Selecting a back support for your wheelchair can be a complicated decision with such a wide variety of product options on the market. Whether you are ordering a back support “on-chair” or an after-market option, this blog will give you confidence in selecting the best one for your needs.
Whether you are choosing a back support for a new wheelchair, or replacing your current one, considering the overall goals of your back support should be your priority. Is your goal to improve comfort or posture? Do you want a lightweight back support or need specialized hardware for fine-tuning adjustments? Your decision should also take skin protection and pressure management into account. Consider your functional goals. If you are higher functioning, you will want a much lower back support with room for your arms and trunk to rotate, reach, and propel. If you need more trunk support, a taller back support will provide balance. I always go back to the saying, “Proximal stability equals distal ability.” If you support your trunk, your extremities will be able to perform and successfully complete your meaningful activities.
Back supports come in different shapes, sizes, and contours to fit the many different needs of wheelchair users. The list below outlines the purpose of solid back supports and can help you narrow down the many options on the market. You can also utilize the keywords to help describe the type of back support you want in your online search.
Once you have narrowed down the purpose(s) of your back support, there is still a decision to be made! Back supports are made with many different shell materials, support materials, and hardware options. All of this should be taken into consideration with your healthcare team to best match your back support to you!
In our industry, shell material traditionally is aluminum. However, if a high-end, lightweight back support is at the top of your priority list, you can choose a carbon fiber option. There are also varying support materials to choose from, including a variety of foam types, air, or gel. Your decision can sway in a particular direction based on your comfort, cooling properties, or skin protection goals.
It may surprise you, but you may pick a specific brand of back support based on the hardware alone. Is the hardware easy for you or a caregiver to take on and off? Do your back canes have enough “real estate” for the hardware to fit easily? How much adjustability do you need to be built into the hardware so that you can perfectly fit the seat to back angle or contours of your posture? All of these are important questions to ask and a great reason to trial different options to determine what fits into your lifestyle the best. Try using the following keywords to improve your online search.
Key Search Words: one-hand release, adjustable, accommodate, fixed
To ensure you feel confident when selecting your back support, let's review a few landmarks that you will want to know. These will be important to know when selecting your back support, but also when deciding how and where to mount it onto your wheelchair with your provider or therapist.
A recent study completed by Presperin Pederson et al. (2020) found that posture, function, pain, and satisfaction all improved with solid back supports when compared to upholstery. If selected and fit appropriately, a solid back support can provide many positive outcomes. That said, a solid back support is not your only option. Upholstery backs are what comes standard on manual wheelchairs, requiring the supplier or therapist to select an upgrade option if you want anything other than standard upholstery. Of course, upholstery is an easier material to use with a folding frame wheelchair, but it is typically accompanied by the disadvantage of poor positioning. Over time, upholstery tends to stretch which promotes poor positioning and worsens anatomical postures. Tension adjustable upholstery is an upgraded upholstery selection that is a superior option if a solid back support is not right for you. It can provide mild positioning and comfort when adjusted to your spinal curves.
Another back support option is a custom molded back. These can fit into most power, ultralightweight manual, high back (upright) manual, or manual tilt-in-space wheelchair systems. It requires a skilled technician who is trained in performing the fitting and should only be considered when all other off-the-shelf options and additional semi-custom options have been exhausted. The higher price tag and limited adjustability after delivery make a custom molded back support only right for a certain group of individuals.
In the end, if you find yourself overwhelmed with the process of choosing a solid back support, consult with your healthcare team first. Together, you can comb through the options that are on the market. Your overall seating goals will lead you to a few final choices, which you can then trial, helping you make a well-informed decision.
