Wheelchair stability: effect of body position

When a wheelchair user reaches and leans, the static stability decreases in the direction of the lean and increases in the opposite direction. The purpose of this study was to determine the extent of this effect. We studied 21 nondisabled subjects in a representative wheelchair, measuring the static forward, rear, and lateral stability on a tilting platform. Reaching and leaning away from the tip added stability, with mean increases ranging from 9.1% to 124.3% of the neutral-position values, whereas reaching and leaning toward the tip reduced stability, with mean decreases ranging from 25.2% to 52.3% (p < 0.0001). The stability range ("away" minus "toward") varied from 52.4% to 149.5%. Reaching forward had a greater effect on stability than did reaching back or to the side. Wheelchair users with the ability to control their body positions can profoundly affect the stability of their wheelchairs, a factor that should be considered in wheelchair selection and training.