SUNRISE MEDICAL MK-130101 Mid Wheel Drive Power Wheelchair Instructions

September 27, 2024
SUNRISE MEDICAL

MK-130101 Mid Wheel Drive Power Wheelchair

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Specifications

  • Product Type: Manual Wheelchair Power Assist Device

  • Model: Empulse R90 push device

  • Compatibility: Can be used with folding or rigid manual
    wheelchairs

  • Control: Hand controller mounted on the side rail

  • Power Source: Battery-operated

Product Usage Instructions

Attaching the Push Device

To attach the push device to the manual wheelchair, follow these
steps:

  1. Position the unit on the wheelchair frame.

  2. Securely clamp the device to the frame using the provided
    brackets.

  3. Ensure the hand controller is accessible and mounted on the
    side rail for easy control.

Using the Push Device

Once the push device is attached, follow these guidelines for
optimal usage:

  1. Control the speed using the hand controller mounted on the side
    rail.

  2. Pay attention in small environments to maneuver
    effectively.

  3. Use on harder ground and pavement for best results.

  4. Monitor battery levels for extended distances and recharge as
    needed.

FAQ

Q: Can the push device be used on all types of manual

wheelchairs?

A: The push device is compatible with most folding or rigid
manual wheelchairs, but may require different brackets depending on
the type and width of the wheelchair.

Q: How do I know when to recharge the battery of the push

device?

A: Monitor the battery levels regularly and recharge when the
power is low to ensure uninterrupted usage.

Q: Is it safe to use the push device in outdoor

environments?

A: The push device is best suited for harder ground and
pavement. Avoid using it on soft surfaces like grass and dirt to
prevent loss of traction.

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PLEASE SEE THE DISCLAIMER INFORMATION PROVIDED ON THE LAST PAGE OF THIS DOCUMENT
Choosing Your Optimal Manual Wheelchair Power Assist Device
When choosing a power assist/add-on device for a manual wheelchair, consider that each has distinct capabilities, benefits, and drawbacks. This guide provides an easy-to-understand overview of the considerations and implications for each broad category of devices.

Independent Propulsion Power Assist

Push Devices

PRODUCT CONSIDERATIONS

Wheelchair Compatibility

Air Travel Considerations

Wheel Add-Ons

Pull Devices

Wheelchair Footprint

Control in Small Environments

Use in Outdoor Environments

Use for Extended Distances

CLIENT CONSIDERATIONS

Hand Function/Strength for Attaching to the Wheelchair

Ease of Use

Options for Degenerative Diagnosis

Considerations with Stopping

Compatibility for Hemiplegic Clients
Hand Function for Controlling

Caregiver Power Assist

Caregiver Push Devices

Caregiver Wheel Add-Ons

(Page 1 of 13)

Independent Propulsion Power Assist
There is strong evidence for increased incidence of upper limb (UL) repetitive strain injuries (RSI) among manual wheelchair users. These injuries occur due to repetitive movements and result in muscle tears, inflammation, nerve impingement, bursitis, and pain. They primarily affect the shoulders, wrists, and elbows and can manifest as rotator cuff impairments, carpal tunnel syndromes, and “tennis elbow,” among other symptoms. Research indicates that power assist devices can help to preserve independent function & UL health and reduce risk of future damage while still allowing independent mobility with a manual wheelchair.
Push Devices
A unit is clamped on to the wheelchair frame and “pushes” the manual wheelchair forward. Speed on/off is controlled by a hand controller generally mounted on the side rail.

Empulse R90 push device

Push devices are generally the easiest power-assist devices to attach and remove

Wheelchair Compatibility

PRODUCT CONSIDERATIONS
Air Travel Considerations

Wheelchair Footprint

Factor
Most can be used with
either folding or rigid manual wheelchairs, but require different
brackets depending on type and width.

Consideration

Factor

Consideration

Factor

Consideration

Consider the

These are the Check that the The power assist For the devic-

bracket’s weight smallest and light- size of the battery is mounted to the es that do add

compared to its est of the models. meets both wheelchair’s cam- length, consider

durability.

