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This is the fifth slide lecture in a series of eight lectures that
are intended to provide an overview of the wheelchair mobility
and seating evaluation process. The lecture series contains:
•Seating Biomechanics
•Wheelchair Seat Cushions
•Pressure Mapping
•Wheelchair Backs
•Manual Wheelchair Set Up & Propulsion Biomechanics
•Rehabilitation Technology Suppliers & Clinicians
•Service Delivery
•Strategies for Effective Documentation
Schmeler, MR & Buning, ME
October 1999
Manual Wheelchairs: Set-Up &
Propulsion Biomechanics
Mark Schmeler, MS, OTR/L, ATP
Mary Ellen Buning, MS, OTR, ATP
Center for Assistive Technology, UPMC Health System
Department of Rehabilitation Science & Technology
University of Pittsburgh
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Schmeler, MR & Buning, ME
October 1999
Abstract and Presenter Bio-sketch
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Mark Schmeler is the Director of Clinical
Services at the Center for Assistive Technology.
He has many years of front-line clinical
experience in seating and mobility with
individuals with complex seating needs.
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Mary Ellen Buning is a research associate in the
Rehabilitation Science and Technology
Department with interest in AT education,
service delivery and functional outcomes that
result from AT devices and services.
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Schmeler, MR & Buning, ME
October 1999
Outline
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This presentation will cover the
following:
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Categories of Manual Wheelchairs
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Repetitive Strain Injuries
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Propulsion Biomechanics
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Adjustability & Set-Up
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Schmeler, MR & Buning, ME
October 1999
Wheelchair Categories (Medicare)
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Standard (K0001)
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Standard Hemi (K0002)
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Lightweight (K0003)
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High Strength Lightweight (K0004)
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Ultra Lightweight (K0005)
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Rigid “Sport” Ultralites
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Reclining
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Tilt in Space
The Health Care Finance Administration (HCFA) is the Federal
Agency that administers Medicare. HCFA regulates Medicare
but many private insurance companies follow HCFA’s lead.
Wheelchairs are given a code by HCFA so that one computer
can talk to another computer. These are often referred to as
“K codes.” The system  is designed so that HCFA either finds
the criteria in the therapist’s documentation that will allow
them to pay for it or not allow them to pay for it.
There are additional “K” categories for other kinds of durable
medical equipment (DME) but these are the ones for standard
wheelchairs.
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Schmeler, MR & Buning, ME
October 1999
Standard (K0001)
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Weight: <36lbs.
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Seat Width: 16” or 18”
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Arm Style: fixed or detachable
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Seat Depth: 16”
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Seat Height: >19” & 21”
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Back Height: nonadjustable
16”-17”
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Footplate Extension: 16” to 21”
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Footrests: fixed or detached
The standard wheelchair is also called the “depot” wheelchair.
It is at the bottom of the pile!
In order for a manufacturer’s wheelchair to fall into this
category it must meet the listed criteria.
This kind of wheelchair is very useful in an airport for
transporting a passenger but in reality there is no way that it
is suitable for everyday use. It is too heavy and has no
adjustablility.
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Schmeler, MR & Buning, ME
October 1999
High Strength Lightweight (K0004)
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Lifetime Warranty on frame
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Weight: <34lbs.
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Seat Width: 14”, 16”, or 18”
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Arm Style: fixed or
detachable
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Seat Depth: 14” or 16”
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Seat Height: >17” & 21”
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Back Height: sectional or
adjustable 15” to 19”
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Footrests: fixed or detached
K0002 and K0003 wheelchairs are a lot like K0001 with some
small variations but… K0004  tend to cost about $1000.
It is lighter but not enough to make a functional difference.
The standard widths given above are narrower than is
standard. Most people today fit into a 22” seat… Americans
are heavier. Even airlines are having a problem with this
factor.
This type of wheelchair can come lower to the floor for easier
propulsion by foot and for increased ease in transfers.
This wheelchair is the same as k0001 with a little more
adjustablility. However, it costs 2x as much to purchase one.
It probably doesn’t cost this much to manufacture but HCFA
sets the price and manufacturers comply.
This is the opposite of the incentive offered for the drug
industries.**