Otto Bock Start M4 XXL User manual

Start M4 XXL, Start M6 Junior
Instructions for use (user) ...................................................................................... 3

2 Start M4 XXL, Start M6 Junior

Foreword1 5..............................................................................................................................................................
Intended use2 5........................................................................................................................................................
Indications for use2.1 5................................................................................................................................
Indications2.2 6...........................................................................................................................................
Contraindications2.3 6.................................................................................................................................
Absolute Contraindications2.3.1 6....................................................................................................................
Relative Contraindications2.3.2 6.....................................................................................................................
Product description3 6............................................................................................................................................
Function3.1 6..............................................................................................................................................
Product overview3.2 7..................................................................................................................................
Safety4 8....................................................................................................................................................................
Explanation of warning symbols4.1 8..............................................................................................................
Safety instructions for use4.2 9......................................................................................................................
Side effects4.3 12........................................................................................................................................
Further information4.4 12..............................................................................................................................
Nameplate and warning labels4.5 12..............................................................................................................
Nameplate4.5.1 12..........................................................................................................................................
Start M4 XXL4.5.1.1 12......................................................................................................................................
Start M6 Junior4.5.1.2 13...................................................................................................................................
Warning labels4.5.2 13...................................................................................................................................
Delivery5 13...............................................................................................................................................................
Scope of delivery5.1 13................................................................................................................................
Options5.2 13.............................................................................................................................................
Storage5.3 14..............................................................................................................................................
Storage during daily use5.3.1 14......................................................................................................................
Storage during extended disuse5.3.2 14............................................................................................................
Preparation for use6 14...........................................................................................................................................
Assembly6.1 14...........................................................................................................................................
Use7 15......................................................................................................................................................................
Further instructions for use7.1 15...................................................................................................................
Getting in and transferring7.2 16...................................................................................................................
Legrests7.3 16............................................................................................................................................
Folding the foot plate up and down7.3.1 17.......................................................................................................
Removing and fastening the calf strap7.3.2 17...................................................................................................
Removing and attaching the leg supports7.3.3 18...............................................................................................
Adapting the angle of the "elevating" leg support7.3.4 19....................................................................................
Adjusting the leg supports7.3.5 19....................................................................................................................
Seat and back upholstery7.4 19.....................................................................................................................
Removing and fastening the seat cushion7.4.1 20...............................................................................................
Removing and fastening the back support pad7.4.2 20........................................................................................
Backrest7.5 20............................................................................................................................................
Side panels7.6 21........................................................................................................................................
Folding down the side panels7.6.1 22...............................................................................................................
Adjusting the height of the forearm support7.6.2 22............................................................................................
Removing the side panels7.6.3 23....................................................................................................................
Adjusting an arm support with swivel unit7.6.4 23...............................................................................................
Push handles7.7 24......................................................................................................................................
Adjusting the height of the push handles7.7.1 24................................................................................................
Removing the push handles7.7.2 24..................................................................................................................
Stabiliser bar7.8 25......................................................................................................................................
Drive wheels7.9 25.......................................................................................................................................
Removing and mounting the drive wheels7.9.1 26...............................................................................................
Spoke protector7.9.2 26..................................................................................................................................
Table of contents
3Start M4 XXL, Start M6 Junior
Table of contents