Consider whether distance and the battery can be transportation

ber tube to prevent adding

how this will affect

easily removed for requirements.

width to

maneuverability,

air travel. A few

the system.

especially in

have lithium

Some devices

small areas.

batteries that can

add length.

be removed and

put into the cargo

hold of the plane

(with prior approv-

al of the airline).

(Page 2 of 13)

Push Devices (Continued)

PRODUCT CONSIDERATIONS

Control In Small Environments Use In Outdoor Environments

Use For Extended Distances

Factor

Consideration

Good in small Consider the cli-

environments if ent’s cognitive

the client can

ability and

control it well. wheelchair skills.

The client will

need to pay

attention and

monitor speed in

tighter/busier

environments.

Factor
Best suited for harder ground and pavement.

Consideration
Depending on the terrain, it can lose traction on soft surfaces like
grass and dirt.

Factor

Consideration

Great for longer It’s not a power

distance travel. wheelchair, but

it will allow the cli-

ent to go

further with less

fatigue/effort.

CLIENT CONSIDERATIONS

Hand Function and Strength
For Attaching / Detaching to
the Wheelchair

Ease of Use

Options For Degenerative
Diagnosis

Factor

Consideration

Factor

Consideration

Factor

Consideration

These devices are Consider if the cli- Some systems Consider whether Most of these Push devices do

generally one

ent has range have simple dials your client has devices can be

not have the

of the lighter of motion, motor to change the

the cognitive programmed to same progrming-

devices in

control, and speed, some use ability and adapt to declining capabilities as a

comparison to

strength to push buttons or reaction speed strength and UL

power

the other types

remove the

a series of taps. to adequately function. Some wheelchair, and

(13-17 lbs.),

device. In some These devices control the device, are able to adapt power seat

allowing easier models, the wheel do not have a especially in busy to the loss of connection or can retract off braking function areas or at faster some ability on

functions can’t be added.

removal from the ground so it and require the speeds. Some of

one side

Consider whether

the wheelchair. doesn’t need to rider to stop the the devices are (hemiplegia). your client would

be removed when wheelchair using not as intuitive

be better suited

not being used. the handrims

to use.

for a power

after cutting

wheelchair.

power to the

unit using the

control system.

(Page 3 of 13)

Push Devices (Continued)

CLIENT CONSIDERATIONS

Considerations
With Stopping

Compatibility For
Hemiplegic Clients

Hand Function
For Controlling

Factor

Consideration

Factor

Consideration

Clients need to Once the chair

Most can be These devices can

have the strength is set in motion, controlled by one be challenging

to stop the wheelchair by

even if they turn hand. Remember off the device, they require the

to use for full hemiplegics.

holding the

the chair does rider to stop the

handrims/wheels. not have brakes wheelchair using

like a power

the handrims

wheelchair. They after cutting

will need to

power to the

physically stop unit using the

the wheelchair. control system.

Factor
These devices have some type
of a control box for speed
and on/off.

Consideration
Consider whether your client has
adequate strength and finger function to
safely control the wheelchair.

Wheel Add-Ons
Motors are incorporated into the wheels, which then provide forward propulsion.

EMPULSE M90 wheel add-on

Wheelchair Compatibility

PRODUCT CONSIDERATIONS
Air Travel Considerations

Wheelchair Footprint

Factor

Consideration

Factor

Consideration

Factor

Consideration

Most can be

With most Consider whether Check the size Consider whether Consider if

used with either devices, the

the battery can of the battery the device adds the increased

folding or

wheels are be easily removed

meets

width to the

width will

rigid manual

similar to a

for airline travel transportation wheelchair as it impede function.

wheelchairs, but normal manual or transport . requirements. depends on the

require different wheelchair but Powered wheels Also some device unit selected.

brackets depend- with extra weight. need to be

batteries are

ing on type. The tire options stowed carefully. easier to remove

may be limited.

than others.

