- Manual Mobility -
using your muscles for mobility and healing
(a Canadians' perspective)

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updated July 10, 2013

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- Thoughts on Lever Drives -
emails to/from a persons searching for a suitable wheelchair

Hi,

I wanted to thank you for your website. 2 years ago I was in a car accident and now am hemiplegic. My boyfriend discovered your site 5 days ago, and recent nights I've been up too late checking out all the links.

So mostly I just wanted to send a bit of fan mail saying how useful your site is. Therapists and mobility dealers seem to only know the most common items like standard wheelchairs, electric scooters and electric chairs. But I'd love to be able to get one of the alternatives. I used to bike a lot (though no racing), so I was already planning on getting a trike next summer.

But my main current concern is that with only one good arm, I can't get up wheelchair ramps or curb cutouts in a manual chair. I was going to buy a scooter, but for me this would mean also buying a $35,000 minivan which I will hate.

So I am now trying to figure out if one of these manual devices would give me the extra oomph I need to do wheelchair ramps. (Besides keeping me more active, of course.) Do you have any sense / information on whether a lever system used with one arm would give enough extra push for someone with one fairly normal arm?

In addition to any input from you, I'm currently figuring out how to test the invacare CLD lever drive, plus I'm keeping an eye out for the new one-lever RioMobility product. But it's so hard to find first hand information about these things, or to test them, that I thought it couldn't hurt emailing you to see if you had any thoughts.

Anyway, your site has opened up a whole other set of possibilities for me that I hadn't even known about, so thanks.

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My Reply

I'm a quadraplegic with my bottom stronger than the top and my left stronger than my right. My weakest limb is my right arm but I'm fortunate that I have some movement and grip strength in it. The grip can be quite strong because it claws up and doesn't want to release. My left arm has about 1/3 strength.

I have the Handmaster lever drive but unfortunately they are no longer in business. Their Broken HM-1 - (Slovenia) may have worked for you and their Kuli would have been good for indoors. The Broken Rio Mobility Pivot - (USA) has improved on the basic design of the Handmaster and Rio Mobility told me a few years ago that they were working on a one handed model but I haven't seen it listed (steering outdoors may be a problem - see the CLD paragraph below). I almost purchased their lever drive attachment but the gearing was too high for me. The lowest gear was about the same as the high gear of my Handmaster. There should be an easy way to lower the gearing but the two lever design was only good for me for exercising my right arm and no good if I wanted to go anywhere quickly so I decided to look for a different design.

The Broken Rota Mobility RoTrike - (USA) is an exciting design but unfortunately they are still working out the finer points of the design. I have one of their first designs and it has a lot of promise. I'm looking forward to their next model and it could work quite well for you. You will have to confirm that the gearing would work for you as it is a little on the high side for me. Their RoChair is geared much lower. Steering with one arm is not really a problem and pulling the lever all the way back applies the brakes. I can use my left hand fingers and have a standard brake lever to apply the front whee brake.

I've heard about the Broken Invacare CLD drive and it could very well be just what you need. I do have a concern about the steering though (as with the HM-1). On the flat there should never be problem if they make the steering wheel slightly lower than the other small wheel. That way the steering wheel is always in contact on slightly uneven surfaces. Outdoors steering can become a problem for any 4 wheeled chair as on uneven surfaces only 3 wheels can make contact with the ground. If your steering wheel comes up you could be in danger of steering right off the sidewalk. If both wheels steer then there is no problem (like the RoChair). Trikes always have all wheels on the ground but they are not as stable as 4 wheels.

Handcycles may be an option for you. I have the Broken Dragonfly - (USA) handcycle attachment from RioMobility and it is easy to use with one arm. I strap my bad arm to the other side to give it range of motion and some exercise. Because it's front wheel drive it can't climb steep hills but ramps should be okay. It could really benefit from a reverse gear and I got this Broken Sturmey Archer - (Taiwan) 5-speed (with reverse) internally geared hub adapted to my front wheel and the Broken Schlumpf Mountain Drive - (Switzerland) 2-speed bottom bracket on my chainring. This gives me a tremdous gear range of 640% between high and low gear and two speeds for the reverse gear. There are some concerns with the reversing hub as it wasn't designed to be laced into a hub but having reverse is absolutely wonderful.

There are lots of upright handcycles on my website but the Broken Hase Handcycle - (Germany) drives the rear wheels so steep hills are not a problem. It steers by tilting the steering column left or right which has it's benefits when making tight turns (usually the cranks turn to an awkward angle when making tight turns). It's a bit low and long for indoors though. If I was really interested in it I would ask if the seat could be raised and the wheelbase could be shortened (similar dimensions to the Rotrike?). The reversing Sturmey Archer hub and the Mountain drive would also be a consideration. The cost would be quite high.