Caster wheels and caster forks7.10 27.............................................................................................................
Approach in case of stiffness7.10.1 27................................................................................................................
Wheel locks7.11 28.......................................................................................................................................
Using the wheel locks7.11.1 28..........................................................................................................................
Drum brake7.11.2 28........................................................................................................................................
Knee lever wheel lock for user and attendant7.11.3 29..........................................................................................
Using the wheel lock lever extension7.11.4 29......................................................................................................
Lap belt (seat belt)7.12 30..............................................................................................................................
Anti-tipper/swinging anti-tipper7.13 31.............................................................................................................
Anti-tipper7.13.1 31..........................................................................................................................................
Swinging anti-tipper7.13.2 32............................................................................................................................
Transport wheels7.14 33................................................................................................................................
Crutch holder with hook-and-loop fastening strap7.15 34...................................................................................
Headrest7.16 34............................................................................................................................................
Tray7.17 35...................................................................................................................................................
Additional options7.18 36...............................................................................................................................
Disassembly and transport7.19 36...................................................................................................................
Use in vehicles for transporting persons with reduced mobility7.20 37..................................................................
Start M6 Junior7.20.1 37...................................................................................................................................
Required accessories7.20.1.1 37..........................................................................................................................
Using the product in a vehicle7.20.1.2 38...............................................................................................................
Restrictions for use7.20.1.3 41.............................................................................................................................
Start M4 XXL7.20.2 42......................................................................................................................................
Care7.21 42..................................................................................................................................................
Cleaning7.21.1 42............................................................................................................................................
Cleaning by hand7.21.1.1 42................................................................................................................................
Cleaning belts/straps7.21.1.2 42..........................................................................................................................
Disinfection7.21.2 43........................................................................................................................................
Maintenance and repair8 43...................................................................................................................................
Maintenance8.1 43.......................................................................................................................................
Maintenance intervals8.1.1 43..........................................................................................................................
Maintenance tasks8.1.2 44..............................................................................................................................
Repair8.2 44...............................................................................................................................................
Inner tube, rim tape and tyre replacement8.2.1 44..............................................................................................
Disposal9 45.............................................................................................................................................................
Disposal information9.1 45............................................................................................................................
Legal information10 46..............................................................................................................................................
Liability10.1 46..............................................................................................................................................
Warranty10.2 46............................................................................................................................................
Service life10.3 46.........................................................................................................................................
Technical data11 46...................................................................................................................................................
Appendices12 48........................................................................................................................................................
Threshold values for wheelchairs transportable by train12.1 48...........................................................................
4 Start M4 XXL, Start M6 Junior
Table of contents

1 Foreword
INFORMATION
Last update: 2019-12-19
►Please read this document carefully before using the product.
►Follow the safety instructions to avoid injuries and damage to the product.
►Have yourself instructed by qualified personnel in the proper and safe use of the product.
►Please keep this document in a safe place.
INFORMATION
►New information regarding product safety and product recalls as well as the declaration of conformity can be
obtained at [email protected] or from the manufacturer’s service department (see inside or outside of rear
cover for addresses).
►You can request this document as a PDF file at [email protected] or from the manufacturer’s service depart
ment (see inside or outside of rear cover for addresses). The PDF file can also be displayed in a larger size.
►Report all serious incidents that have occurred in connection with the product, both to the manufacturer (see
rear cover for contact information) and to the relevant authority in your country.
►For further questions about the instructions for use, please contact the qualified personnel who issued the
product to you.
You have received a product that is very versatile for everyday use at home and outdoors.
In order to exclude injuries of any type, familiarise yourself with the handling, functions and intended use of the
product before using it. These instructions for use provide you with the related necessary information.
Please note the following in particular:
• All users must be instructed in the use of the product by qualified personnel with the aid of these instructions
for use.
• Attendants (persons who operate and push the product) must also be instructed in the use of the product by
qualified personnel with the aid of these instructions for use.
• The product has been adapted to the needs of the user. Further changes may be made only by qualified per
sonnel. We recommend checking the product settings regularly in order to assure an optimum fit over the long
term. For growing children and youths in particular, fitting should be performed every six months.
• In case of questions or problems, please consult the qualified personnel that adapted the product or the manu
facturer's service (see inside back cover or back page for addresses).
• The product may be combined only with the options listed here. The manufacturer assumes no liability for com
binations with third-party medical devices and/or accessories not included in the modular system. Please also
observe the information in the section "Liability".
• Service and repairs to the product may only be carried out by qualified personnel. If you have any problems,
please contact your specialist dealer. This ensures that any necessary repairs will be made exclusively with
Ottobock spare parts.
• Your product may differ from the models shown. In particular, not all the options described in these instruc
tions for use will be installed on your product.
• The manufacturer reserves the right to make technical changes to the model described in these instructions for
use.
2 Intended use
2.1 Indications for use
The wheelchair is intended solely for everyday indoor and outdoor use by people who are unable to walk or have a
walking impediment and for operation by the patient or another person.
The product is suitable for users whose anatomy (suchas body dimensions and weight) permits the intended use
of the product.
The wheelchair may only be used with the options listed on the product order form.
Ottobock assumes no liability for combinations with medical devices and/or accessories from other manufacturers
not included in the modular system.
Combinations based on a combination agreement that have been evaluated for effectiveness and safety are an
exception to this.
5Start M4 XXL, Start M6 Junior
Foreword

