Wheelchair Skills Training - Stopping

Original Editor - Lee Kirby as part of the Wheelchair Service Provision Content Development Project

Top Contributors - Naomi O'Reilly, Kim Jackson and Amrita Patro  

Stopping

Description and Rationale

While the learner is moving the wheelchair forward or backward, he/she may intentionally come to a stop at a pre-determined location (e.g. next to a table or wall) or need to come to a sudden stop in reaction to an unexpected event (e.g. other wheelchairs or pedestrians moving into the path) to avoid injury to themselves or others.

General Training Tips

• The learner should be alert to the fixed and moving environment while the wheelchair is moving.
• Sudden stops or changes of direction can lead to the wheelchair user falling forward or to the side in the wheelchair.
• When attempting to stop as close as possible to a rear target without contacting it, the learner may need help to understand what is the rearmost point on the wheelchair (e.g. a knapsack or rear anti-tip devices) because it may not be visible to the wheelchair user.
• When there is ample space in which to stop, on a level surface the wheelchair will coast to a gradual stop due to frictional forces and rolling resistance when the wheelchair user stops pushing.
• If the wheelchair user wishes to stop more quickly, the rate of slowing can be controlled by how hard the hand-rims are gripped. The hand-rims should be allowed to run through the wheelchair user’s hands. While stopping, the hands should be ahead of top dead center (about 1:00 o’clock using the clock analogy). 
• If the wheelchair user stops too quickly while moving forward, the wheelchair user may fall forward out of the wheelchair or tip over forward. To prevent this, the wheelchair user should lean back whenever he/she is required to stop quickly.
• When stopping while moving backward, to avoid tipping backward when stopping, the wheelchair user should avoid grabbing the wheels suddenly and should lean forward slightly.
• On a slope, the wheelchair will continue to roll (or even accelerate) unless stopping forces are applied. If the wheelchair starts to roll too quickly down an incline that is wide enough, instead of grasping both hand-rims to stop, the wheelchair user can grab one, turning across the slope.
• On a slope that is being descended in the wheelie position, when stopping part-way down the incline, the learner may remain facing downhill or turn the wheelchair across the slope.
• Sudden stops can transfer weight forward onto the casters, allowing the unloaded rear wheels to skid.

Progression:

• Start at a slow speed before stopping and increase as tolerated.
• Start in a smooth level indoor space and progress to the outdoor setting.
• Start on the level and progress to inclined surfaces.
• Re avoidance of moving obstacles, the learner should start with a single moving obstacle moving slowly at a consistent speed, seen well in advance, to obstacles moving more rapidly and unpredictably, with less warning (e.g. actual pedestrian traffic in a crowded setting). 

Variations: 

• The learner can practice stopping progressively closer to an obstacle, but without touching it. This can include progress from a tall obstacle that can be seen no matter how close the person is to it (e.g. a door), to one that is lost to sight as the user gets closer (e.g. a line on the floor).This requires good awareness of the most forward and rear-most aspects of the wheelchair. A mirror positioned to the side of the wheelchair can provide useful feedback.
• The wheelchair user can see how quickly he/she can stop on command.
• Different moving obstacles can be used (e.g. a rolled ball, a swinging pendulum).
• When moving forward, the wheelchair user can practice both quick stops (leaning back and grabbing both hand-rims firmly) and swerves (leaning toward the direction of turn and grabbing one hand-rim firmly). 
• See wheelie variation later.

References