Wheelchair Footrests & Leg Rests Expert Overview

Leg supports, including footrests and leg rests, are an integral part of safe and efficient transportation when using a wheelchair. In this article, health care expert and occupational therapist, Dr. Joseph Muniak will provide an overview of leg supports, including relevant industry standards and the types of incidents that can occur when they are used improperly, or not at all.

Wheelchair Leg Support Expert Witness Investigations

Wheelchair Components – Leg Supports: Footrests & Leg Rests

Investigating Incidents Involving Leg Supports

Incidents involving wheelchairs, and specifically leg supports, can be caused by mechanical failure, improper use, and/or interaction with certain terrain.

Mechanical failures can result from improper assembly, lack of maintenance, overloading, or manufacturer defects. Leg support issues can lead to injuries involving the ankles, legs, skin integrity, and whole-body safety if the person is inadequately fitted, experiences operational failure, or uses the wheelchair improperly.

Another common cause of injuries involving leg supports is when the person assisting someone in a wheelchair does not ensure that the person’s legs remain on the footrests/leg supports, or leg supports are simply not being used. When a wheelchair is in motion, this can quickly lead to the occupant of the wheelchair being dragged forward out of the wheelchair when their feet touch the ground.

Leg support involvement during safe transfers is another common area of investigation. Leg supports often swing away and/or are removable for transfers to and from a wheelchair.

Proper usage during transfer is the safest way to ensure that leg supports will not impact how a transfer occurs. There are, however, wheelchairs in which the leg supports do not swing away or are not removable. This factor needs to be considered when investigating safe transfers involving footrests and leg rests.

Neglecting to act on these factors, indicators, and components can result in a hazardous condition for the wheelchair user and those assisting them.

Industry Standards

Wheelchairs are classified as durable medical equipment (DME). DME includes a variety of items that help individuals complete daily activities. DME is regulated by the U.S. Food and Drug Administration (FDA), which is an agency of the U.S. Department of Health and Human Services.

Title 21 of the Code of Federal Regulations (21 CFR 803) outlines mandatory requirements for manufacturers, importers, and device user facilities to report certain device-related adverse events and product problems to the FDA.

In addition to federal standards and regulations, there are other standard of care considerations for the safe and efficient operation and utilization of wheelchairs, specifically leg supports. Examples include: inspection, maintenance, and device use education and training.

Types of Leg Supports

Wheelchairs are utilized in various settings to provide seated transportation and increased independence in mobility. They have numerous parts and component options that can be selected to maximize individualized safety and function.

Wheelchair Component Expert Witness Diagram

Leg supports come in many styles, and with many options for functionality so that the individualized needs of the user can be met. Leg support designs can support both lower limbs or have individualized plates to support each foot. A basic component of a leg support is commonly referred to as a footrest.


The footrest consists of a leg support attachment with a footplate, that is either swing-away, detachable, or stationary. Footplate designs vary, one option includes a singular plate in which both of the user’s feet are on a singular plate. There are multiple strapping and material options available to keep the individual’s feet safe and secure, especially for users who rely on individualized fitting and accessories due to impaired strength, sensation, and/or tone due to neurological diagnoses such as spinal cord injury.

Leg Rests

The term “leg rest” globally refers to a leg support that has a padded component to support the calf region. In addition to the options described above, a leg rest can have elevating, articulating, and telescoping options.

  • Elevating leg rests function just the way they sound, allowing the legs to be elevated using a lever on the side.
  • Articulating leg rests allow for extension simultaneously with elevation.
  • Telescoping options allow the leg support to be lengthened or shortened as needed, and can be used in conjunction with elevation on a leg rest or footrest style leg support.

Leg Support Functionality

When customizing a wheelchair for the needs of a specific user, functional components to consider are the angle of the leg supports away from the seating system base, the clearance height of the footplate from the floor, and the ability or inability of the leg supports to be removed during transfers.

Not every individual needs leg supports on their wheelchair. Some individuals use their feet to propel their wheelchairs while seated. Other individuals may not have lower extremities or feet, and therefore do not need footrests or leg rests. Specialized leg supports are also offered for individuals who have incurred leg amputation, to promote knee extension in below knee amputations, or residual limb safety as needed.

Leg supports will affect a wheelchair’s turning radius and play an integral role in the safe and effective maneuverability of patients. In addition to the types and functionality of leg supports, there are also multiple options to ensure a person’s legs and feet remain on the leg supports during wheelchair motility, as this can be a common issue with misuse or accidents.

Wheelchair Expert Witness Investigations

The health care experts at Robson Forensic can analyze the causation behind wheelchair mishaps and the address the relevant standards of care.

For more information, submit an inquiry or call us at 800.813.6736.

Featured Expert

Joseph Muniak, Doctor of Occupational Therapy & Health Care Administration Expert

Joseph Muniak, MS, OTD, OTR/L, CBIS, HEM

Doctor of Occupational Therapy & Health Care Administration Expert
Dr. Muniak is a board-certified Occupational Therapist (OTR) and hospital administrator with expertise in the continuum of care provided to patients in the acute hospital, inpatient rehabilitation,… read more.


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