The safe use of the wheelchair can only be ensured if it is used as intended in accordance with the information
contained in these instructions for use. The user is ultimately responsible for accident-free operation.
2.2 Indications
Minor to pronounced or complete restrictions of mobility and strength deficits of the lower and upper limbs, caused
forexample by:
Paralysis
• Paraplegia (tetraparesis, paraparesis, hemiparesis, hemiplegia)
• Cerebral palsy
• Multiple sclerosis
• Progressive muscular dystrophy or spinal muscular atrophy
• Traumatic brain injuries
• Stroke
Loss of limbs
• Amputation in combination with severe circulatory or balance disturbances
• Amputation with insufficient weight bearing on the sound leg
• Multiple amputation
Defects or deformation of the limbs
• Dysmelia, phocomelia
• Osteogenesis imperfecta
• Scoliosis
Joint contractures or joint damage (of a significant extent, cause cannot be treated)
• Polyarthrosis, polyarthritis
• Morbus Bechterew
• Arthrogryposis multiplex congenita
• Neurogenic functional disturbances
Other diseases
• Cardiac insufficiency, circulatory insufficiency
• Vestibular disorders
• Cachexia
2.3 Contraindications
2.3.1 Absolute Contraindications
There are no known contraindications given proper use.
2.3.2 Relative Contraindications
There are no known contraindications given proper use.
In certain versions and with certain settings, the wheelchair tends to tip backwards due to its design. This is an
intentional feature designed to enable users with the corresponding physical prerequisites to manoeuvre quickly
and nimbly. Users lacking the necessary physical or psychological prerequisites must not be supplied with such
versions/settings!
3 Product description
3.1 Function
The wheelchair is intended exclusively for transporting one person on the seat.
The wheelchair can be used on solid ground both indoors and outdoors.
6
Product description
Start M4 XXL, Start M6 Junior

3.2 Product overview
1
Start M4 XXL
1 Side panel with forearm support 8 Caster wheel
2 Seat cushion 9 Drive wheel with handrim
3 Leg support, elevating (option) 10 Swinging anti-tipper (option)
4 Wheel lock (here: knee lever wheel lock) 11 Release button for quick-release axle
5 Crossbrace 12 Back support, back support upholstery
6 Frame 13 Drum brake lever (option)
7 Foot plate (segmented) 14 Push handles with stabiliser bar
7Start M4 XXL, Start M6 Junior
Product description

2
Start M6 Junior
1 Side panel with forearm support 8 Caster wheel
2 Seat cushion 9 Drive wheel with handrim
3 Leg support, removable 10 Anti-tipper (option)
4 Wheel lock (here: knee lever wheel lock) 11 Release button for quick-release axle
5 Crossbrace 12 Back support, back support upholstery
6 Frame 13 Push handle, height-adjustable (option)
7 Foot plate (segmented)
4 Safety
4.1 Explanation of warning symbols
WARNING Warning regarding possible serious risks of accident or injury.
CAUTION Warning regarding possible risks of accident or injury.
NOTICE Warning regarding possible technical damage.
8
Safety
Start M4 XXL, Start M6 Junior