(Page 4 of 13)

Wheel Add-Ons (Continued)

PRODUCT CONSIDERATIONS

Control In Small Environments Use In Outdoor Environments

Use For Extended Distances

Factor
Great in small environments
where maneuverability
is essential, as the client is fully in control of the device.

Consideration
A winner in this regard as long as the footprint size isn’t altered and the width doesn’t impede getting through doorways
or reduce maneuverability.

Factor
Best suited for harder ground and pavement.

Consideration
Remember: it is not a power wheelchair and it has normal manual wheel-
chair-sized wheels and tires.

Factor

Consideration

Great for longer It’s not a power

distance travel. wheelchair, but

it will allow the cli-

ent to go

further with less fatigue/effort.

CLIENT CONSIDERATIONS

Hand Function and Strength
For Attaching / Detaching to
the Wheelchair

Ease of Use

Options For Degenerative
Diagnosis

Factor

Consideration

Factor

Consideration

Factor

Consideration

This type of device Consider wheth- Because the cli- Consider whether Most wheel

Wheel add-on

adds weight to the er the wheels ent pushes the your client has add-on devices devices do not

wheels- some add will need to be handrims like

the cognitive

can be pro-

have the same

significant weight, removed and a normal man-

ability and

grammed

capabilities as

others are minimal how often. Is this ual wheelchair, reaction speed to for increasing

a power

additional weight. doable by the cli- learning how to adequately control weakness or wheelchair, nor

ent or family? use them is easy. the deceleration to accommodate can power seat

The motor of the wheelchair,

strength

functions be

multiplies the especially in busy differences. added. Consider

force generated

areas or at

whether your cli-

and can extend faster speeds.

ent would be bet-

the distance

ter suited

per push.

to a power

wheelchair.

(Page 5 of 13)

Wheel Add-Ons (Continued)

CLIENT CONSIDERATIONS

Considerations
With Stopping

Compatibility For
Hemiplegic Clients

Hand Function
For Controlling

Factor

Consideration

Factor

Clients need to Wheel-Add Ons Can program

have the strength do not have brakes for one side

to stop the like a power wheel- substantially

wheelchair by chair. Most have weaker than the

holding the some braking func- other. Will likely

handrims/wheels. tions and allow the need to use a

rider to slowdown foot for accurate

through handrim

steering.

control using less

force than with out

the power assist.

Consideration
These devices can be challenging to use for full hemiplegics.

Factor

Consideration

These devices Consider whether

require the client your client has

to push the adequate strength

handrims like a and control to

normal manual push the handrim.

wheelchair, but

they multiply the

force generated

and can extend

the distance

per push.

Pull Devices
A front wheel assembly is attached to the frame of the wheelchair and a motorized wheel provides the power. Handlebars allow the client to steer.

EMPULSE F55 pull device

EMPULSE F55 pull device

PRODUCT CONSIDERATIONS

Wheelchair Compatibility

Air Travel Considerations

Wheelchair Footprint

Factor

Consideration

Factor

Consideration

Factor

These devices

Consider

These devices Does the client This device will

require a fixed whether your cli- are bigger and need to transport add substan-

front end so that

ent can

heavier than the the device? If so, tial length to

the unit can transfer in and other types of how will it be load- the wheelchair.

clamp onto the out without

power-assist ed? Is there space Depending on the

wheelchair.

swing-away

devices.

available? device, it can sub-

hangers/foot-

stantially reduce

plates.

maneuverability.

Consideration
Best used in outdoor
environments.

(Page 6 of 13)

Pull Devices (Continued)

PRODUCT CONSIDERATIONS

Control In Small Environments Use In Outdoor Environments

Use For Extended Distances

Factor

Consideration

Factor

Depending on Great in outdoor

Great for

the device, they environments outdoor activities.

can substantially and should be Depending on

reduce

removed for

the device,

maneuverability most indoor

they can have

indoors.

environments. substantial speed

Depending on the and torque.

device, some are

easier to remove

than others.

Consideration
Does the client have the wheelchair skills and cognitive ability
to use the device safely?

