Wheelchairs may seem straightforward to use, until you need to move up and down hills or stairs. Around 3.7 million people use a wheelchair in the United States. They push themselves an average of 2,000 to 3,000 times a day, but some don’t have access to formal skills training that helps them smoothly navigate the world.
One study shows that 75% of adults who use a wheelchair had a fear of falling. Nearly 65% reported falling out of their chair, and more than half had incidents resulting in an injury. Even without accidents, improper technique could also cause injuries to the muscles and nerves.
A unique, free program called Skills on Wheels by Indiana University in Indianapolis aims to address this gap. Around 20 kids ages 8-17 spend multiple days in the university natatorium learning how to navigate using props like ramps and speed bumps. Then they spend a day practicing those new skills outside in an everyday setting.
Savannah Healton,12, has spina bifida, a neural tube defect in the spine. She needs a wheelchair, and lately, she’s been practicing how to do wheelies.
“It’s basically where you push two times, and then you pop into your wheelie,” Healton said. “So if you’re going up a curb, you can get into your wheelie so you can go up the hill or the curb or wherever you’re going.”
A child’s confidence can take a big hit if they don’t know how to maneuver their wheelchair or have a fear of falling out of it, said Skills on Wheels Program Director and Indiana University occupational therapy researcher Tony Chase. Kids may decide to skip certain activities at school or with friends if they know there will be obstacles like narrow doors or stairs.
“We would love to change the world, and just make it all of a sudden accessible, but that’s a little bit too lofty of a goal,” Chase said. “So instead, let’s try to make kids more confident in navigating this inaccessible world.”
Lack of access to wheelchair training
Researchers have developed a list of 33 core skills that are essential for navigating a wheelchair in a variety of environments.
But some children might not learn these skills in school or even in physical or occupational therapy.
Maria Fuchs, an occupational therapist volunteering with the program, said she didn’t learn much about hands-on wheelchair training during grad school.
“A lot of times wheelchair training isn’t a main focus…other things like feeding or dressing or play skills, things like that, are kind of the priority,” Fuchs said.
Kids often just learn the basics — like using the wheel locks and how to take the wheelchair apart, she said, and that’s if their insurance covers it.
Kerri Morgan, an occupational therapy and neurology researcher at Washington University in St. Louis, said some people’s insurance won’t reimburse them for rehab to learn how to use a wheelchair.
“There’s this gap in education, [and] there’s the gap in actually having the environment in the medical model where clinicians know how to justify it in their notes, so that health insurance pays for it,” Morgan said.
Morgan said it’s common for wheelchair users to learn new skills through other people with disabilities or watching online videos. But that isn’t always accessible or safe if someone isn’t advanced enough to try a skill, their wheelchair is set up differently or there isn’t someone standing behind them to catch them if they fall.
Even with a spotter, practicing some skills can be dangerous. Large wheelchairs can weigh between 15 and 50 pounds, and that doesn’t include the weight of the person inside it.
That’s why Savannah’s mom, Chanda Healton, holds onto a strap that connects to the back of her daughter’s wheelchair so it’s safe for Savannah to practice wheelies.
The program isn’t just helpful for Savannah, it allows Healton to learn proper techniques in case the wheelchair starts to tip backwards. Now Healton plans to bring Savannah back to the program next year.
“It’s amazing,” Healton said. “First time I watched her I had tears in my eyes. I’m like oh my gosh, that’s my baby girl. She’s not a baby anymore, are you? You’ll always be my baby.”
