Motion Composites’ ultra-lightweight manual wheelchairs are known for their aesthetic styling from top to bottom. Footrests and footplates are no exception. But beyond the appearance, proper footrests are crucial to seating, positioning, and functional independence.
Components must all work together to ensure optimal configuration of the manual wheelchair and therefore front rigging cannot be selected in a vacuum. The idea is that they are chosen to mesh seamlessly into the overall system for best performance. The focus of this blog is to review the decision-making process for proper footrest and footplate selection to provide optimal and individualized set up of the equipment for the client’s best outcome.
We first need to discuss frame style as this directly affects the positioning of the lower extremities and types of foot supports we can choose from. Frame styles include rigid with a fixed front end, folding with swing away footrests, or folding with a “fixed” front end. Frame selection with optimal footrests should promote functional independence and safety, such as during transfers (mechanical lift, sliding board, pop over, or stand pivot). Requiring the use of the lower extremities for weight-bearing during transfers will most likely lead to a wheelchair with swing-away footrests on a folding wheelchair, or a flip-up footplate option on a rigid wheelchair. Ensuring a clear area for proper foot placement with appropriate frame style selection will promote safety and independence with transfers.
The type of footplate attached to the footrest, along with optimal adjustments, will promote the best lower extremity placement within the wheelchair. Selection should be made using the knowledge of how a product functions and with regard to clinical presentation.
Footplate style offerings will be based on wheelchair model and will include a variety of fixed, adjustable, and material options. There is typically a no charge option footplate for both rigid and folding wheelchairs. These no-charge options are usually set at a fixed angle and have little to no adjustment. However, because of the lack of adjustments with no hardware, they are generally the lightest in weight.
Angle adjustable options commonly require a medical or clinical justification. Limited range of motion, contractures, irregularities in shape or position and use of ankle orthotics can be reasons for the need of an angle adjustable footplate. It is also important to remember to select footrest options that can accommodate asymmetrical positioning needs of the lower extremities. Adjusting the footplate to match the natural posture of the foot will provide the best base of support for function, positioning, and comfort.
Angle adjustable footplates can come in multiple materials, each of which can have advantages and disadvantages. Weight of material, adjustability (as in how each model specifically adjusts) and cost all need to be considered when making the most appropriate selection. Motion Composites’ footplate material options include Aluminum, Composite, and Carbon Fiber.
After the product selection is made, dialing in the fit using correct measurements will lead to the best outcomes both for function and position. Maintaining optimal pressure distribution throughout the manual wheelchair depends on multiple factors, including proper placement of the feet and legs.
If the footrest length is not correct, either too short or too long, the weight distribution in the seat and on the cushion will not be optimized. Too short, and the load accumulates over the bony prominences in the pelvis, specifically the ischial tuberosities, and can increase the risk for pressure injuries.
If the footrest is too long, optimal posture and positioning can be lost in the search for support. The load shifts to the thighs and there is potential for sliding forward in the chair. The pelvis can then be pulled into sacral sitting, increasing the risk for pressure injuries on other bony prominences like the coccyx or tailbone. Accurate measurements should be taken to select the correct footrest length for optimal pressure distribution.
Improper footrest length can also impact seated stability, functional propulsion, and ADL completion. If the foot is not supported properly, the end user will have limited stabilization which can lead to discomfort, poor posture, and even lack of confidence in the wheelchair overall, decreasing functional independence and QOL. Proper foot support and correct length help stabilize the pelvis and can improve the functional abilities of the trunk, shoulders, and arms.
Knowing how footplates and footrests adjust can provide guidance for the most appropriate selection of the wheelchair and allow for fine-tuning adjustments, likely asymmetric, to support the legs and feet.
Other front riggings available for consideration include an elevating leg rest option for a folding wheelchair, residual limb support, or a high mount attachment if the available adjustment range does not meet the required need of the client’s lower leg measurement.
Motion Composites offers a wide variety of footrest configurations to ensure the necessary features are available. Our order forms detail which options are available on each wheelchair model, as well as length ranges and adjustability.
Check out these examples of Motion Composites footrests and footplates.
Transfer style, positioning needs, and overall function are the considerations needed when selecting footrests and footplates. Check out our Options and Accessories Guide to see all of the great footrest and footplate options available through Motion Composites. Feel free to connect with your local rep or your local provider to learn more.
