Understanding the Difference Between Robust and Resilient Wheelchairs, and Why it Matters - Erik Kondo

Infographic four quadrant diagram showing Robust vs. Resilience in wheelchairs.

Wheelchairs that are sturdy and don’t break easily are Robust. 

Wheelchairs that are easy and affordable to repair are Resilient.

Ideally, from the standpoint of the wheelchair user, their wheelchair would be both Robust and Resilient. They don’t want their wheelchair to break, but if it does, they want it fast, easy, and affordable to repair.

But what about from the viewpoint of the manual wheelchair industry? What type of wheelchair is best for them to produce? It makes sense that while the wheelchair frame is under warranty, they don’t want it to break. But for profit reasons, they also don’t want it to be easy to repair.

Why is this the case? In the United States, the Medicare insurance standard for an ultra-light (K0005) manual wheelchair is five years between replacement. But the the manufacturer must provide a lifetime warranty on the structural parts of the frame. The wheelchair industry makes the most profit by selling new wheelchairs, not by repairing them (extending their lifespan of usefulness). Therefore, they don’t want their wheelchairs to last longer than five years.

As a result, ultralight wheelchairs are made with Robust frames that can last much longer than five years (to meet the lifetime warranty requirement). But the other parts of the wheelchair such as casters, backrest, sideguards, wheel-locks, brackets, and other components tend to fail within a few years. These components are relatively expensive and time consuming to repair since the parts need to be approved, ordered, delivered, and installed. Therefore, despite having Robust frames, K0005 wheelchairs are typically NOT Resilient since they are so difficult and expensive to repair.

It is not uncommon for wheelchairs users (with comprehensive health insurance) to replace their wheelchair every five years due to failing casters or other accessories while the wheelchair frame is still perfectly fine. This situation is ideal for the wheelchair industry. Wheelchairs that last too long (too Robust) are not profitable for the wheelchair industry. Wheelchairs that can be easily repaired rather than replaced (too Resilient) are not profitable for the wheelchair industry.

Wheelchairs that can be refurbished and transferred (2nd hand) to someone else are not profitable for the wheelchair industry (no new sale is made). Therefore, there is a strong incentive to make bespoke (custom) wheelchairs that have minimal adjustability. After replacement, a wheelchair that cannot be adjusted is less likely to be sold or given to someone else and is more likely to end up in long term storage and eventually thrown out. All of the above is not some baseless conspiracy theory, it results from the inherent profit motive of the wheelchair industry to build planned obsolescence and sell “single person use” wheelchairs.

On the other end of the spectrum are the low quality (Fast-Food Style) hospital wheelchairs that are neither Robust nor Resilient. These wheelchairs are so poorly made, with cheap materials and manufacturing methods, that they only last a year or two under continual usage. Repairing these wheelchairs is comparatively expensive relative to throwing it out and buying another. If you fix one part, another will soon break, so there is little incentive to repair them.

Unfortunately, people who are unable to afford a replacement end up using a wheelchair in a constant state of disrepair and progressive deterioration. This sad situation is very common in Low and Middle Income Countries (LMICs).

What’s the solution? Manufacture wheelchairs that are both Robust and Resilient with less regard for profit and more regard for how these wheelchairs will benefit their users (and ultimately society as a whole).