In Search of a Therapeutic Wheelchair

By |2018-10-30T11:20:32+00:00November 1st, 2018|
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Andy Imlay was able to get off of opioid pain medication after about two years of using Rowheels. He settled on the HX model after trying the LX Wheels in his initial demo.

Andy Imlay was able to get off of opioid pain medication after about two years of using Rowheels. He settled on the HX model after trying the LX Wheels in his initial demo.

Like most longtime manual wheelchair users (53 years and counting), I have been dogged by chronic shoulder pain for decades — rotator cuff tears, acromioclavicular joint pain, frozen shoulder syndrome. I have managed to stave off shoulder surgery by occasionally easing up on activity, accepting help loading and unloading my chair from my vehicle, having periodic cortisone injections and getting physical therapy when symptoms worsened. Also, recently, chronic low-dose opioid use has given me some relief.

I have also found that regular at-home workouts with bands or hand weights and stretching exercises can help balance out harmful effects of overused muscles, reduce pain and partially restore healthy functioning shoulders — but only if I am dedicated, consistent and know how to engage specific underused muscles. Studies have shown that another helpful activity is reverse wheeling: taking time to regularly wheel backwards up a moderate incline, but there is only so much of that you can do.

But what if a wheelchair existed that could be propelled by pulling back on the rims instead of pushing forward?

As a graduate student in mechanical engineering at Florida International University in 2004-2006, Salim Nasser, 43, a C5 quad since 1994, designed the first reverse wheelchair propulsion system aiming to do just that. In 2010, his design won a national design contest sponsored by NASA. Rimas Buinevicius, a successful entrepreneur, read about Nasser’s design and contacted him in 2011 after spending four months in a wheelchair from a broken leg. Nasser and Buinevicius co-founded Rowheels in 2011.

I contacted Rowheels to see if I could get a pair of demo wheels to attach to my TiLite TR rigid chair for a trial. Since my purpose was to see if it would work for not only me, but also other active lifestyle wheelers, I requested contact info for other Rowheels users so I could have a more diverse group to report on. None of the Rowheels users I interviewed have received any form of compensation from Rowheels, nor have I.

Three Users Weigh In

Anthony Maleski, 41, uses a wheelchair as a result of a traumatic brain injury in 2008. After eight years of wheeling, he developed pain in his shoulders and elbows. “I purchased a set of Rowheels LX wheels and put them on my Quickie GT a little over two years ago. After a while, I decided to go to the high gear wheels. I like to go fast and keep up with everyone else around me,” he says. “The wheels have helped with the pain quite a bit.”

He uses a Rough Rider with mountain bike wheels as a second chair in rough terrain. “I mainly use my Rowheels on my Quickie around the house and most of the time when I’m out in civilization. In my small house, it’s easier to move and turn around and get out of tight spots and corners. You can wiggle out. You have more options.” He says it’s fun using the chair in his home, mainly because his kids are so fascinated by it. “I have four kids, and they are always wanting to use it. Whenever I get out of the chair, there is a contest to see who gets to use it.”

In 2016, Andy Imlay was working long days at a theme park in his wheelchair. Imlay, 39, has cerebral palsy and was taking 150 mg/day of tramadol, an opioid, for moderate to severe shoulder pain. He came across the Rowheels website, asked for a demo, and has been using his HX wheels on his TiLite Aero Z since then. “I’m happy to report that as of a month ago, I no longer take any pain meds,” he says. “I absolutely think it has everything to do with the Rowheels. And I’ve lost some weight. The high gear wheels cause me to pull back harder.”

He says going up ramps is a little tricky, so he uses anti-tip bars and the push-pull method — pushing the tires forward on the down stroke for an “after-boost” after pulling back on the rims to go forward. “The demo chair had the LX wheels and I almost flipped the chair over,” he says. “The HX model is better suited for me. It’s best to be careful and gentle.”

Dee Majeski says her rotator cuff issues started to improve after using HX Rowheels for two months. Now she has no shoulder pain at all.

Dee Majeski says her rotator cuff issues started to improve after using HX Rowheels for two months. Now she has no shoulder pain at all.

Loading the chair into his four-door 2014 Dodge Avenger is a little more difficult due to the added wheel weight, but he can do it. If someone rides with him, they usually help him stow the frame and detached wheels in the rear seat.

Dee Majeski, 49, lives in Racine, Wisconsin, and has partial paralysis from a surgery complication four years ago. She has some mobility but uses her chair full-time. She started getting shoulder issues after a couple of years of wheeling. “I saw something on Facebook about Rowheels, so I got a pair. The most amazing thing is I had started having rotator cuff issues, and now I don’t have any shoulder issues any more. Probably only after about two months I started getting better.”

Majeski runs 24-by-2-inch knobby tread solid Kenda tires on her HX wheels. Laminate flooring compensates for the difficulty the knobbies add to indoor pushing and the knobbies are worth it outside. “I love being outdoors with my dog. I don’t get stuck in ruts when I go off in grass.” She says the wide knobby tread also helps in winter. “We get a lot of snow here sometimes.”