4.2 Safety instructions for use
Hazards during preparation for use
WARNING
Independent modification of settings
Serious injuries to the user due to unallowable changes to the product
►Do not modify the settings established by the qualified personnel. Only the settings described in the section
“Use” in these instructions for use may be adjusted independently.
►In case of problems with the settings, please contact the qualified personnel who fitted your product.
►Discuss all changes to the settings with the qualified personnel/therapist in advance in order to minimise
health hazards and avoid putting the therapy results at risk.
WARNING
Settings outside the safety limits
Tipping over, falling due to adjustment errors because of failure to observe the physical/psychological require
ments of the user
►In certain versions and with certain settings, the product tends to tip backwards due to its design. This is an
intentional feature designed to enable users with the corresponding physical prerequisites to manoeuvre
quickly and nimbly.
►Users with the necessary physical and psychological preconditions can be supplied with such versions/set
tings. If the physical/psychological preconditions change, the product may no longer be used with these set
tings. Inform the responsible qualified personnel immediately in this case.
WARNING
Improper handling of packaging materials
Risk of suffocation due to neglect of the duty to supervise
►Packaging materials must be kept out of the reach of children.
Risk of hand injuries
CAUTION
Pinching on components
Pinching, crushing due to lack of caution in danger areas
►Do not reach between the drive wheel and wheel lock or drive wheel and side panel when driving the wheel
chair.
►Do not reach into the spokes of the rotating drive wheel.
►Pay attention not to pinch parts of your body at the wheel lock lever or between the side or frame parts.
CAUTION
Heat development when braking with handrims
Burns due to insufficient hand protection
►Wear wheelchair gloves when travelling at high speeds.
Hazards while driving
WARNING
Improper use of the wheel lock
Falling due to abrupt braking, rolling away of the wheelchair, damage to the wheel lock
►Do not use the wheel lock as a driving brake.
►Apply the wheel lock to prevent the wheelchair from moving on uneven ground or during transfers (e.g.into a
car).
9Start M4 XXL, Start M6 Junior
Safety

CAUTION
Lack of driving experience
Tipping over, falling due to errors in handling the product
►Practise on level, open ground first.
►Learn with the support of an assistant how the product reacts to changes in centre of gravity, e.g.downward
or upward slopes, inclines or when overcoming obstacles.
CAUTION
Leaning forward in the wheelchair
Tipping over, overturning due to incorrect centre of gravity
►Do not lean too far out of the wheelchair when trying to pick up objects.
►Lean well forward with your upper body when climbing gradients, overcoming obstacles on gradients or on
ramps. If users cannot lean their upper body forward, accompanying persons must support the wheelchair
from behind.
CAUTION
Risky operation
Falling, tipping over backwards due to approaching obstacles incorrectly
►Push slowly when crossing obstacles (e.g. steps, curbs) and negotiating uphill or downhill slopes and
inclines.
►Never cross obstacles at an angle. Always approach obstacles head on (at an angle of 90°).
►Raise the front wheels before crossing obstacles.
►Avoid collisions with obstacles and dropping off curbs/ledges.
►Avoid riding cross-country.
CAUTION
Lack of tipping resistance on public transport
Tipping over, user falls, damage to the product due to incorrect positioning
►When using public transit, always observe the currently applicable legal requirements and the safety notices
of the public transit operator.
►Use the permanently installed seats in the vehicle. If you depend on using your wheelchair as a seat, please
use the designated wheelchair spaces and safety securing equipment provided. Always ensure that you are
held in place securely.
CAUTION
Incorrect handling at level crossings
User may fall or tip over due to driving error
►Only cross railway systems and railway tracks in the designated areas.
►Negotiate level crossings so the caster wheels of the product cannot get caught in the gap between the rail
and the road surface.
CAUTION
Driving in the dark
Risk of collisions with other traffic participants due to lack of lighting
►Wear bright clothing or clothing with reflectors.
►Install active lighting on your product.
►Ensure that the reflectors on the product are clearly visible.
10
Safety
Start M4 XXL, Start M6 Junior

