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Clinical Considerations: Power Wheelchairs

When it comes to enhancing mobility for individuals with physical limitations, power wheelchairs are often considered the pinnacle of personal mobility solutions, offering enhanced mobility and increased participation in daily life.

However, there are various clinical considerations healthcare providers must understand to ensure their optimal provision and the safety and well-being of their patients.

What is a power wheelchair?

A power wheelchair is a self-propelled device that does not require manual power to move, typically used by individuals who are unable to move their own wheelchair due to muscular or cardiovascular conditions.

What is the difference between a power-operated vehicle (POV) and a power wheelchair (PWC)?

PMD (power mobility devices) broadly fall into two categories.

Power-operated vehicles (POVs):

This includes electric scooters and is defined as a '3- or 4-wheeled device with tiller steering, limited adjustability and seat modification capabilities'.

Power wheelchairs (PWCs): 

A power wheelchair is a motorized chair with four to six wheels, designed for individuals who require constant mobility support due to significant mobility limitations.

The benefits a power wheelchair

Power wheelchairs offer a significant number of benefits over manual wheelchairs and POVs including:

Increased mobility

Mobility is defined as:

"Movement in all of its forms, including basic ambulation, transferring from a bed to a chair, walking for leisure and the completion of daily tasks, engaging in activities associated with work/play, exercising, driving a car, and using various forms of public transport”

Power wheelchairs can increase mobility by facilitating easier transfers, improving transport options and enhancing manoeuvrability in internal spaces.

Enhanced participation in daily activities

Power wheelchairs offer greater independence and reduce fatigue, allowing patients to increase their participation in daily activities.

Decreased pain and discomfort

As well as removing the need for manual propulsion, power wheelchairs can also be customised with a range of tailored headrests, backrests and supportive cushioning can improve posture, and alignment and ensure equal distribution of pressure points.

Improved health-related quality of life

When properly utilized, power or custom power wheelchairs can delay, reduce or avoid further injury and support quality of life in a wide range of health conditions.

Clinical Consideration for a power wheelchair

Whilst power wheelchairs offer significant benefits and advantages to patients, there are several clinical considerations to be made by healthcare professionals including:

  • Does the user lack strength to consistently get around in a manual chair even if optimally configured?

  • Do they have a pain interference, lack of ROM (range of motion), or other skeletal deformities/tone or spasticity that unable to be accommodated for in manual seating?

  • Do they have consistent movement at any site: tongue, chin, head, shoulder shrug, single-digit movement?

Power wheelchair options

Power wheelchairs can be propelled by either the front, mid or rear wheels. Each configuration offers advantages and disadvantages.


Rear-wheel-driven devices are not as frequently seen as mid or front-wheel-driven devices.

Whilst they provide excellent control at higher speeds and are well suited to unstable or inconsistent terrain, they have a very large turning radius and are the least intuitive type of power wheelchair to operate.

As they provide users with the maximum amount of visual input, they are well suited to patients with auditory, visual or cognitive limitations.


As well as being the most intuitive to use, mid-wheel devices have the tightest turning devices of all power wheelchair devices. They also offer good traction on most surfaces including inclines and side slopes.


Front-wheel-driven devices often work well for patients with 'forward' centres of gravities (including the bariatric population).

Their larger front wheels help climb obstacles well with minimal impact on the user.


NPL Home Medical works with industry-leading providers of power wheelchair technologies.


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