• Broken Bike-On - (USA) is a good mail order source for different trikes and handcycles.
• Broken The Hostel Shoppe - (USA) is good for trikes

Some other products that may be of interest:
• Broken Neater - (UK)
• Broken MagicWheels - (USA)
• Broken TrackChair - (Australia)
• Broken Profhand - (Taiwan)
• Broken BerkelBike - (UK)

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Hi

I'm the hemiplegic person who emailed you last December about manual mobility devices. I finally have been able to try out a few types.

First though, a little about me. My injury was slightly higher than yours - I was in a car accident and dislocated my head, meaning my brain stem was damaged. My right side is nearly normal, but my left side has major problems. Actually my biggest problem is tone. My muscle control isn't awful, but that doesn't help much when e.g. any effort means that my hand curls up into a claw.

Anyway, on to what I've learned about lever wheel chairs and their usefulness for hemiplegics like myself:
(To remind you, my big problem with regular wheelchairs is that my one arm is not strong enough to push me up handicapped ramps or curb cutouts.)

• Broken Riomobility Pivot Lever Drive - (USA)
Wheels with attached levers, gears, and brakes. You swap these out for the wheels on your own chair

Pricing
- $4,000 US. You must buy both wheels, even if you can only use one lever.
- They mail it and accept a return within 30 days for refund of the cost. I had to pay shipping from them ($50 US) and back to them ($100 US).

Gearing
- Multiple gears, so potentially good for hills. Changing gears seemed like it might have been do-able with only one good hand.

Steering and Braking
- The intended methods of braking and steering require two hands. But the device would not have gotten in the way of braking and steering with a good leg, as hemiplegics normally do.
- The parking brake requires two hands to engage. This fact was described in the user's manual, but I had not seen this before arranging to have it shipped, and the salesperson on the phone implied that hemiplegics have used their device before, so I was unaware of this problem until I got the device in person.

Tires / Wheelchair requirements
- The wheels are pneumatic. I was not able to pump them up myself above 40 psi because I couldn't get a good seal on the valve (it's a regular bike schrader valve). I also nearly gave the tube a stem flat trying to put the pump on the valve using my 1 and a 1/4 hands. I wasn't even aware that some wheelchairs have pneumatic tires, so I didn't ask about this in advance.

The tires had tire liners that should help prevent flats, but I still worried about taking the chair on city streets where there might be glass. Changing a tire would be totally out of the question for me, and I wanted this for things like errands where I wouldn't necessarily have someone else with me.

- I would have liked to at least try out the device anyway, to see what the levers and gears could do for me, but I couldn't put the wheels on my wheelchair. I had told the salesperson the exact types of wheelchairs I have, and he said they were compatible, but it turned out that the axle size was too large, so I never could try it out at all.

Transport
- Like any other manual chair. Compatible with devices like the Chairtopper.

Riomobility is now designing a device for hemiplegics, but the technical salesperson wouldn't give a release date or discuss any anticipated features, saying it was still in development.

• Broken Invacare CLD drive

Pricing
- $700, so the cheapest of the options

Gearing
- Only a forward, reverse, and neutral gear, not multiple gears for going uphill.
- It was even harder for me to move uphill than a regular chair is pushing the rims with my one good arm. I did not make it up the ramp at all, whereas in a regular wheelchair, I can usually get a couple feet up a ramp before petering out.
- On flats, I could only move very slowly. You had to move the lever a lot back and forth to move the chair any distance at all. There was nearly no resistance, so I think it was geared very high. Actually, my arm got a bit sore just taking the chair along a flat hallway for 5-10 minutes, maybe because of all the back and forth and holding up my arm, though perhaps with time I could have built strength in the correct muscles.

Steering and Braking
- Braking with my good foot on the floor was possible, but steering with my good foot was not - the built-in steering interfered with that.
- Their steering with their lever was designed to be one-handed. It seemed decent when going relatively straight or around corners. But trying to make a U-turn seemed nearly impossible. Maybe I would have gotten better with practice, but even so, it seemed to require a 5-point turn with multiple changes between the forward and reverse gear.

Tires / Wheelchair requirements
- Compatible with the Invacare 9000 series chairs; I'm not sure about other chairs.

Transport
- Like any other manual chair. Compatible with devices like the Chairtopper.

• Broken NuDrive - (UK)
Levers (and hubs?) you add to your own wheelchair's wheels.

Pricing
- $3-4000, but you can buy only one lever instead of two, cutting this cost in half.

Gearing
- The biggest problem for me was that it only has one gear. They tell you to choke up or down on the lever for different leverage. But it was geared too high on flat land, so was hard to move at any decent speed, and geared too low for going up wheelchair ramps using one arm. (Although it was better on hills than the CLD drive was- I could make it several feet up a ramp, versus with the CLD drive I could not get even a few inches up a ramp).
- When I got stuck on the ramp, since I can only use one arm, the chair pivoted. The levered wheel didn't roll back since I was holding on, but the wheel on my bad side turned, and my one good leg was not strong enough to prevent this. I ended facing sideways and there was no way to recover.
- There was no backwards gear, but you could put it in neutral and use the rims, which seemed fine for e.g. making a U-turn in tight spaces.

