Custom or Configured Considering Choices

Custom and configured, are terms often used to differentiate types of wheelchairs. Sometimes this terminology is interchanged however there are important differences to understand when considering frame type.

Custom Configured

Lets begin with custom configured. As a teenager I used to sew clothes. I liked the ability to customize the look of a piece of clothing by choosing my own fabrics but I initially would use a store bought pattern. When I would purchase the pattern, it often had multiple sizes and you would cut out the specific pattern size you wanted. There were also a few areas that you could further adjust on the pattern to customize giving specific guidance on where and how to increase length for a longer torso for example. Essentially though the sizes were just proportionally adjusted to meet a broad spectrum within the size range. To adjust further or for specific individualized fit, requires modification to the pattern or the pieces.

A configured wheelchair follows a set pattern. You will find that there are still significant options within the order form for a configured wheelchair, especially for an active user designed mobility base. As such a configured wheelchair can often be customised to meet a users needs but only within the parameters of the chairs specifications. Building a configured chair generally uses pre-determined components then the individualization comes with how these pieces are put together. As such you will have the ability to select seat width and depth, horizontal and vertical placement of the wheel and front and rear seat to floor heights all important when considering best functional outcomes and individualized set up.

However, people are unique both physically and in what they want to be able to do. Based on someone's goals, needs and functional capacity we may find that there are some set ups not possible within a configured chair.

Custom Built

If I again reflect on my clothes sewing as a teenager, I got to a point where I wanted to create more unique and customized pieces. As I had spent several years working with patterns I found there were specifics within different patterns that worked best for my shape and style so I moved away from buying patterns and started to create my own – for these I would often use old newspapers and build my pattern based on measurements rather than cutting a pattern of a pre-determined measurement and modifying it.

A custom built wheelchair is built around a users needs and measurements. Rather than selecting the seat rail from a prefabricated prepared and standardized stack, the seat rail will be built based on the specific measurements provided. For a custom frame, work with the supplier – know the measurements of the user and the position required for best functional outcomes and the product specialist can assist with the chair measurements. When I scripted my first TiLite almost 20 years ago, we definitely followed the measure twice cut once philosophy where myself and the dealer both took measurements but I also had a more experienced colleague checking and confirming all our measurements.

When TiLite receive a custom chair order they will first create a CAD drawing. This is an engineers plan of the chair based on the critical measurements and requirements. This drawing is then used as a “pattern’ for how the chair will be built, from how long each piece of tubing is cut too; where and how acutely it will bend and where and how pieces will be welded together to create the frame.

Considering a custom built rigid chair

When we are scripting up a configured chair, the caster position is predetermined. This may result in limitations in the build and potential issues with stability and responsiveness. The ability to customize where to position the caster can make a significant difference to both the ride feel and the manoeuvrability of the chair. Positioning of the caster can also impact on the chairs stability and rolling resistance.

When we consider the seat depth of a standard wheelchair this is usually determined by the length of the users femur and pelvis, so posterior gluteal to posterior popliteal. With a rigid manual wheelchair this user measurement is still crucial, however unlike a folding chair where the seat rail usually matches this seat depth, in a rigid chair the seat rail is one piece that makes up the seat rail then bends down towards ground where the footplate is attached. For a user with a very short seat depth or very high centre of gravity, extending the frame depth can counteract potential instability whilst still maintaining optimal set up for the user.

One of the most important considerations is that a custom built chair is built to the user where as a custom configured chair is fitted to a user. For some users a configured chair will be a great option for others you may need to consider a custom build. It's essential that not only the user and dimensions are considered but that all domains of the ICF model for the user have been covered to ensure maximum functionality across all aspects of their life. If you want to learn more about scripting chairs for active users, you can attend one of our manual into manual workshops. Our Permobil Product specialists and dealer network can also provide more information on potential solutions.

Author

Tracee-Lee Maginnity BHSc (OT) 

Clinical Services Specialist