Ultra Lightweight Wheelchair
Justification and Benefits of Ultra Lightweight Manual Wheelchair
Ultralights Can Maximize Consumers' Independence
The calling card of the ultralightweight manual wheelchair (HCPCS code K0005) is indeed its very light weight. Thanks to the best materials (top-grade titanium and aluminum) and the best engineering practices and designs, many of today’s K0005 frames weigh far less than 20 lbs. Their high-level performance and their sleek good looks make ultralightweight chairs much revered and sought after by active full-time wheelchair users.
Ultralights are also admired by the ATPs and clinicians who work with those consumers. K0005s can offer customized fit and configurability unmatched by other manual wheelchair types, which occupational and physical therapists certainly appreciate when working with clients who have complex seating & mobility needs.
K0005 CLINICAL CONSIDERATIONS
What clinical issues might lead a clinician or ATP to consider assessing a client for an ultralight chair?
The importance of getting a good client history and says key questions include, “Does the client have a history of upper-extremity pain or dysfunction? Is the client experiencing any pain with propulsion currently?”
Which mobility-related diagnoses might signal a need for an ultralight chair, some do not focus as much on diagnosis as they do on clinical presentation. However, individuals with paraplegia, higher-level quadriplegia, hemiplegia, multiple sclerosis, brain injury or those with developmental disorders such as cerebral palsy, spina bifida and muscular dystrophy can maximize their independence with the use of a K0005 mobility base.
Using diagnoses to choose a chair isn’t the best strategy: “Every client is different, and the selection of an ultralight chair should not be solely driven by diagnosis. The important piece is the client’s functional potential and the longterm goals that have been determined in therapy.
JUSTIFYING THOSE CLINICAL NEEDS
Once you’ve determined that the K0005 frame will meet your client’s needs, the second challenge begins: convincing your funding source.
It’s important from the start to establish how an ultralight — compared to a less-adjustable chair — will significantly improve the client’s ability to perform at least one mobility-related activity of daily living: toileting, bathing, feeding, dressing or grooming. Documentation needs to specifically involve performing an MRADL, rather than just the client’s ability or inability to get to the kitchen or bathroom.
Documentation could describe specific adjustments to the ultralight frame that would significantly impact MRADL performance, decrease pain using a pain scale rating, reduce the need for pain medication due to improved chair configuration, or enable full-day wheelchair use versus frequent rests. While the client may have sufficient strength and range of motion for manual wheelchair propulsion, clinicians should note cardiac or respiratory issues when the weight or configuration of an ultralight frame could make a difference versus less-adjustable frames.
Ultralights are prescribed when end users are unable to or have increased difficulty propelling a lower-coded chair due to clinical deficiencies such as a compromised cardiopulmonary system, upper-extremity (UE) weakness, a decrease in UE range of motion, decreased endurance for propulsion, spasticity, pain with propulsion, and orthopedic deformities. In some situations, the client’s ability to transfer to and from their wheelchair requires a lower or higher seat-to-floor height that K0001-K0004 chairs cannot offer.
