What is the Most Comfortable Manual Wheelchair?

The pursuit of comfort in a wheelchair is often a challenging task. It can be difficult to enjoy sitting in a steel and vinyl chair that is made for the masses. There are many important factors that can make a wheelchair comfortable – or miserable. The problem is most people aren’t aware of their options.

But, don’t worry!

I am going to show you how to find the most comfortable manual wheelchair! Already have a wheelchair? I’ll also show you how you can make your current wheelchair more comfortable with the most comfortable wheelchair cushions and backs!

Because the best wheelchair is a comfortable wheelchair, right?

Disclaimer: my recommendations below are for comfort only not for clinical pressure relief. If you have a history of pressure ulcers, skin problems, or are at risk for them, please consult your healthcare professional and a RESNA-certified Assistive Technology Professional in your area. Also, the recommendations are for the general population and may not apply to people with severe deformities or progressive neurological disorders.

Why Are Wheelchairs So Uncomfortable in the First Place?

Think about the construction of a wheelchair. It is essentially a metal frame with a metal cross brace under the seat. Stretched tightly across this frame is a piece of vinyl or nylon upholstery. That same upholstery is also strung across the back posts.

Then, there are two metal arms with hard rubber pads that never seem to be in the right spot. Finally, those 2 back canes are always rubbing the shoulders. No fun!

Wheelchair Upholstery Problems

Then that upholstery is bolted to a frame. In effect, the wheelchair rider is sitting in a sling. Remember in grade school when you would swing on the swing set and your butt would go numb? Or just hurt from the squeezing motion of the seat as you settled in it?  You get the same effect sitting in a wheelchair.

As the upholstery on a manual wheelchair stretches and settles with time, it sags in the middle. That’s what wheelchair nerds like me call the “hammock effect.” Eventually, the rider sits lower and lower in a hole until it is just like being in a grade school swing.

Manual Wheelchairs Often Don’t Encourage Good Posture

Because of the way standard manual wheelchairs are made, there is not a lot of support for an elderly person’s posture.

• The arms are too low causing the person to hump their back forward to make contact with them.
• The legs don’t always elevate causing leg swelling, leg pain, and even lower back pain.
• As the upholstery stretches on the back of the wheelchairs, the shoulders and back round out leading to back pain.
• The same stretching on the wheelchair seat cushion leads to a leaning posture too.

Insurance Companies Don’t Pay for Comfort!

For an insurance company to pay for a wheelchair, it has to be proven to them that it is “medically necessary.” It must be needed for the person to care for themselves and to provide mobility when they can’t move on their own. Providing the most comfortable wheelchairs is not part of their equation.

There is one small exception to this policy that even some durable medical equipment companies do not know about. Insurance companies including Medicare and Medicaid will pay for “general use” cushion and back cushions.

General use cushions are simple foam type cushions that can make sitting in a wheelchair more comfortable. Insurance guidelines are way beyond the scope of this article, but it can be done. Ask your DME provider.

The Wheelchair is Not Sized Properly

I’ll try not to get on my soapbox here. But, it’s hard. Fitting people properly for wheelchairs is what I do for a living. These are general comments too – I have taken hours long classes about this.

I often see people that are placed into wheelchairs that just plain don’t fit. Usually, the chairs are too wide and too short. For proper wheelchair use and positioning, the wheelchair seating area should be NO MORE than 1″ to 2″ wider than the hip measurement.

The seat depth (from the wheelchair back to the front of the seat) should be NO LESS than 1″ less than the seat depth of the user (back of the butt to the inside of the knee).

If a wheelchair is too wide, the user may lean and not be able to reach the wheels properly which causes pain. If the seat depth is too short, the legs will often spread which causes pain too.

The footrest length is very important too! The top of the legs (femur) should be parallel to the floor when the footrests are at the right length, generally. There are exceptions based on individual patient needs.

Ok, sounds terrible, doesn’t it? Here is how to fix these problems.

Finding the Most Comfortable Wheelchair for the Elderly

Many of the problems listed above, can be dealt with during the wheelchair selection process. I know. I know. Most people don’t know a thing about wheelchairs until they need one. Often, at that point, they just take what they are offered. And what the insurance company provides for them.

But, you do have a choice. Most plans will allow you to upgrade and pay the difference. OR the insurance plan will buy the base wheelchair and you can pay for the added accessories. Check with your DME provider or insurance company first.

If you decide to purchase a manual wheelchair outside of insurance benefits, here are the same recommendations I make to the patients I serve as an Assistive Technology Professional.

Recommended Features Checklist for Wheelchair Comfort

• Nylon Upholstery – Nylon holds its shape longer and is more breathable than vinyl upholstery so it isn’t as hot to sit on.
• Adjustable angle back – allows the back to be set at a slight recline rather than a straight up and down 90 degrees.
• Elevating leg rests – If leg pain or swelling is a problem, get a chair with elevating leg rests to raise the legs and reduce pain and swelling
• Seat Cushion – If your bottom is uncomfortable, add a seat cushion to your chair for a softer sitting surface. I have some recommendations below.
• Back Cushion – For lower back pain, add a supportive back cushion for better back support but make sure it folds with the chair or removes easily.
• Cushion rigidizer – this is a plastic or wood insert that goes under the cushion to give it more support.
• Lightweight – lightweight wheelchairs are easier and more comfortable to propel.