Steering and Braking
- The intended braking and steering require two hands. As a hemiplegic, I couldn't use their intended steering and braking mechanisms, but I could use my good leg to steer and brake just like I do with a normal manual wheelchair. This might not be good for steep hills, but it's OK enough for braking on wheelchair ramps if you don't let yourself build up speed.

Tires / Wheelchair requirements
- The device requires a wheelchair with wire spokes. For me this would have meant an extra $4,000 purchase, since I don't otherwise need a high quality wheelchair (since I can't use manual wheelchairs on ramps, right now I only use cheap manual chairs within my home).

Transport
- Like any other manual chair. Compatible with devices like the Chairtopper.

• Broken RoScooter (Rota Mobility) - (USA)
A new product this year (2013). Very much like an electric scooter in design and function, except it's manual, with a center-mounted lever. So it's a complete mobility device, not just a separate lever or a wheel with a lever like the others. The same company makes a wheelchair (the Rochair) and trike (the RoTrike), both with center mounted levers.

Pricing
- $1500
- If you get a bike shop involved, you can get it shipped to the shop for you to try and return without paying a restocking fee; you only need to pay return shipping. Otherwise, there is a 20% restocking fee.

Gearing
- Eight gears like the RoTrike, but you don't need as much strength as for the Rotrike and it can't go as fast, so it must use different gears. But the RoScooter is faster than the RoChair - the owner called it "peppy."
- The owner recommended backing up steep hills, due to the front wheel drive
- It goes backwards via an interesting mechanism- you rotate the steering column 180 degrees. It's not clear to me whether using only one hand I could turn the steering device around 180 degrees to go backwards (I haven't tried it in person). If I did get it into reverse, I couldn't use the brakes in reverse because they'd be on the wrong side. This might be OK on flats, but not on slopes. (comment from Murray: There are attachments that allow two levers onto one brake so you could have a brake lever on both sides.)

Steering and Braking
- Designed to be OK in many indoor settings: shorter in length than the Rotrike, and it's supposed to make relatively tight turns.
- The owner said the scooter has good stability (due partly to having slightly larger wheels than an electric scooter).
- Designed in part specifically for hemiplegics (yay!), so 1-handed braking, steering, and engaging the parking brake. They've had people with asymmetric weakness from stroke use the scooter, but no one has tried it who is as seriously hemiplegic as I am.
- It has bicycle brakes and gears, which might not be good for a quadriplegic, but are potentially very good for a hemiplegic.
- While the owner has steered the scooter with one hand, he said it took more strength to do this. For me, being female, it's not clear whether I'd have enough strength in my one good hand / arm to steer.

Tires / Wheelchair requirements
- The front tire is pneumatic while the back two are solid. The owner seemed to think that pumping and flats shouldn't be an issue with the types of tires they have, but that those wheels could also be swapped out for solid wheels.
- The original design had no arm rests on the seat, which could be problematic for me, since to stand up, I need to use my good hand to push down on an arm rest. However in a later design, they have possibly added arm rests to the seats.
- It has less chair support than the company's other two products, the Rotrike and Rochair, so you need good trunk control.

Transport
- It is only 35 pounds, and it comes apart into relatively small parts, so if you were able-bodied, it would be easy to disassemble and transport in a car. But then I'm not able-bodied, am I? otherwise I wouldn't need to use something like this.
- I do now have a minivan with a platform scooter lift in it (a Joey lift). However, the RoScooter's seatback is too high to load into my minivan using my platform lift. (Electric scooters and wheelchairs usually have seatbacks that fold down.)
- It is not compatible with lifts for manual wheelchairs (eg the Chairtopper).
- Maybe a simple ramp could work in the right vehicle, if you could guide the scooter up the ramp?

For me, I am close enough to independent, and my city is spread out enough, that not being able to take this device with me in a car turned out to be a fatal flaw, so I never had one shipped to me to try.

Since I've finally gotten rid of some foot pain that was seriously limiting the time I could spend on my feet, I've given up on the idea of a manual chair or scooter and am just trying to increase the amount of time I spend walking or standing. And I've just bought a recumbent trike, so hopefully this will also give me more strength and exercise.

For others, the RoScooter may work well if you don't need to transport your scooter in a car, and it will be interesting to see what Riomobility comes up with for hemiplegics.

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Manual Mobility

We need your help to keep this site current
click the Broken if you wish to report a broken link
please email your suggestions or comments to info@manualmobility.com

updated July 10, 2013