Customization of manual wheelchair components: a state-of-the-art review.
Sameer More, Michelle Dunn, Shannon A Rios and 1 others
PMID 40128781WHAT IT FOUND
Customization of manual wheelchair components has shifted from manual carving to digital workflows using 3D scanning and CAD.
While custom-contoured cushions are well-researched, evidence for other components is scarce, and clinical adoption is limited by the need for specialized technical skills.
Key findings
01The review identifies a shift in manufacturing from manual techniques, like hand-carving foam, to digital workflows involving 3D scanning, parametric modeling, and computer-controlled milling or additive manufacturing.
02Research is heavily skewed toward custom-contoured cushions, with significantly fewer studies addressing the design and manufacturing of frames, back supports, and head supports.
03A major barrier to clinical implementation is the requirement for specialized computer-aided design skills, which many healthcare providers and manufacturers lack, necessitating further automation of these workflows.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The review is limited by a lack of generalizability across different economic contexts, as it did not distinguish between high- and low-income countries. There is a significant gap in published literature from manufacturers, meaning many practical innovations may not be captured. The definition of 'custom' wheelchair overlaps with 'ultralight', potentially conflating different user groups and equipment types. Most studies focused on ultralight manual wheelchairs, limiting applicability to other wheelchair categories like folding frames. There is insufficient evidence on the direct impact of custom wheelchairs on user quality of life or health outcomes.
Declared interests
The authors declare no competing interests. The study was supported by non-U.S. government research funds.
The easy way to misread this
Do not assume that custom-contoured seating technologies have been proven to reduce pressure injuries or improve functional mobility in this review. The paper notes a lack of robust evidence linking these specific manufacturing advancements to improved clinical outcomes for users.