Rehab Balance User manual

Manual | English

© 2020 HD Rehab AB
This manual is available in PDF format at hdrehab.com.

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HD Balance | Manual
CONTENTS
1. Warranty 4
2. General information 5
2.1 Intended use - HD Balance 5
2.2. General safety aspects 5
2.3 Tests 6
2.4 Identication of the wheelchair 6
2.5 The wheelchair parts 7
2.6 Delivery Inspection/Installation 7
2.7 Symbols / Markings 7
3. Functions and Settings 8
3.1 Brakes 8
3.2 Wheels 9
3.3 Antitip device/tipping bar 9
3.4 Push bar 10
3.5 Separate operating handles 10
3.6 Covers / Cushions 10
3.7 Seat tilt & Recline function 11
3.8 Backrest Height 12
3.9 Setting the Flexi-Back 12
3.10 Adjustable seat / seat depth 13
3.11 Armrests 13
3.12 Leg rests 14
3.13 Footrest 15
3.14 Calf support 15
4. Accessories 16
4.1 Headrest / Neck rest 16
4.2 Bag hook 16
4.3 Thoracic support 17
4.4 Table 17
4.5 Pommel 18
4.6 Positioning Belt / Harness 18
4.7 User Card 19
5. Transport 19
5.1 Transport of wheelchair with
patient in vehicles 19
5.2 Weight of removable components 20
5.3 Folding the wheelchair for
transportation 20
5.4 Transferring in and out of
the wheelchair 20
5.4 Driving technique 21
6. Maintenance and Care 22
6.1 Daily functional checks 23
6.2 Long term storage 23
6.3 Recycling and disposal 23
7. Technical data - Measures 24

4HD Balance | Manual
THANK YOU FOR CHOOSING A WHEELCHAIR FROM HD REHAB,
WE HOPE IT WILL SERVE YOU WELL
WE MANUFACTURE QUALITY OF LIFE
HD Rehab helps people achieve an improved quality of life. Our products help make
the lives of users, their families, and caregivers easier, safer, and more comfortable.
HD Rehab oers assistive products for people living with disability. Our primary product is wheelchairs,
which we have been designing, developing, and manufacturing for over 40 years. We accept no
compromises in quality. Precision, safety for user and caregiver, function, and design are our guiding
principles. We are condent that you will feel the dierence compared to any other wheelchair.
GLAD TO BE FLEXIBLE
Whether you are a user, a family member, or a caregiver, we welcome your requests and opinions. Our
designers and developers work closely with the production team at our facility on the island of Lidingö
in Stockholm. Our creative employees use their specialist knowledge, experience, and inventiveness to
nd solutions for the unique needs of each individual.
1. WARRANTY
The warranty is only valid if the product is used as directed and the service and cleaning instructions
are followed.
THE WARRANTY COVERS:
Frame 5 years against defects in materials, manufacturing and/or assembly.
Leg-/arm-/headrests Two years against defects in materials, manufacturing and/or assembly.
Upholstery Two years against defects in materials and faults in manufacture.
Gas springs Two years against defects in materials and faults in manufacture.
WARRANTY & LIMITATION OF LIABILITY
HD Rehab assumes no liability for damages arising out of the following:
- That the instructions in the manual were not followed.
- Incorrect installation or setup by a third party other than HD Rehab.
- Unauthorized modications/adaptations.
- Use of spare parts from other manufacturers than HD Rehab if they are not mentioned in the document
“Permitted modications”, 95724-1.
- Use by persons weighing more than the maximum user weight stated on the chair.
- That the wheelchair is adjusted to an inappropriate position or setting for the user.