Hazards when overcoming obstacles
WARNING
Overcoming steps and obstacles without assistance
Tipping over, falling of the user due to failure to observe transportation instructions
►Always have accompanying persons help you negotiate steps and other obstacles.
►Use available facilities (e.g. access ramps or lifts).
►If such facilities are not available, have 2 assistants carry you over the obstacle.
WARNING
Improper lifting by attendants
Tipping over, falling of the user due to lifting on components that come loose or are not intended for lifting
►Only lift the product on permanently welded components (e.g. main frame).
►Do not lift the product on components installed with screw connections or add-on components.
WARNING
Reduced ground clearance with the "foot-propelled chair" option
Tipping over, falling due to getting caught on obstacles
►Please note that wheelchairs with the "foot-propelled wheelchair" option might fall below the minimum ground
clearance of 40mm depending on the selected settings for the lower leg length and the front seat height.
►Adjust your driving to the reduced ground clearance and exercise particular caution with obstacles on the
ground e.g.steps, curbs and thresholds.
Hazard in case of broken skin
CAUTION
Contact with broken skin
Reddening of the skin or pressure points due to contamination with germs or incorrectly adapted seat cushion
►Check before using the product that the skin is not broken in areas subject to prolonged pressure (e.g.but
tocks, back and rear of the thighs).
►In case of problems, please contact the qualified personnel who adjusted the product.
►No liability is assumed for injuries caused by the use of the product with broken skin.
Hazards due to fire, heat and cold
CAUTION
Extreme temperatures
Hypothermia or burns due to contact with components, failure of components
►Do not expose the product to any extreme temperatures (e.g.direct sunlight, sauna, extreme cold).
►Do not leave the product in the immediate vicinity of heaters.
Hazards due to improper use of the product
WARNING
Overloading
Severe injuries if the product tips over due to overloading, damage to the product
►Do not exceed the maximum load capacity (see the nameplate and section "Technical data").
►Please note that certain accessories and add-on components will reduce the remaining load capacity.
WARNING
Exceeding the service life
Serious injuries due to failure to observe the manufacturer’s requirements
►Using the product beyond the specified expected service life leads to increased residual risk.
►Observe the specified service life.
11Start M4 XXL, Start M6 Junior
Safety

WARNING
Incorrect pushing or pulling of the wheelchair
Falling, tipping over due to user error
►Only the push handles may be used for pushing or overcoming obstacles.
►The attendant should make sure that he/she has a secure stance and firm grip (on both sides).
►In case of damage, have the push handles repaired promptly.
CAUTION
Use of the product during diagnostic examinations and therapeutic treatment
Impairment of the examination results or the effectiveness of treatment due to interactions of the product with
devices that are used
►Make sure that examinations and treatments are carried out exclusively under the prescribed conditions.
CAUTION
Uncontrolled driving behaviour, unexpected sounds or odours
Falling, tipping, collision with persons or nearby objects due to defects
►If any faults, defects or other hazards that can lead to personal injury are detected, the product must be taken
out of service immediately. This includes uncontrolled movements as well as sounds that are unexpected or
previously not noted or odours that deviate significantly from the state of the product at the time of delivery.
►Please contact your authorised dealer.
NOTICE
Use under incorrect environmental conditions
Damage to product due to corrosion or abrasion
►Do not use the product in salt water.
►Make sure that the wheel bearings are not damaged by sand or other particles.
4.3 Side effects
The following side effects may occur during use of the product:
• Neck, muscle and joint pain
• Circulatory disorders, risk of pressure sores
Contact a doctor or therapist in case of problems.
4.4 Further information
INFORMATION
Even in the event of compliance with all applicable guidelines and standards, alarm systems (e.g. in department
stores) may respond to your product. Should this happen, remove your product from the area where the alarm
was triggered.
4.5 Nameplate and warning labels
4.5.1 Nameplate
The nameplates are found on the crossbrace.
4.5.1.1 Start M4 XXL
Label Meaning
AManufacturer’s product name
BCE marking
CMaximum load (see section “Technical data”)
DManufacturer information/address
ESerial number1)
FManufacturing date2)
GSymbol for medical device
12
Safety
Start M4 XXL, Start M6 Junior