Factor
Great for longer distance outdoor
travel.

Consideration
As there are many different models, make sure the wheel size and power
suits the client’s needs and activities.

CLIENT CONSIDERATIONS

Hand Function and Strength
For Attaching / Detaching to
the Wheelchair

Ease of Use

Options For Degenerative
Diagnosis

Factor

Consideration

These devices Consider if the cli-

are heavier and ent has the hand

generally require function to use.

good hand

Also, consider

function to attach whether the

to the wheelchair. attachment

clamps stay on

the chair (adding

weight) when

the device

is not in use.

Factor
These devices are controlled by handlebars
with both a throttle and squeeze-trigger
brakes.

Consideration
Does the client have trunk control and limb function to control safely at
higher speeds and over uneven
terrain?

Factor
These devices require good
trunk and upper extremity
function.

Consideration
May be dificult for progressive
disabilities.

(Page 7 of 13)

Pull Devices (Continued)

CLIENT CONSIDERATIONS

Considerations
With Stopping

Compatibility For
Hemiplegic Clients

Hand Function
For Controlling

Factor
Depending on the power assist, it will
have manual hand brakes, electronic brakes,
or both.

Consideration
Does the client have adequate trunk control and limb/hand
function to manage the
brakes?

Factor
These devices are difficult to
use for full hemiplegics.

Consideration

Factor

Consideration

A different device These devices Does the client

should be

are controlled have the strength

considered for by handlebars, and endurance to

full hemiplegics. requiring hand safely manage

grip and strength. the device?

Caregiver Power Assist
There are clients unable to functionally propel manual wheelchairs and cannot successfully operate a power wheelchair. For these clients, research has shown power assist devices can better allow caregivers to provide this mobility, improving client function and participation.

EMPULSE R20 caregiver push device

Caregiver push devices can help with climbing curbs

Caregiver Push Devices
A powered wheel is attached to the wheelchair, generally to the rear. These devices are designed for clients who are dependent on caregivers for mobility but who are also not power wheelchair candidates.

(Page 8 of 13)

Caregiver Push Devices (Continued)

Wheelchair Compatibility

PRODUCT CONSIDERATIONS
Air Travel Considerations

Wheelchair Footprint

Factor
Most of these devices can be used with either a folding, rigid, or
tilt-in-space wheelchair. Depending on the device, it can be removed for vehicle transport or the client can sit in the system during transport.

Consideration

Factor

Consideration

Factor

Some devices Models differ in Consider the Depending on the

have limitations this category in battery’s location device, this type

on the type of regard to how the and whether it’s of power add-on

tires and wheels battery is removed easy to remove can add length to

that can

for storage,

for storage or the wheelchair.

be utilized.

transport,

transport.

or charging.

Consideration
As the unit is generally mounted at the rear of
the wheelchair, consider whether this impedes a carer walking behind the wheelchair.

Control In Small Environments Use In Outdoor Environments

Use For Extended Distances

Factor
These devices work quite well
in small environments.

Consideration

Factor

Consideration

As the unit is These devices are

Consider

generally mount- designed for more whether an

ed at

urban outdoor add-on wheel can

the rear of environments and manage the

the wheelchair, generally have

speed and

consider if the slower maximum terrain the

unit adds length.

speeds.

client requires.

Factor
These devices are designed for assisting caregivers in
moving a wheelchair over longer distances.

Consideration
Consider whether an add-on wheel can manage the speed and terrain the client requires.

(Page 9 of 13)

Caregiver Push Devices (Continued)

CLIENT CONSIDERATIONS

Hand Function and Strength
For Attaching / Detaching to
the Wheelchair

Ease of Use

Options For Degenerative
Diagnosis

Factor
Models differ in this category in regard to product weight and how they attach to
the chair.

Consideration
Consider the ease of adding/ removing the device. It’s also
important to consider if the wheelchair can be folded with
the device in place.

Factor
Most units are simple to use
with on/off and speed adjustments.

