There are many
different types of foot supports available. The style you
want or need might determine the specific wheelchair
frame that you will order. For instance, a fixed tapered
front-end cannot be ordered on a lightweight wheelchair
frame. Fixed,
non-removable front ends are often found on rigid
wheelchair frames and some ultralight or custom model
wheelchair frames. This option provides stability to the
frame and may prevent folding the frame vertically. The
specific frame choice might have the bars holding the
foot support come straight down, providing more foot
space. Or, they could taper inward, bringing your legs
and feet closer together.
Front riggings describe
swing away or removable foot rests or leg rests. Swing
away footrests and leg rests make it easier for you to
transfer because they can be moved out of the way. They
are also a good choice if you will be using one foot or
both feet to propel or if you want to move the chair
closer to other objects such as the bed or toilet.
Footrests are typically
bilateral (left and right) pieces that have a bar on the
outside of the leg and a footplate that support the foot.
Leg rests are typically
bilateral (left and right) and have a bar on the outside
of the leg, a footplate, AND a pad behind the calf.
Because these usually can elevate, they require a pad
behind the calves to prevent the calves from falling
behind the wheelchair when the leg rest is elevated.
Angled Front Riggings
The bars for the footrests or leg
rests might come at different angles such as 60, 70 or 90
degrees. There is also an adjustable angle option that
allows changes to any angle. These numbers describe the
angle at the top of the front rigging bar where the knees
are when the person is sitting in the wheelchair. A
60-degree angle front rigging has a more opened angle
than a 90-degree angle front rigging. The 60-degree front
rigging will pull your lower leg further away from your
thigh, opening up the knee angle.
Consider these points when
determining what angle of front rigging to order:
- Angle of your thigh-to-your
calf
- Overall wheelchair length
- Functional positions of the
legs when sitting
- Thigh-to-calf angle: This
is important because there may be some tightness
or limitations at your knee that will not allow
you to sit correctly in a wheelchair that has a
60-degree angled front rigging or an elevating
leg rest. The hamstring muscle in your leg is
connected to the pelvic bone and goes past the
thigh to the lower leg. It is called a two-joint
muscle because it crosses the hip joint and the
knee joint. If the hamstring muscle is tight, it
will pull at the hip and knee. This will cause
the pelvic bone to tilt backward (opening the
angle at the hip), and the lower leg to move
inward (closing the angle of the knee). This must
be accommodated for and the best way to do that
is to allow the lower legs to come in more.
Therefore, a 60-degree angled footrest or
elevating leg rest will not be appropriate. You
should consider a 70- or 90-degree footrest and
bring the footrest inward toward the frame of the
wheelchair.
Any bony contractures where
the angle of the thigh-to-calf are less that 90
degrees should be accommodated for as well by
ordering a 70- or 90-degree footrest. An
elevating leg rest should never be used when
there are tight hamstrings or orthopedic
contractures because the elevating leg rest will
pull on the lower leg. The lower leg will not
open at the knee and the person will be pulled
out of the wheelchair frame. Many elderly people
have tight hamstrings. They often erroneously
purchase standard style footrests (60 degrees) or
think that elevating leg rests will be more
comfortable. Unfortunately, this error in
footrest or leg rest choice makes them slip
forward in their wheelchair, causing them to feel
like they are falling out of the wheelchair.
That's because they are sliding out of the
wheelchair!
- Overall wheelchair
length: A 60-degree footrest sticks out
farther than a 70-degree footrest. This small
measurement might mean less maneuverability in
small spaces. A 90-degree footrest, however,
might limit how much caster play there is because
it brings your feet under the wheelchair frame
right next to the caster housing. This might
limit the turning ability of the casters. Make
sure this will not be a problem when ordering
wheelchair front riggings.
- Functional positions of
the legs when sitting: Sit in your existing
wheelchair or in a standard chair and reach for
items or perform usual activities that will be
done from the chair, such as dressing, computer
work, household tasks, etc. Do you feel more
balanced or can you reach farther when your lower
legs are positioned at various angles? For
instance, most people have a greater forward
reach when their knees are flexed a little (bent
toward the chair) than when the legs are out
further. This might determine the angle of front
rigging desired.
Tapered front riggings are
offered on some wheelchair models. This brings the feet
closer together. It may allow a better position of
function. The tapered front riggings might also allow
placement of the legs closer to the wheelchair frame
without interfering with the casters. If you wear braces
on your feet, the space for your feet when using tapered
front edges might not be enough for comfortable foot
placement.
Footrest and Leg Rest Lengths
The length of the footrest (from
attachment to the frame down to the footplate) is usually
adjustable and is a tube sliding inside another tube.
However, if you order a wheelchair frame that is lower to
the ground to allow foot propulsion, the length of a
standard footrest or leg rest might be too long. The tube
will hit the floor. A hemi leg rest or footrest must be
ordered. The tubing will be shorter to allow clearance of
the floor.
Elevating leg rests are
ordered if you have the knee range of motion to open the
thigh to calf angle. They are used to decrease edema
(swelling) in the feet, for legs that have knee
contractures or tightness that prevent bending at the
knee, for legs that are casted or splinted at the knee,
and sometimes for a change in position or to provide
comfort. Elevating leg rests may be ordered standard or
articulating and also are ordered depending on the seat
height.
Standard elevating leg rests have
a ratcheting device that brings the leg rest upward. The
leg length stays the same. This may cause the foot to
push against the footplate as the leg is raised. It might
not allow the knee to straighten. An articulating leg
rest will lengthen the bar as the leg rest is raised.
This will provide enough length for the leg to extend and
the foot will not push against the footplate.
Custom Options for footrests/leg
rests may also include:
- A footplate that swings
under to clear the wheelchair frame;
- A leg rest or footrest that
has the bars in the center rather than to the
sides to allow angling for leg contractures,
bringing the legs under the frame more and
clearing the casters
- Extensions to lengthen the
footrests/leg rests
Footplates support the
bottom of the feet. They come in many styles. One piece
footplates support both feet. They can be tubular,
provide a surface to place the feet on, but minimal
surface support throughout the foot or can be a
footboard. They can flip up or remain in the same
position. The flip up style will stabilize a wheelchair
frame, but can flip up to allow the chair to be folded or
to allow for clearance for transfers. A footboard also
allows attachment of more custom foot supports such as
foot boxes.
Bilateral footplates on chairs
with swing away front riggings can be standard, which
support the foot usually to the ball of the foot. A
larger footplate may be ordered that will support more of
the foot. An angle adjustable footplate will allow the
ankle angle to be changed. This is necessary when there
are limitations at the ankle. These may be ordered with
the option of flipping up to provide room for transfers,
or bringing the foot to the floor.
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