Label Meaning
H WARNING! Read the instructions for use before using the
product. Observe important safety-related information
(e.g.warnings, precautions).
IThe product has not been approved by the manufacturer for use
as a seat in vehicles for transporting persons with reduced
mobility
JManufacturer’s reference number for the product variant
KSerial number (PI)3),1)
LGlobal Trade Item Number (DI)4)
1)YYYY = year of manufacture; WW = week of manufacture; PP = production site; XXXX = sequential production
number
2)YYYY = year of manufacture; MM = month of manufacture; DD = day of manufacture
3)UDI-PI to GS1 standard; UDI = Unique Device Identifier, PI = Product Identifier
4)UDI-DI to GS1 standard; UDI = Unique Device Identifier, DI = Device Identifier
4.5.1.2 Start M6 Junior
Label Meaning
AManufacturer’s product name
BCE marking
CMaximum load (see section “Technical data”)
DManufacturer information/address
ESerial number1)
FManufacturing date2)
GSymbol for medical device
H WARNING! Read the instructions for use before using the
product. Observe important safety-related information
(e.g.warnings, precautions).
IManufacturer’s reference number for the product variant
JSerial number (PI)3),1)
KGlobal Trade Item Number (DI)4)
1)YYYY = year of manufacture; WW = week of manufacture; PP = production site; XXXX = sequential production
number
2)YYYY = year of manufacture; MM = month of manufacture; DD = day of manufacture
3)UDI-PI to GS1 standard; UDI = Unique Device Identifier, PI = Product Identifier
4)UDI-DI to GS1 standard; UDI = Unique Device Identifier, DI = Device Identifier
4.5.2 Warning labels
Label Meaning
Fixation point to attach the product in vehicles for transporting
persons with reduced mobility
5 Delivery
5.1 Scope of delivery
• Wheelchair ready for use
• Instructions for use (user)
5.2 Options
The standard model can be fitted to the user's personal requirements thanks to a large range of options. For use of
these options: see Page15 ff.
13Start M4 XXL, Start M6 Junior
Delivery

5.3 Storage
5.3.1 Storage during daily use
The wheelchair must be stored in a dry place.
5.3.2 Storage during extended disuse
The wheelchair must be stored in a dry place. During longer storage periods, an ambient temperature between
-10°C and +40°C must be maintained.
It is not necessary to disassemble or fold up the wheelchair.
During extended storage, the knee lever wheel lock on wheelchairs with PU tyres (=tubeless tyres) must be
released since tyre deformation may otherwise result.
Tyres contain chemical substances that can react with other chemical substances (such as cleaning agents, acids,
etc.).
6 Preparation for use
6.1 Assembly
CAUTION
Exposed pinch points
Crushing, pinching due to incorrect handling
►When folding the wheelchair out or together, only grip by the specified components.
CAUTION
Failure to verify readiness for use before putting into operation
Tipping, falling due to incorrect adjustment or installation
►Before you start using the wheelchair for the first time, check the chosen wheelchair settings with the support
of qualified personnel.
►After every assembly, check for proper mounting of the drive wheels. The quick-release axles must be
securely locked in the receiver bushings.
►Pay particular attention to the stability against tipping, free running of the drive wheels and correct function of
the wheel locks.
►Check the tyre pressure. The correct tyre pressure is printed on the sidewall. Ensure that the pressure is the
same in both tyres.
INFORMATION
On the topic of disassembly/transport: see Page36.
It only takes a few simple steps to prepare the wheelchair for use:
1) Attach the drive wheels to the quick-release axle housings:
→Press in the button on the quick-release axle (see fig.3).
→Attach the drive wheel to the receiver bushing and release the button on the quick-release axle.
→The quick-release axles must not be removable after releasing the push-button.
→INFORMATION: For the “lock-release assist” option see the section “Drive wheels”.
2) Loosen the safety strap by means of the push-button (see fig.4, item1).
3) Unfold the wheelchair (see fig.5).
INFORMATION: While you are next to the wheelchair, tip it slightly toward you and press on the edge
of the seat upholstery closest to you.
4) If necessary: Insert the leg supports into the retainer (see Page18).
5) Fold down the foot plates (see fig.12).
6) If necessary: Pull the part of the flap that can be fastened forwards and fasten tightly to the seat upholstery
(see fig.7).
7) Fit the seat cushion. The seat cushion is secured against sliding by being pressed on to the hook-and-loop
fastener.
14
Preparation for use
Start M4 XXL, Start M6 Junior