Consideration
Most caregivers can understand and use these devices success-
fully.

Factor

Consideration

As these are Push devices do

controlled by the not have the same

attendant, client capabilities as a

loss of function power wheelchair,

will not impact and power seat

these devices. functions cannot

be added. Consider

whether a large

change in function

is anticipated and

whether the client

might be better

suited to a power

wheelchair.

Considerations
With Stopping

Compatibility For
Hemiplegic Clients

Hand Function
For Controlling

Factor

Consideration

Factor

Consideration

Factor

Consideration

The device has Does the caregiver As these devices Appropriate for These devices

Some devices

power and speed have adequate are controlled by dependent

have some type use very simple

up/down control. strength/skill to the attendant, hemiplegic users. of a control box to dials/push buttons.

Depending on the manage the chair they can be

Remember: it adjust speed and

Others use

device, it may or in the necessary appropriate for does not have the on/off. This

squeeze triggers.

may not have environments, more complex

capacity of a

control box is Consider the ease

electronic braking. including steering hemiplegic cli- power wheelchair. mounted in the

of use for

and stopping?

ents.

attendant position the caregiver.

Some devices may

on the back canes.

not have

electronic brakes.

(Page 10 of 13)

Caregiver Push Devices (Continued)
Caregiver Wheel Add-On
Powered wheels are attached to the wheelchair, replacing the normal rear wheels. These devices are designed for clients who are dependent on caregivers for mobility but who are not power wheelchair candidates.

ZIPPIE iXpress caregiver wheel add-on

Wheelchair Compatibility

PRODUCT CONSIDERATIONS
Air Travel Considerations

Wheelchair Footprint

Factor
Most of these devices can be used with either a folding, rigid, or
tilt-in-space wheelchair.

Consideration

Factor

Consideration

Factor

Some devices Models differ in Consider the

The powered

have limitations this category in battery’s location wheels can add to

on the type of regard to how the and whether it’s the overall width

tires that can battery is removed easy to remove of the wheelchair.

be utilized.

for storage,

for storage or

Consider if this

transport,

transport.

is an important or charging.

maintenance

issue.

Consideration
Consider if the increase in width
will impede function and maneuverability.

Control In Small Environments Use In Outdoor Environments

Use For Extended Distances

Factor
Most devices do not add additional length to the wheelchair, but could add width.

Consideration
A winner in this regard as long as the added width doesn’t impede getting through
doorways or reduce.

Factor

Consideration

Factor

Consideration

These devices are A great solution These devices are A great solution

designed for for a dependent designed for for a dependent

urban outdoor user who is not a urban outdoor user who is not a

environments power wheelchair environments. power wheelchair

with harder candidate and is They general- candidate and

surfaces.

using the device ly have higher

whose carer

mostly on

speeds, more

cannot push

sidewalks and power, and a bit

a manual

paved surfaces. more capacity wheelchair over

when compared the distances

to add-on wheel

required.

devices.

(Page 11 of 13)

Caregiver Wheel Add-On (Continued)

CLIENT CONSIDERATIONS

Hand Function and Strength
For Attaching / Detaching to
the Wheelchair

Ease of Use

Options For Degenerative
Diagnosis

Factor

Consideration

Models differ in Consider if the

this category in device needs to

regard to product be removed from

weight and how the wheelchair.

they attach to the Most can stay on

chair. Some a wheelchair per-

are considerably manently. If the

more complicated chair needs to be

to remove

folded, consider

than others.

if the device

allows this.

Factor
Most units are simple to use
with on/off and speed adjustments.

Consideration
These devices are simple to learn how to use.

Factor

Consideration

As these are

Wheel add-on

controlled by the devices do not

attendant, client have the same

loss of function capabilities as a

will not impact power wheelchair,

these devices. and power seat

functions cannot

be added. Consider

whether a large

change in function

is anticipated and

whether the client

might be better

suited to a power

wheelchair.

