Table 7.

Wheelchairs.

Type	Practical considerations
Manual	Manual wheelchairs should be light- weight or ultra-lightweight. With disease progression, patients have a hard time propelling the wheelchair. Consider renting or borrowing manual wheelchairs instead of purchasing one. Removable wheels make it easier to transport wheelchair in a small vehicle.
Transport (companion)	Transport wheelchairs are light and inexpensive, but must be pushed by a caregiver. They fold and fit into a car’s trunk. Many families borrow or buy one as a back-up chair for travel.
Power	Power wheelchairs do not fit into standard cars (modified van is needed for transportation). Ramps are required to enter homes. Wheelchairs can be equipped with ventilators and augmentative and alternative communication devices. Tilt-in-space mechanism is used for pressure and pain relief. Multiple drive controls are available to allow users with different degrees of weakness to control the power wheelchair (e.g., joystick, head array, eye gaze).

For all wheelchairs, positioning and modifications with disease progression are essential to ensure proper seating and avoid secondary complications such as skin breakdown and back pain.