Mastering Mobility: Enhancing Opportunities Through Wheelchair Skills

Mastering Mobility: Enhancing Opportunities Through Wheelchair Skills

Clinicians explore the essential skills that improve accessibility for both power and manual wheelchair users.

March 31, 2025 | By Laurie Watanabe

Complex Rehab Technology (CRT) is all about customization—each seating and mobility system is tailored to fit a single individual. But just as every wheelchair is unique, so too is its user—not only in their personal aspirations and functional abilities but also in how effectively they utilize their device. For every rider who effortlessly pops a wheelie to navigate a curb, there is another who is unsure where to begin.

Essential wheelchair skills—such as maneuvering ramps, navigating doorways, managing curbs, and performing transfers—are critical for accessibility. And at the core of mastering these skills is proper wheelchair configuration.

The Role of Configuration in Skill Development

Leslie Wade, MOT, OTR/L, ATP, a regional clinical education manager at Permobil Americas, emphasizes the importance of an optimally configured wheelchair. “Learning to maneuver an ultralight wheelchair can be transformative, increasing mobility, independence, and confidence,” Wade said. “The first step is ensuring the rider has a properly configured ultralightweight wheelchair with an appropriate seating system.”

Michelle L. Lange, OTR/L, ATP/SMS, of Access to Independence Inc., agrees. “There are numerous factors that influence a person’s success in mobility,” Lange noted. “Before training a specific skill, it’s crucial to assess if any fundamental aspects—like seating position—are hindering progress. If a manual wheelchair isn’t configured correctly, no amount of practice will make wheelies or propulsion efficient.”

Lauren Rosen, PT, MPT, MSMS, ATP/SMS, program coordinator at the Motion Analysis Center, St. Joseph’s Children’s Hospital of Tampa, highlights how poor configuration can significantly affect a child’s engagement. “If a chair is hard to push, a child may opt to stay indoors instead of playing outside,” Rosen said. “An improperly set-up wheelchair can limit activity and independence.”

In power chairs, small adjustments in programming can make a substantial difference. “A poorly programmed chair can be difficult—or even unsafe—to drive,” Lange noted. “Features like tracking technology help users stay on course, reducing the need to compensate for every environmental barrier.”

Prioritizing Critical Skills

Given the limited time available for skill training in rehabilitation settings, clinicians must prioritize the most essential techniques.

For self-propellers, Wade suggests starting with the basics: “Proper pushing techniques, efficient transfers, and navigating tight spaces are fundamental. These skills not only prevent shoulder strain but also maximize propulsion efficiency.”

For power wheelchair users, Lange underscores the importance of driving proficiency. “It’s surprising that tracking technology isn’t standard, considering how crucial it is for outdoor navigation,” she said. “By stabilizing the chair’s path, tracking technology minimizes the user’s need to make constant joystick corrections.”

Preparation for Unexpected Challenges

Rather than avoiding difficult situations, Rosen believes in proactive training. “Years ago, spinal cord injury (SCI) patients wouldn’t leave rehab until they could manage curbs and right a flipped wheelchair,” she explained. “Now, shorter hospital stays often mean crucial skills are left untaught.”

She advocates for teaching users how to recover from falls. “If you tip backward in a chair, knowing how to upright it can be invaluable,” she said. Practicing these techniques on soft grass with a trained spotter provides a safe learning environment.

Peer Learning and Lifelong Adaptation

Connecting new wheelchair users with experienced mentors can be incredibly motivating. “Peer learning allows individuals to see firsthand what’s possible,” Wade said. “It fosters confidence and self-sufficiency.”

Additionally, wheelchair skills evolve over time. “A technique learned in rehab may look different a year later as users adapt to their daily routines,” Rosen noted. “And as people age, changes in strength, endurance, and joint health may necessitate adjustments, such as adding power-assist devices or transitioning to a power wheelchair.”

Lange stresses the importance of ongoing training and assessment. “Mobility needs change over time. Regular evaluations help ensure that users maintain independence and safety as their abilities and environments shift.”

Ultimately, mastering wheelchair skills enhances not just mobility but overall quality of life. “Teaching these skills is rewarding because it empowers individuals to take control of their journey,” Wade concluded. “The key is prioritizing safety and meeting each person where they are.”

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