Considerations
With Stopping
Push Devices(Continued)

Compatibility For
Hemiplegic Clients

Hand Function
For Controlling

Factor
The device has power and speed up/down control. Depending on the device, it may or
may not have electronic braking.

Consideration
These devices are easy for caregivers to use.

Factor

Consideration

Factor

Consideration

As these devices Appropriate for These devices

Some devices

are controlled by dependent

have some type use very simple

the attendant, hemiplegic users. of a control box to dials/push buttons.

client hemiplegia Remember: it adjust speed and Consider the ease

will not impact does not have the on/off. This

of use for

their use of

capacity of a

control box is

the attendant.

the device. power wheelchair. mounted in the

attendant position

on the back canes.

(Page 12 of 13)

Choosing Your Optimal Manual Wheelchair Power Assist Device
References
1. Kentar, Y. et al. 2018. Prevalence of upper extremity pain in a population of people with paraplegia. Spinal Cord 56, 695-703.
2. Choukou, Best, K. L., Potvin-Gilbert, M., Routhier, F., Lettre, J., Gamache, S., Borisoff, J. F., & Gagnon, D. (2021). Scoping review of propelling aids for manual wheelchairs. Assistive Technology, 33(2), 72-86. https://www.tandfonline.com/doi/abs/10.1080/10400435.2019.1595789?journalCode=uaty20
3. Didier Pradon, Elodie Garrec, Isabelle Vaugier, Thierry Weissland & Caroline Hugeron (2021) Effect of power-assistance on upper limb biomechanical and physiological variables during a 6-minute, manual wheelchair propulsion test: a randomised, cross-over study, Disability and Rehabilitation, DOI: 10.1080/09638288.2021.1973586
4. Elliot W. Flockhart, William C. Miller, Jory A. Campbell, Johanne L. Mattie & Jaimie F. Borisoff (2021) Evaluation of two power assist systems for manual wheelchairs for usability, performance and mobility: a pilot study, Disability and Rehabilitation: Assistive Technology, DOI: 10.1080/17483107.2021.200106
5. Khalili, Eugenio, A., Wood, A., Van der Loos, M., Mortenson, W. B., & Borisoff, J. (2021). Perceptions of power-assist devices: interviews with manual wheelchair users. Disability and Rehabilitation: Assistive Technology, ahead-of-print(ahead-of-print), 1-11. https://www.tandfonline.com/doi/abs/10.1080/17483107.2021.1906963?journalCode=iidt20
6. Sawatzky, Mortenson, W. B., & Wong, S. (2018). Learning to use a rear- mounted power assist for manual wheelchairs. Disability and Rehabilitation: Assistive Technology, 13(8), 772-776. https://www.tandfonline.com/doi/abs/10.1080/17483107.2017.1375562?journalCode=iidt20
7. Wong, Mortenson, B., & Sawatzky, B. (2019). Starting and stopping kinetics of a rear mounted power assist for manual wheelchairs. Assistive Technology, 31(2), 77-81. https://www.tandfonline.com/doi/abs/10.1080/10400435.2017.1366373?journalCode=uaty20

DISCLAIMER: FOR PROFESSIONAL USE ONLY. THIS DOCUMENT (AND THE WEBSITE REFERENCED HEREIN) DO NOT PROVIDE MEDICAL ADVICE. Sunrise Medical (US) LLC does not provide clinician services. The information contained on this document (and the website referenced herein), including, but not limited to, the text, graphics, images, and descriptions, are for informational purposes only and should be utilized as a general resource for clinicians and suppliers to then use clinical reasoning skills to determine optimal seating and mobility solutions for individual patients. No material on this document (or on the website) is intended to be used as (or a substitute for) professional medical advice, diagnosis or treatment. Clinicians should adhere to their professional medical training and their institution’s or practice’s recommended guidelines. Reliance on this document (and the information contained herein) is solely at your own risk.

Sunrise Medical (US) LLC, Fresno, CA 93727 MK-130101 Rev. B ©05.2024

800.333.4000

w w w. S u n r i s e M e d i c a l . c o m / E I M
(Page 13 of 13)

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