Wheelchair Skills Training - Curbs
Original Editor - Lee Kirby as part of the Wheelchair Service Provision Content Development Project
Description and Rationale
The learner gets the wheelchair up curbs of various heights. Level changes (e.g. curbs, home entries, uneven sidewalk sections) are common obstacles in the natural and built environments. The ability to manage low curbs (~5 cm) is useful but practice on low curbs also provides an opportunity to hone techniques that will be needed for higher curbs (~15 cm). Although curb cuts (“pedestrian ramps”) are now commonplace in many parts of the world, curbs or large level changes are still commonly encountered.
General Training Tips
- This skill is similar to and builds upon the previous ones, specifically the “rolls on soft surface” and “gets over obstacles or gaps” sections.
- A low curb can be approached with stationary and momentum methods but the momentum method is usually necessary for high curbs.
- It is slightly more challenging to deal with the rear wheels than for the preceding skills because the tilted position, due to having the casters on top of the curb, moves more weight to the back of the wheelchair. This shift of weight is present until the rear wheels are all the way up on the upper level.
- In the stationary approach, if the wheelchair user has difficulty getting the rear wheels up onto the upper level, the wheelchair user should roll the wheelchair backward until the front wheels are almost off the edge of the curb. Before backing the rear wheels away from the curb edge, the wheelchair user should lean forward and place his/her hands on the hand-rims in the position where the most force can be applied. The hands should remain on the hand-rims as the wheelchair user sits up and the rear wheels are backed away from the curb, ensuring that the hands and trunk will be optimally placed when moving forward again. When the rear wheels strike the curb, the wheelchair user should lean forward and push the rear wheels up onto the upper level. The forward lean should be timed to coincide with when the rear wheels contact the curb.
- As noted earlier, with the momentum method, the wheelchair user should ensure the casters are on the upper surface (rather than in the air) when the rear wheels strike the curb. If the casters are still in the air, the energy from the forward pitch caused by the collision of the rear wheels with the curb will be expended in noisily bringing the casters down onto the upper level (“caster slap”) rather than bringing the rear wheels up onto the upper level.
- The learner should start with a minimal level change and progress to higher ones.
- The wheelchair user might find it easier to ascend low curbs in the backward direction.
- The wheelchair user may use the external environment if available (e.g. door frame) to pull the rear wheels up onto the upper level.
Description and Rationale
The learner gets the wheelchair down curbs of various heights. The rationale is the same as that for the “ascends curbs” section.The appropriate technique for a high curb differs in some respects from that used for a lower curb height.
General Taining Tips
- The wheelchair may be able to simply roll forward off the upper level of a low curb. This is less of a problem for wheelchairs with long wheelbases. The forward roll-off approach for low curbs is convenient and allows the learner to watch for traffic. It may be as safe and effective to go off the lip at a moderate or full speed as it is to go slowly.
- For a high curb, the backward approach is simple and generally safe if the wheelchair has adequate rear stability and sufficient visibility is available to avoid oncoming traffic. However, even more so than for descending low curbs, it is important to keep the rear wheels moving backward to avoid a rear tip. Learning the backward approach on low curbs is helpful when advancing to higher curbs. To perform the backward approach, the wheelchair user should line the rear wheels up with the edge of the curb. The wheelchair user should lean as far forward as possible (chest on lap, if necessary) and reach forward on the hand-rims. The wheelchair user should move backward very slowly and let the rear wheels roll evenly down off the upper level under control. Once the rear wheels are on the lower level, the wheelchair user can sit more upright if this is possible without tipping over backward. The wheelchair user should avoid braking suddenly when the rear wheels land on the lower level because this can induce a rear tip; keeping the wheelchair moving backward reduces the likelihood of this problem. If the wheelchair can be brought to a stop with the rear wheels on the lower level and the casters on the upper level, the wheelchair user can turn to the left or the right to get the casters off the upper level without scraping the footrests use the full-wheelie position to move backward away from the curb.
- Approaching the curb edge in the forward direction, the wheelchair user can transiently pop the casters as they reach the curb edge. The wheelchair user approaches the curb edge squarely with all four wheels on the surface and pops the casters as they reach the edge. This is similar to the technique used to pop the casters transiently for the “gets over threshold” and “gets over gap” skills. The extent of the caster pop should be sufficient to allow the rear wheels to land on the lower level at about the same time or slightly before the casters land. This method requires good timing and skill, but is a natural way to maintain forward progression and to watch for traffic. It can be difficult to spot, so two spotters are recommended.
- See the wheelie variation later.