3 4
5 6
7
7 Use
7.1 Further instructions for use
• Attaching loads (e.g.backpacks) can adversely affect stability. Suspending additional loads on the wheelchair
is not permitted.
• The recommended overall width for manual wheelchairs in an operational state is 700mm. This specification
should ensure unhindered use of escape routes,for example. Please note that the product dimensions can
exceed the recommended value in versions with very large seat widths (for more information see see Page46
ff.).
• The wheelchairs in this series fully satisfy the minimum technical requirements for wheelchairs transportable by
train. However, please note that it is possible that not every individual wheelchair will fulfil the minimum require
ments due to the variation in designs (please see see Page48 for further details).
15Start M4 XXL, Start M6 Junior
Use

7.2 Getting in and transferring
CAUTION
Incorrect handling when getting in
Risk of falling, tipping or rolling away due to incorrect handling
►Activate the wheel lock each time before you get into or out of or transfer to or from the wheelchair.
►Always get into the wheelchair from the side, where possible.
►Never step on the foot plates when getting in and out.
►Do not support yourself on the wheel lock when getting in/out.
CAUTION
Incorrect caster wheel position when leaning forward in the wheelchair
Tipping over, falling due to incorrect caster wheel positioning
►Prior to activities that require you to bend forward in the wheelchair (e.g.tying your shoes), maximise the sta
bility of the wheelchair.
►In order to do so, push the wheelchair backwards until the caster wheels turn forward.
Users can choose the method for getting into and out of the wheelchair which is most suitable for them. The
respective procedure should be discussed and practised with a therapist.
As a rule, the frame tubes, seat bottom or side panels can be used as supports for getting into the wheelchair.
If getting in independently is not possible, transferring or getting in always has to be performed with the help of an
assistant. The manufacturer also offers transfer aids for getting in, such as transfer boards.
7.3 Legrests
WARNING
Reduced ground clearance with the "foot-propelled chair" option
Tipping over, falling due to getting caught on obstacles
►Please note that wheelchairs with the "foot-propelled wheelchair" option might fall below the minimum ground
clearance of 40mm depending on the selected settings for the lower leg length and the front seat height.
►Adjust your driving to the reduced ground clearance and exercise particular caution with obstacles on the
ground e.g.steps, curbs and thresholds.
The leg supports support the user's feet.
The height of the leg support has been adjusted by qualified personnel to the length of the user's lower legs.
The angle of the foot support has been set by the qualified personnel so that it allows the ankles to rest in a com
fortable position.
Different leg support types and other accessories may be installed depending on the order:
“Angle-adjustable” leg support (see fig.8)
The depth of the foot supports is 160mm. The leg support can be folded up to make getting into the wheelchair
easier.
“Segmented, angle-adjustable” leg support (see fig.9)
Each leg support can be folded up individually to make getting into the wheelchair easier.
“Elevating” leg support (see fig.10)
The leg support allows positioning of the leg at different angles.
Amputation leg support (see fig.11)
Alternative for installation on an “elevating” leg support.
16
Use
Start M4 XXL, Start M6 Junior

8 9
10 11
7.3.1 Folding the foot plate up and down
1) Hold the foot plate by the edge and fold it up or down (see fig.12).
2) Only for leg supports with single-panel foot plate: Make sure the support of the foot plate is locked into the
receiver (see fig.13).
12 13
7.3.2 Removing and fastening the calf strap
The calf strap offers additional support for the user’s legs. It also prevents the feet from sliding off the foot plate
into the danger area. The calf strap can be removed for cleaning.
Fastening the calf strap
1) Open all hook-and-loop closures.
2) Thread the calf strap through the eyelet on the foot plate (see fig.14, item1).
3) Thread the other end through the eyelet on the swivel segment (see fig.14, item2; see fig.15).
4) Adjust the length and fasten the hook-and-loop closure (not illustrated).
Removing the calf strap
1) Undo the hook-and-loop closure.
17Start M4 XXL, Start M6 Junior
Use

