What factors should be considered in making a choice between a power or manual wheelchair for someone with a spinal cord injury?

Deciding between a power or a manual chair is one of the more difficult decisions that therapists and patients have to make together. A patient may have a very strong opinion that they want a certain type of chair, and the therapist may bring up certain ideas to consider, or concepts, or considerations for that patient based on their shoulder health, their age, their lifestyle, their level of injury—the type of stability that they have in their shoulder blades is really important as well. So there maybe some factors that the therapist can contribute and issues that they can bring up that will help with that decision. A manual chair is a little more accessible in more places. It can access curbs and stairs and areas that power chairs cannot be lifted into. And a manual chair doesn’t require a specialized van to transport it. So it can be a little bit easier for someone to have a manual chair and be able to get around to different areas—homes, vehicles—then they would be able to in a power wheelchair. But a power chair can often provide long-term endurance for longer treks. Someone who has to negotiate hills—especially like a college campus where they often have to get across hills, or difficult terrain in order to get to and from classes in a timely manner—a power chair might just make more sense. The nice thing is that there’s a middle option which is power-assist wheels, which could be considered as well for someone who has the ability to propel a manual chair, but maybe needs a little assistance from those power-assist wheels and that can be a nice middle option.