For more information on specifications and fitting of the RoughRider wheelchair see www.whirlwindwheelchair.org/roughrider
Rider Name
Rider Age
Rider Gender
Rider Reference #
Rider contact information
Distributing Organization
Assessment performed by
Date
Yes
No
1. Rider has head control
2. Rider can maintain upright sitting position
3. Rider does not have significant contractures
4. Rider needs pressure relief cushion. Notes:
____________________________________
If any of the answers are"No" in the grey boxes,
the RoughRider may not be appropriate for this
rider without intermediate-level service.
Seat Width The seat with is measured inside the frame tubes.
The RoughRider backrest width matches the seat width.
Seat heights (and footrest adjustment range) vary slightly
based on seat depth. Seat heights are measured from the
top of the seat tubes of the 14" seat depth to the floor.
Choose Wheelchair Width:
12.5"
(18
/
" Seat height)
1
2
14"
(19"
Seat height)
15.5"
(19
/
" Seat height)
3
4
17"
(20
/
" Seat height)
1
4
18.5"
(20
/
" Seat height)
3
4
Axle Position
Select initial axle position, 1 through 5
#1 is farthest forward and is the most active position
#5 is farthers backwatrds and is the most stable
Axle position (adjustable)
#1 (Farthest forward)
#2 (Second from front)
#3 (Center- a good starting point)
#4 (Second from rear)
#5 (Farthest back-good for double amputees)
Whirlwind Wheelchair
D
B
C
Select Wheelchair Size Options
1
2 3 4
5
http://whirlwindwheelchair.org
RoughRider
Rider Measurements
A
Hip Width
Rider Hip Width (A)
Rider Lower Leg Length (B)
The footrest height is adjustable from 11" to 17"
Actual footrest height range varies with seat height
Rider Upper Leg Lenth (C)
Measured behind knee to back of buttocks
Rider Backrest support Height (D)
Record where backrest should contact riders back with
cushion; Effective height of back support will vary
Backrest Height Select Backrest Height Position
Backrest Height (Adjustable)
14"
16"
18"
Seat Depth Actual length of seat surface.
There is an additional 1
between the back edge of seat and backrest.
Choose Seat Depth (Adjustable)
14"
16"
18"
®
Backrest
D
Height
Upper Leg Length
C
Lower Leg Length
B
/
" space
1
2
Updated 25-Oct-11
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