2) Remove the calf strap from the frame tube.
14 15
7.3.3 Removing and attaching the leg supports
Removing the “segmented, angle-adjustable” leg support
1) Fold the foot plate up.
2) Push the pan bar of the leg support back and down (see fig.16, item1).
3) Swing the leg support outwards and to the side by 90° (see fig.17, item1) and pull up to detach (see fig.17,
item2).
Mounting the “angle-adjustable” leg support
1) Hold the leg support out to the side by 90° and insert the pivot bearing into the leg support retainer (see
fig.17, item2).
2) Swing the leg support into the direction of travel until it engages.
3) Fold the foot plate down.
16 17
Removing the “elevating” leg support/amputation leg support
1) Activate the release lever (see fig.18, item1).
2) Swing the leg support outwards and to the side by 90° (see fig.18, item2) and pull up to detach.
Mounting the “elevating” leg support/amputation leg support
1) Hold the leg support out to the side by 90° and insert the pivot bearing into the leg support retainer (see
fig.19, item1).
2) Swing the leg support into the direction of travel until it engages (see fig.18, item2).
18
Use
Start M4 XXL, Start M6 Junior

18 19
7.3.4 Adapting the angle of the "elevating" leg support
Lowering the leg support
1) Turn the release lever upwards to the stop (see fig.20, item1).
2) Simultaneously move the leg support down to the desired angle (see fig.20, item2).
3) Twist the release lever back down. The leg support will automatically snap into place in the next free position.
Swinging up the leg support
1) Grasp the leg support and pull it up (see fig.20, item2).
2) Release the leg support at the desired angle. The leg support locks into place automatically.
20
7.3.5 Adjusting the leg supports
Further adjustments may be made only by qualified personnel.
7.4 Seat and back upholstery
WARNING
Seat cushions and back support pads may ignite
Burns due to user error
►The seat and back support upholstery as well as seat cushions, padding and covers fulfil the normative
requirements for flame resistance. However, they may still ignite if fire is handled improperly or negligently.
►Keep away from all ignition sources, especially lit cigarettes.
CAUTION
Wear of the seat and back upholstery
Loss of functionality due to prohibited continued use
►Have the seat and back upholstery replaced immediately in case of damage.
The product is equipped with seat and back upholstery. Hook-and-loop fasteners on the seat upholstery are used
to attach the seat cushion. The seat cushion ensures pressure relief during use of the wheelchair. It was chosen by
qualified personnel according to the needs of the user.
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Use

7.4.1 Removing and fastening the seat cushion
1) Lay the seat cushion onto the seat upholstery and secure it against sliding by pressing it onto the hook-and-
loop fastener (see fig.21).
2) To remove, detach the seat cushion from the hook-and-loop closure on the seat upholstery.
21
7.4.2 Removing and fastening the back support pad
The back padding can be removed from the wheelchair for cleaning.
Removing the back support pad
1) Remove the seat cushion.
2) Pull the flap of the back support pad off the seat upholstery (see fig.22).
3) Fold the back support pad to the rear and pull it off the hook-and-loop straps of the back support upholstery
(not illustrated).
Fastening the back support pad
1) From the rear, apply the edge of the back support pad to the upper hook-and-loop strap.
2) Fold down the back support pad and secure it to the upholstery straps with the hook-and-loop fasteners (see
fig.23).
3) Pull the part of the flap that can be fastened forward and attach it to the seat upholstery with the hook-and-loop
fastener (see fig.22).
22 23
7.5 Backrest
WARNING
Incorrect use of back support angle adjustment
Falling, tipping over due to operation without anti-tipper
►Note that adjusting the back support angle shifts the centre of gravity. Only use the back support angle
adjustment with the anti-tipper activated.
►Drive in street traffic only with a vertical back support.
The product can be equipped with a fixed or optionally an angle-adjustable backrest.
20
Use
Start M4 XXL, Start M6 Junior