Guide to Selecting Wheelchair Legrests: Maximizing Comfort, Support, and Independence

When it comes to wheelchair comfort, functionality and legrests are big players in the mobility world. I have worked with many wheelchair users over the years, I have seen how choosing the right legrest can change our daily comfort, posture and long term health.

This brief guide reveals insights you might not be aware of. Let’s see how to pick the best and unique legrest for you.

Understanding Your Body’s Mechanics

Your body’s natural movement patterns should be the top priority when choosing wheelchair legrests. Everyone’s mobility, joint flexibility and comfort needs are different, so self-assessment is key.

Knee Mobility Assessment

The range of motion in your knees determines which legrest options will work best for you:

• Full Range of Motion: If you can bend your knees normally (0-135 degrees) you have the most legrest options available. Standard swing-away legrests or flip-up footplates will generally work for you.

• Limited Flexion (90 degrees or less): If knee bending is restricted consider adjustable-angle legrests that can be set to your natural position. This prevents uncomfortable stretching and joint damage.

• Knee Contractures: For fixed knee positions greater than 90 degrees you’ll need legrests designed for that fixed angle. These often require custom fitting and may involve seat depth measurements.

• Asymmetrical Movement: If one leg has different mobility than the other independent dual legrests with separate adjustment are necessary. This ensures each leg gets the support it needs regardless of the difference in flexibility.

• High Muscle Tone: Individuals with spasticity or high muscle tone benefit from rigid legrests that provide resistance during muscle contractions.

Transfer Techniques and Independence 

The way you transfer in and out of your wheelchair should play a major role in choosing the right legrests. The right configuration will increase independence and safety during transfers.

Common Transfer Methods and Legrests

• Side Transfers: If you transfer from the side of your wheelchair (e.g. to a bed or car), central mount legrests provide clear side access paths. Their unified design eliminates obstacles at the sides of the chair making lateral movement smoother.

• Front Transfers: If you transfer forward, swing-away legrests give you maximum clearance. These can be rotated all the way out of the way for standing transfers or sliding board use.

• Standing Pivot Transfers: Consider legrests with footplates that lower flush with the floor. When combined with the right seat height, these allow you to put your feet flat on the ground before standing, giving you stability during the critical moment.

• Minimal Assistance Transfers: If you have limited hand strength or need assistance with transfers, look for legrests with easy release mechanisms that can be operated with minimal force.

Footplate Selection: Foundation for Proper Positioning

Footplates do more than just support your feet – they affect your whole sitting position and pressure distribution in your body. 

Footplate Options for Different Needs

• One-Piece vs. Two-Piece Design: Single footboards support your feet as one unit and take up less space so are ideal for indoor use. Two piece footplates allow for independent adjustment for each foot for leg length differences or different positioning needs. 

• Angle Adjustability: Footplates that can be adjusted for angle and depth keep your ankles at 90 degrees when possible to reduce foot drop and promote circulation.

• Specialty Options:

  • Heel loops help prevent your feet from sliding backward.

  • Calf straps offer mid-leg support, ideal for users with limited control in their lower limbs.

  • Padded surfaces help reduce pressure points, enhancing comfort for those with sensitive skin or prolonged sitting needs.

  • Anti-slip surfaces increase safety for partial weight-bearing transfers

• Amputee Support Solutions: Purpose-designed amputee legrests have shorter lengths and more lateral support. Many have padded surfaces and adjustable height to position residual limbs correctly, preventing damage and discomfort.

Elevation Features: Beyond Basic Support

Leg elevation is important for medical and comfort reasons for many wheelchair users. Understanding the mechanics and benefits enables more informed decision-making.

When to Consider Legrests

• Circulatory Issues: If you have swelling, edema or circulation problems, legrests can reduce fluid buildup by positioning legs above heart level several times a day.

• Post Surgical Recovery: After lower extremity surgery, elevated positioning may be prescribed to reduce swelling and protect healing tissues.

• Pain Management: Elevation can help with arthritis, neuropathy or other chronic pain conditions in the lower limbs.

Types of Elevating Systems

• Manual Legrests: These use ratchet mechanisms or notched tracks to manually adjust elevation angles. They’re more affordable but require either physical ability to adjust or assistance from a caregiver.

• Power Legrests: Operated by wheelchair controls, these allow independent adjustment without requiring hand strength or dexterity. They are well-suited for individuals with limited upper extremity function.

• Biomechanical Compensation Systems: Advanced elevating systems have length compensation mechanisms that extend the legrest as it elevates, keeping the knee in proper position throughout the range of motion. This prevents uncomfortable stretching or compression at the knee joint.

Special Positioning Considerations

Complex physical needs require thoughtful legrest solutions that address both comfort and medical goals.

Working with Healthcare Professionals

For users with structural asymmetries, progressive conditions or complex positioning needs, working with physical and occupational therapists is key. They can:

• Assess how legrest positioning affects overall body alignment

• Recommend specialized solutions for unique anatomical considerations

• Prevent secondary complications like pressure injuries or contractures

• Incorporate legrests into overall seating and positioning plans

Advanced Positioning Solutions

• Multi-Axis Adjustable Systems: These legrests can be fine tuned along multiple planes of movement to accommodate complex leg positions or deformities.

• Integration with Seating Systems: For users with significant positioning needs, legrests that work with specialized cushions and backrests create total support throughout the seating system.

• Growth Accommodation: For pediatric users, legrests with plenty of adjustment range can grow with the child, potentially extending the life of the wheelchair.