said most of her patients have been using manual wheelchairs and either are aging or had a change in condition that makes it difficult to be independent with those chairs.

According to Petito, power wheelchair manufacturers are designing more adjustable seating systems. This allows OTs to do less aftermarket customizing, she said. "The backs are more adjustable and so are the footplates," Petito said, adding the adjustability can make an OT’s job go more smoothly. "That cuts down on the time in the field and the time it takes to do our fittings once the person gets his or her power chair."

Permobil’s Corpus 3G powerchair seating maintains ergonomic features and comfort of the previous generation, but is easier to adjust without parts, said Amy Morgan, PT, ATP, national clinical education manager for Permobil. The top half of the backrest is easily removed for pectoral or thoracic stretching or transportation, Morgan said. The headrest allows 7 inches of lateral adjustment, and the armrests adjust independently if a person is shifted, she said. "Therapists love it because it also captures [the patient] and their posture in the appropriate position," Morgan said. The legrests are arced and allow for the person’s legs to extend as they elevate. "It also allows a little bit of relief for the gastroc muscle while the knee is extended," she said.

The Corpus 3G has built-in shear reduction, she said, and if the person tilts then reclines, they feel virtually no shear. Therapists and patients can set fully backward and forward positions using the control system. "The actuators know the proper sequence for protecting skin and reducing shearing. ... So they push the button and the seat will automatically tilt and then will automatically start to recline."

The Jay Ion Cushion and the Jay Union Cushion by Sunrise Medical are wheelchair cushions that aid in skin protection and pressure relief, Petito said. "These are good for pelvic support and stability, as well as avoiding pressure sores," she said.

To transport powerchairs, Petito said the newest innovation is the Chariot lift from Bruno Independent Living Aids. This lift allows a person to transport a powerchair or scooter with a smaller car. "A lot of people are comfortable in their Corolla or Impala; they don’t want a larger vehicle," said Mike Krawczyk, marketing services manager for Bruno. The Chariot is a lift with wheels, and it uses a fixed hitch to connect with the car. "Previously, there was no effective way or safe way to transport your power chair with a small car," Krawczyk said. "[The Chariot] is not going to go left or right like a trailer does. It’s essentially an extension of the vehicle. It goes the same direction."

Caring for her mom gave Jeanine Carroccio the idea to start Downers Grove, Ill.-based Mobility Lifter to distribute the Liftkar PT. The portable, attendant-operated stair-climber is made by SANO Transportgerate GmbH in Austria. The Liftkar PT comes in three versions, one that allows a manual wheelchair to be rolled onto the device’s platforms, another with an integrated seat and a third that uses adaptors to clip onto a chair with quick-release wheels, Carroccio said. Every model is battery-powered, with a full charge lasting for 300 to 500 stairs, and can lift a maximum of 352 pounds, she said. "We go out to their homes and train three people how to use it." Liftkar PT can be used indoors and outdoors.

California-based Prime Engineering’s KidWalk, a dynamic mobility device, helps children stand, move and interact, according to CFO Bruce Boegel. KidWalk’s large wheels (20 or 24 inches, depending on size) are centered on the child’s hips. "If the child just mildly rotates his upper body, just rotates his shoulders, that’s going to be enough movement to get that unit to move," Boegel said. "It has a little bit of springiness, so it allows them to dip. It’s like a pendulum." The pendulum allows for the natural sway and dipping that occurs during walking, he said. •

Bonnie Benton is a copy editor.