Coaching Manual Wheelchair Users

• Be aware and minimise risk of common injuries from propelling the wheelchair such as blisters, abrasions and lacerations.
• Check participants’ range of movement; they may, for example, find it difficult to raise their arms above their head.
• There is a common assumption that if a participant is in a wheelchair, they cannot bear weight on their legs. Participants may be able to bear weight, depending on their impairment.
• Participants may tire easily during a session due to their lack of motor skill efficiency.
• Participants may struggle with temperature regulation – both hot and cold. For example, a tetraplegic (quadriplegic) may not be able to perspire and will, therefore, require water to be sprayed on them to avoid overheating.
• Make sure participants take in plenty of fluid during sessions.
• There may be a decrease in a participant’s range of movement due to, for example, a rod in the spine.
• Be aware of hot and cold surfaces, as participants may have lack of sensation in their touch.
• There is the potential for damage such as cuts and bruises below their lesion due to lack of sensation.
• Be aware that some participants may require equipment for bowel and bladder control.
• Participants may have a decreased breathing efficiency due to only their diaphragm supporting their breathing (tetraplegic/quadriplegic).
• If transferring to a different wheelchair or sporting equipment (throwing frame/handcycle), participants should do this independently or with the help of a parent/guardian/personal assistant, or with a trained individual. With higher levels of impairment, a hoist may be required for transfer.
•  If participants are not using a sports wheelchair, they may not have an anti-tip system fitted to their chair. If this is an option on their chair, ensure it is fitted. If no anti-tip is fitted, reduce the risk of the chair tipping back during an activity (eg by reducing speed and quick turns) as this may cause head injuries.

Strapping is useful to help improve sitting balance for wheelchair users, particularly:

• spinal cord foot straps to keep feet on footplate when turning
• knee strap to keep central in chair
• lap strap to secure hips to be at one with the chair
• waist strap to give core balance.

Straps can be varied, but for beginners simple Velcro straps work quickly and effectively and provide security and confidence when playing sport.

Similarly, taping/strapping for  those with upper limb impairments enable rackets to be held securely (eg, table tennis/tennis/badminton) and gloves with tactile surface and textured push rims enable those with upper limb impairments to push more effectively.