The choice of wheelchair frame and wheels play an important part in the management of spasticity and perceived comfort. The wheelchair frame can decrease the amount of whole-body vibration felt by the individual when traversing over rough surfaces such as bumps in sidewalks or, tile floors (Vorrink et al. 2008).
Whole body vibration levels measured at the seat surface and the back support were found to be higher than the health caution zone levels recommended by ISO 2631-1 (Garcia-Mendez et al. 2013). Vibration measured in the rigid frames and frames with suspension were noted to be lower than that measured on a folding frame wheelchair, but no comparison calculations were provided. The authors indicate that the use of suspension systems added to the frames did not significantly reduce vibration, but data or comparison calculations were not provided.
Vorrink et al. (2008) found no significant differences between wheel types in vibration forces, speed or meausres of spasiticty or comfort during propulsion.
There is level 2 evidence (from one randomized controlled trial; Vorrink et al. 2008) that the use of high-performance wheels verses standard steel-spoked wheels was no more effective in reducing spasticity or affecting comfort by absorbing vibration forces when wheeling.
There is level 4 evidence (from one post-test study; Garcia-Mendez e t al. 2013) to suggest that whole body vibration exposure for people who use manual wheelchairs are within or above the health caution zone established by ISO.