She also uses the push-pull method for going up ramps. She drives herself and loads her chair into the back of her small Ford Ranger pickup that has suicide doors. “I can stand a little, so I use grab bars to help pull myself into the front seat.”

My Take

Rowheels sent me a pair of LX wheels to demo in September 2018. In my brief two-week trial, I discovered what many longtime active wheelchair users experience. Getting used to reverse propulsion is not easy. It takes time to overcome decades of ingrained muscle memory. In my home, I spent lots of time running into door jambs and making wrong-way turns. My ineptness was both frustrating and comical. But once I got outside on a quarter-mile track, I began to get the hang of it.

Wheeling became easier, but responsiveness and velocity were disappointing. I concluded that the LX wheels are not for me, mainly because they are geared too low for my use, which includes outdoor wheeling at moderate to high speeds. Ideally, I would have liked to try out a pair of the HX wheels over a longer period of time — in order to get used to the counterintuitive wheeling technique.

Other drawbacks: I found that popping wheelies is limited to jumping a 2-inch threshold or bumping up a very small curb. Also, both LX and HX wheels are relatively heavy, so loading them in a vehicle is more difficult.

On the plus side, the braking system, once you get used to it, works fairly well. Brakes are activated by pressing inward on the rims with your hands, wrists or forearms. This causes pressure to be applied to the wheel rims by three hard-rubber stops mounted on the inside of the hand rims.

But the overwhelming benefit is the propulsion system’s preventative and therapeutic potential. Rowheels has succeeded in developing a unique line of products that have been shown to relieve shoulder pain by strengthening opposing muscles that are activated by pulling instead of pushing.


Which Rowheels Product Fits Your Needs?

Note: All Rowheels products are designed primarily for prevention and therapeutic treatment of painful shoulder problems and improved posture.

LX Wheels: Low-gear wheels with quick-release axles launched in 2015. Best for inside spaces, easier wheeling up inclines. May be useful for quads who use a manual chair.

HX Wheels: High-gear wheels with quick-release axles launched in 2016. Suitable for all-purpose wheeling, greater velocity. Requires more effort than LX. Best for paras or other active lifestyle wheelchair users.

Rowheels 1.0: Fixed-wheel LX model inexpensive wheelchair due to launch in January 2019. Suitable for inside spaces, assisted living, older wheelchair users.


Purchasing

Majeski, a veteran, had her Rowheels covered by Veterans Affairs. It took Imlay a year to get his wheels through Easter Seals. Maleski said his wheels were covered by a University of Pittsburgh Medical Center plan. But my call to Numotion to check on insurance funding didn’t get a response. Luke van den Langenberg, a sales engineer for Rowheels, says distribution is more likely through National Seating and Mobility.
Both LX and HX wheels currently sell for $3,000 a pair. The new Rowheels 1.0 wheelchair with fixed LX wheels $999 will most likely be an out-of-pocket cost.


Grit Freedom Chair: Geared Up For Anything

Grit Freedom Chairby Seth McBride
Another innovative chair that aims to reduce shoulder strain and increase mobility is the Grit Freedom Chair, which uses levers as the primary means of propulsion. The Freedom Chair is designed as an off-road chair, with knobby, mountain bike-style tires standard and a single, over-sized pneumatic front caster that copes well with soft surfaces and bumpy terrain.

The lever system is intended to mimic the benefits of bicycle gearing, while eliminating the complicated components — the higher you push on the lever, the lower (easier) the gearing. So when you’re going uphill, you can push on the top of the levers to ease the strain, and if you’re on the flats you can push toward the base for speed. An added benefit of the levers, for off-road use, is that any mud, sand or other grime isn’t transferred from the wheels to your hands.

Originally designed as an everyday option for countries that don’t have well developed road or sidewalk systems, the Freedom Chair is simple and utilitarian, made with standard bicycle components and easily repairable without specialized tools. The simple design does mean that there is not much built-in adjustment for seating position, so expect to play with cushions, strapping and padding for everything from leg stability to trunk support, depending on your level of function.

The Freedom Chair also has a bit of a learning curve, as pushing, turning and braking are all different with the lever system. Reversing is particularly tricky, as you have to remove the levers from their housing, pull back on the wheels like a normal manual chair and then reinsert the levers when you’re ready to move forward again. If you try to back up without removing the levers, they’ll block against the wheels.

The Freedom Chair is most functional on wider paths where there is room to maneuver and weave back and forth up steeper sections. The Freedom Chair really comes into its own on soft surfaces, like sand, gravel and mud. The optional, wider beach wheels, when combined with the large front caster, float over terrain that would swamp a typical everyday chair.

The Freedom Chair starts at $2,995 and comes with a 30-day money-back guarantee. There is also a thriving Facebook community of Freedom Chair users, who are more than happy to share riding tips, chair modifications and any other kind of support to help you maximize your experience.