After selecting a wheelchair and cushion, securing funding from various sources is essential. The wheelchair is then assembled, customized, and thoroughly inspected for safety. During fitting, the user trials the wheelchair, and final adjustments are made for comfort and support. Emphasizing user involvement, safety checks, functional testing, and training ensures the wheelchair meets the user’s specific needs, enhancing their mobility and quality of life.

Planning considerations: 

For live demonstrations, think about where fitting will be carried out and how it is set up. If user volunteers are available, consider small working groups, in order to have an appropriate learner to user ratio, and not overwhelm the user with too many people. Student: instructor and students: wheelchair user ratios.  It will be useful to have enough support staff around to assist with monitoring the groups.

Location/facilities:

A classroom with enough space to have the wheelchairs.

Human resources:

Trained educator, you may contact a local wheelchair vendor that conducts appropriate fitting.

How to teach the content:

• Lecture on procurement processes.
• Case studies.
• You may need to make arrangements for wheelchair users and a matching range of assembled wheelchairs and cushions. It may be useful to collaborate with your local wheelchair service or rehab centre in order to identify appropriate users and source appropriate products.
• If you have no access to wheelchair users or products, it will be useful to have a selection of videos which demonstrate each stage of the fitting process.

Recommended equipment and tools:

• Manual and power wheelchairs with adjustable features (e.g. footrest/backrest/armrest/ height, rear wheel axle position, seat height, etc).
  • Product documentation (e.g. assembly and adjustment manual).
• Cushions
• Tape measure.
• Tools to adjust the wheelchair features (e.g. Allen Wrenches, screwdrivers).
• Pressure mats (if available in your context)
• Cushion fabrication materials. The following are from the WHO training package.
  • Firm foam.
  • Soft foam.
  • Contact cement.
  • Saw or electric knife.
  • Marker

Documentation:

• Local funding form.
• Local supplier ordering form.
• Local product preparation checklist and/or WHO wheelchair ready and safe checklist.
• Completed prescription forms.
• Product specification sheet and assembly.
• WHO fitting checklist.
• You may also find it useful to liaise with your local wheelchair service and use their documentation.

Other comments related to contextual adaptation/implementation:

Cultural sensitivity is important during practical demonstrations of the fitting process, especially when checking for size, and performing the finger pressure test, where pressure mapping equipment is not available.

Learning Objective

Develop solutions and find alternatives for wheelchair provision by facing different stakeholders.

How to Teach

Case studies that highlight complex situations are analyzed and proposed solutions and alternatives are debated to reach consensus.

How to Evaluate

Group work to analyze and find the best solution per case study.

Learning Objective

Demonstrate ability to adjust different wheelchair components to meet individual user needs.

How to Teach

Small group hands-on activity with wheelchairs and prescription forms.

How to Evaluate

Group activity.

Learning Objective

Execute a risk/safety and quality analysis of a provided wheelchair and cushion.

How to Teach

• Match risks with mitigation strategies.
• Complete a safety checklist of wheelchair set up.
• Theoretical & practical learning on quality & safety guide of wheelchair & cushion.
• Observational/comparative studies of different finished products.

How to Evaluate

• Evaluate/observe the student’s practice of quality & safety check.
• Evaluate the percentage of the check list followed.
• Comparative study report.

Learning Objective

List the steps and personnel involved in wheelchair and cushion preparation and fitting and execute the fitting process.

How to Teach

• Lecture (online or in-person) fitting steps.
• Live class of fitting demonstration .
• Practice session of fitting.
• Wheelchair & cushion fitting manuals.

How to Evaluate

• Observe the practice.
• Percentage of fitting checklist covered.
• Demonstrate fitting procedures.
• Quiz.

Learning Objective

Small group hands-on activity with wheelchairs and selection forms.

How to Teach

• Label wheelchair parts and identify the characteristics of set up.
• Theoretical learning & practice.
• Live demonstration/class for measurement & conversion.
• Wheelchair manuals – adjustable features will be explained.
• Participate/assist in the product preparation.

How to Evaluate

• Quiz/test.
• Evaluate prepared product against prescription measurements.
• Demonstration of product preparation  (process).

Learning Objective

Understand common fitting problems and associated solutions in wheelchair adjustment, including returning the product.

How to Teach

• Theoretical learning.
• Live demonstration on a wheelchair user.
• Practical understanding/learning.
• User feedback learning.
• Fitting process.
• Practical learning

How to Evaluate

• Case study evaluation.
• Evaluate fitted product & user.
• Demonstration of fitting problem solving.
• Quizzes.
• Evaluate understanding of the problem through case studies.

Learning Objective

Demonstrates the technique to evaluate the appropriateness of the pressure distribution achieved with the cushion being fitted(e.g. manual pressure test; pressure map).

How to Teach

• Theory & practical learning sessions.
• Recorded (videos) learning.

How to Evaluate

• Quizzes.
• Practical demonstration/evaluation.