SEE ALSO: Wheelchairs That Recline for Comfort

The items in this checklist are ideal to get the most comfort out of a wheelchair. These features need to be balanced with the patient’s needs, the insurance requirements if applicable or the financial ability of the elderly or their caregiver.

For other wheelchair buying suggestions, check out my online wheelchair buying guide.

Reviews of Comfortable Wheelchairs

Karman Healthcare’s Ergo series of wheelchairs are designed to fit the human body better with a specially shaped frame. The seat rails are curved to match the natural curvature of the human leg. The armpads are wider and designed to support and cushion the armpad. Even the handrims have a slight curve to them making them easier to grip and hold onto as well!

The upholstery is another reason this chair makes my top list. First, it is thicker and more padded than most of its competitors. Actually, it is two upholsteries in one. The main layer is attached to the chair frame like most other manual wheelchairs.

Then, there is a second breathable, padded layer that wraps around the main layer. This second layer is antibacterial, removable and washable. That makes this wheelchair easier to clean and keeps it looking good for years. Plus, it is stain-resistant and odor-free!

It comes in 16″, 18″, and 20″ seat widths. All widths are set at a 17″ seat depth. The armrests aren’t adjustable but are pre-set at 8″ which will be fine except for extremely tall people. You even get a few color choices too including black, red, and white.

This chair is easy to transport too. It only weighs 25 lbs and you can make it even lighter by removing the footrests and the “pop-off” wheels. These wheels have a quick release axle so that you can remove them at the touch of a button.

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It has many of the same benefits of it’s bigger cousin, with a few key differences:

• The rear wheels are smaller and make the chair lighter weight (only 18 lbs) but the chair has to be pushed by a caregiver.
• Wheel locks are on the push handles so the caregiver can apply them easily and quickly.
• Only one seat size: 18″ wide
• Footrests are fixed and nor removable.Weight capacity is less at 220 lbs.

Here is how you pick between the two. If the user needs to be able to move the wheelchair by themself and it is being used primarily at home, go with the larger wheel version (S-115). If the chair is mainly used outside of the home for transportation, go with the transport Version (S-2501).

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This manual wheelchair has most of the adjustments and options I recommend to make a wheelchair more comfortable for its users. Because of this, it will better fit people who are taller or shorter than average height.

Here is a rundown of all the adjustments that can be made with this wheelchair – straight out of the box!

It has height adjustable arm rests that can be quickly adjusted with a simple lever. So, the arms can be raised or lowered as needed to make the user comfortable. They also flip back out of the way too!

The back adjusts in height too – from 16″ to 18″. It does require tools but only a single bolt for each side. This adjustment means the chair will fit taller people a little better.

Speaking of tall people, the seat depth of this chair can be increased to 18″ without any additional parts. For people with longer legs, a longer seat depth is much more comfortable. The height of the chair is also adjustable. It has two positions: a higher and a lower setting for different leg lengths.

These adjustments may seem intimidating but are not. Someone with basic mechanical skills and tools will be able to make these adjustments. Most do not require tools! The manufacturer has an adjustment guide to help.

The nylon upholstery breathes and is cooler against the skin. It is also durable and easy to clean.

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We use the Drive Medical Viper at the home medical equipment company where I work. It is for sure a very comfortable wheelchair that the user will like. There are a few concerns that I’ll go over too.

Like the Drive Cruiser X4, this wheelchair offers a lot of adjustability. The arm height is adjustable from 10″ to 14″, flip back, and are even removable to help with side transfers.

This chair also offers an adjustable angle back. So, if the user doesn’t like to sit perfectly upright or has a postural issue that prevents it, the seat back can be reclined slightly (up to 20 degress) to make the user more comfortable. But, this is an adjustment that requires a tool so it can’t be adjusted on the fly.

Other key adjustments include:

• Seat depth adjusts from 16″ to 18″
• Seat height has a low and a high setting
• Back height adjusts from 17″ to 19″

The chair is easy to transport because it weighs only 35 lbs and you can make it lighter by using the quick release axles to remove the rear wheels. It is easy to lift and load into a trunk for weaker caregivers.

But, this brings me to my concern with the Viper. It works great when it is used at home. However, it doesn’t take a whole lot of abuse and has a bit of a reputation for being “loose and wobbly” after time. This is particularly true when the chair is repeatedly folded and unfolded for transportation.

If you choose this chair, you can minimize this by tightening the bolts on the chair periodically – at least once a month. Just know that this chair will require a bit more maintenance than the others.

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Most Comfortable Wheelchair Cushions

The best way to make a wheelchair more comfortable is to look at the seating surface and cushion. Adding a cushion to a wheelchair seat will immediately increase your comfort and reduce pain and pressure. But, not all wheelchair cushions are created equally! Here are the most comfortable wheelchair cushion based on my professional experience.

This is one of my favorite cushions because it has multiple layers of comforting materials.

At it’s core, it is a wheelchair gel cushion that distributes pressure across the surface of the cushion. This gel core is surrounded by a resilient foam that resists flattening out. These comfort surfaces are then surrounded by a fluid-proof layer and a soft, stretchy cover that is washable and has a non-slip base.

It is available in 16″, 18″, and 20″ widths to fit the most common wheelchair sizes. Total thickness is 3″.

One potential drawback: gel cushions tend to harden in cold climates. If the cushion stays indoors you won’t have any problems. But, if you keep it in a cold car or trunk, you should choose an air or foam cushion instead.

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This cushion is the retail version of the ROHO cushion I use in my practice as an custom wheelchair specialist. Note though it’s not quite the same so if you do have a history of pressure sores or bed sores or are at risk for them, consult with a professional.

The ROHO Mosaic uses air cells to provide comfort and a softer sitting surface. The cells are a waterproof poly vinyl material and they are connected together.

This allows the air to shift from cell to cell to maximize comfort. It is extremely lightweight and supports up to 250 lbs. It comes in three sizes: 16″ X 16″, 18″ X 16″, and 18″ X 18″.

To add air, you use a valve that looks like the one on bicycle tires. You use the hand pump that comes with the cushion and add air to the cushion. Finally, twist the valve to close it. It is really easy to do and you don’t have to do it very often.

The only concern with pumping the cushion is that some people have a tendency to put too much air in these cushion thinking “more air must be better.” But, this isn’t true. You want the cushion to be squishy and not hard. The person sitting on it should sink into it slightly (but not so soft that they hit the bottom of the wheelchair seat).

Here is a great video that walks you through the process. After you have done it a few times, you won’t have any problems with it.

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The Everlasting Comfort cushion is made of 100% memory foam that is also gel infused to provide cooling comfort. Memory foam is used frequently in my industry to provide pressure relief and comfort to wheelchair users because it gives as well as retains its shape. The material is very similar to the foam used in high quality mattress toppers for seniors.

It is designed to support your hips, tailbone, spine, butt and lower back. The manufacturer offers a Lifetime Replacement Guarantee too!

There is a wheelchair back cushion to match it that you can see below.

This cushion fits 18″ wide wheelchairs and is 3″ high. The cover is made of a soft and breathable mesh with a non-slip bottom that can be machine washed. However, it is not waterproof so it shouldn’t be used if you are dealing with incontinence.

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If you need just a basic wheelchair cushion that also offers some comfort, this cushioned seat and back cushion combo from Drive Medical fits the bill. Especially if the chair isn’t used for hours at a time.

It is made of a basic high-resiliency foam that is molded to the curvature of your legs. The cover is soft, removable, and washable. But, it is NOT waterproof.

It is a comfortable wheelchair cushion especially for short periods of time. If you use your wheelchair most of the day or for long stretches of time, I would suggest one of the other cushion above. They provide better and longer support.

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This cushion is really just a custom shaped pillow to fit a wheelchair and make it softer, plush, and more comfortable. I like that is also adds comfort to the back rest and arm rests too.

The removable cover is a washable poly cotton blend over cut foam cushions. The foam, however, is a basic quality foam and may not support heavier people very well. It is going to be most comfortable for smaller framed and lighter weight people.

It offers universal sizing to fit the most common wheelchairs. There are several colors to choose from and this would make a great gift for wheelchair users too!

How to Make Wheelchair Backs More Comfortable

Sometimes, wheelchairs can be a real pain in the … back! Bad upholstery and steel back canes can make sitting in a wheelchair for long periods of time nearly impossible. Here are some options to make your wheelchair back more comfortable.

This soft and comfortable wheelchair back cushion matches the Everlasting Comfort wheelchair cushion above. So, if you like things to match or are a little OCD, you can have a nice matched set.

This back has two adjustable straps that attached the cushion to you wheelchair back and keep it from moving. That way, the back will always be in the right positions.

It is made of the same high quality materials and the seat cushion and also has the same Liftetime Replacement Guarantee.

This ergonomic back supports the lumbar and lower back with memory foam that provides comfort and bounces back to last for years.

When shopping for a comfortable wheelchair back cushion like this, it’s important to make sure it has straps. Straps wrap about the back canes of the wheelchair and keep it in place so that it doesn’t move. This recommendation has that.

I also chose this one because it comes in 9 fun colors for people who want to customize their chair a little bit.

Note that you will have to remove the back cushion to fold up the chair, but you’d have to do that for the seat cushion too.

Summary and Final Recommendations

I considered many wheelchairs for this guide but found this was the only wheelchair available online that met all my recommendations. I am continuing to research this topic because I would love to give you more than one product to consider!

Don’t forget about your hands too! Using the best wheelchair gloves will help protect and comfort your hands during a day of propelling your chair!

Do you have any tips for making a wheelchair more comfortable? Have you used a wheelchair that you thought was comfortable? Help my readers out by leaving the details in the comments below!