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HD Balance | Manual
2. GENERAL INFORMATION
HD Balance is a class 1 CE labelled medical device.
2.1 Intended use - HD Balance
The wheelchair model HD Balance 24 is a manual wheelchair designed for users who can propel
themselves to a certain extent. This model can also be used by users who cannot propel themselves.
The wheelchair model HD Balance 16 is a manual wheelchair designed for users who cannot propel
the wheelchair themselves.
Both models are intended for use by users in need of much comfort and support when seated. The
seat and back on both models can be tilted in various positions to give the user a varied position
during activity and rest. A varied seat position is very important. Note that prolonged sitting without
a position change can lead to discomfort and excessive pressure. If injury is suspected, look for
information regarding symptoms and contact the health care system.
A medical professional should always be consulted prior to using an HD Balance wheelchair. This
applies to both new and used wheelchairs. Note that a new prescription may be needed if a user’s
disability changes or new needs arise. All prescription and adjustment of the wheelchair must be
carried out by qualied personnel.
Where the wheelchair has several users, each patient’s specic needs must be taken into account. In
addition, the chair’s upholstery on the back and seat cushions must be washed or changed for each
user. Washing instructions are on the seat and cushion covers.
If the user has a pattern of movement or behaviour that strains the chair excessively a strengthened
frame version and one piece footrest and calf support must be used. This includes users with
signicantly increased tonus/spasticity.
The wheelchair is approved for use as a seat during transportation in vehicles.
2.2. General safety aspects
HD wheelchairs are intended for use both indoors and outdoors. Before using the wheelchair, it is
important that users and carers are familiar with how the chair works and should be used.
Test the driving characteristics and features.
• Read the whole manual and ensure that it is readily available. Note that deviations may occur
especially if the wheelchair is specially equipped or adapted. The wheelchair can also be equipped
with accessories and equipment from other suppliers.
• From a safety perspective, it is important that the maintenance instructions (see Section 8) are
followed. A good rule is to keep the seat clean and periodically test the controls and brakes.
• Especially when the chair has been transported, a further check should be done to note that no
cables or the like have been damaged.
• If damage is detected or any detail found to be missing, the wheelchair must be taken out of
service until this is xed.
• The wheelchair should be operated and used judiciously to avoid unnecessary risks.
• The wheelchair is not intended to be operated by children.
• Be aware that certain items of clothing are not suitable for the user to wear as they may get caught
in the wheels. Be especially careful with scarves and similar items that can be tightened around
the user’s neck if they get caught.
• If the wheelchair is exposed to external heat sources such as sunlight, some parts may become
hot. Pay attention to this so that the user is not harmed.
• Be careful with all wires so that they do not get damaged.
• The user might accidentally slide out of the wheelchair, be aware of this. See info regarding belts.
RISK OF TIPPING
• The risk of the wheelchair tipping backwards will increase if the seat is equipped with an increased
seat tilt capacity. In these cases, the risk of tipping is always evaluated on an individual basis.
• Keep in mind that the risk of tipping also increases when bags/oxygen bottles are hung on the
seat back, especially if the seat is at the maximum backward tilt.

6HD Balance | Manual
• In addition, some users have involuntary movements or are very active, and want to grab hold of
solid objects (e.g. door frames, handles). Use caution with these users and be aware when their
behaviour can tip the wheelchair. Avoid parking near xed objects.
RISK OF PINCHING
• Since the chair has many dierent conguration options, the caregiver should be aware of the
user’s position in the chair, to avoid the possibility that the user could become trapped. Normally
the risk of pinching is small.
• Remember that the user cannot always communicate that a pinching injury is occurring.
MOVING IN TO AND OUT OF THE WHEELCHAIR
• Moving in to and out of the wheelchair can be done in dierent way depending on the user’s ability to
actively participate. It can be done independently, with help of one or two caregivers, or with a lift.
• The wheelchair brakes must be locked before moving in or out.
• Remove or fold in legrests fully so they do not hinder. If needed foot plates can be folded up.
• Seat tilt and back recline may need to be adjusted per the particular needs of the user.
• Caregivers need to be mindful of their ergonomic positioning when assisting.
LIFTING
This advice is general since there are many dierent lifting aids available.
• When lifting in and out of the chair, be very attentive that the user’s arms and legs do not get
caught. Fold in the leg rests or remove them so that they do not get in the way. Follow the lifting
aid instructions carefully.
• Often training is a requirement for operating the lifting aid.
CE MARKED ACCESSORIES / CUSTOMIZING
• HD Rehab has a wide range of CE-marked accessories that are authorized for use with the
wheelchair while maintaining the CE marking. There are also combination agreements covering
accessories from other manufacturers that are approved for use on HD Balance while maintaining
the CE marking. Accessories that have not been approved may not be used.
• Any change to the wheelchair or use of accessories not certied and CE-marked by HD Rehab is a
special adaptation. Wheelchairs customized without HD Rehab approval do not retain HD Rehab
CE marking and the warranty is void. A transfer of liability then occurs. Always consult HD Rehab if
unsure about what applies. We can help with special adaptations for individual users.
DAILY FUNCTIONAL CHECK
To ensure that the chair works as it should, a daily function test should be performed before the user is
positioned in the seat. See section 6. Daily functional checks.
REPLACEMENT PARTS AND SERVICE
If the wheelchair is in need of replacement parts or service contact the reseller.
SAFETY NOTICES AND PRODUCT RECALLS
Information regarding any safety notices and product recalls can be found at hdrehab.com.
WARNINGS
In addition to these general safety aspects there are warnings and notices contained in each section in
the manual. They are marked with an exclamation point as follows:
- Here is the warning
2.3 Tests
EN and ISO wheelchair tests and crash test have been carried out for HD Balance at RISE Research
Institutes of Sweden, Borås, Sweden. EN and ISO resistance to ignition tests have been carried out at SP,
Borås, Sweden. More information and certicates are found at hdrehab.com.

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HD Balance | Manual
2.4 Identication of the wheelchair
Manufacturer, year of manufacture, serial number (SN),
and article number (REF) in text and bar code formats are
printed on the front cross tube of the wheel frame, see
diagram 1.
2.5 The wheelchair parts
1 Wheel frame 9 Push bar/handles
2 Seat frame 10 Tip protection
3 Back frame 11 Leg rest
4 Back system 12 Calf support
5 Drive wheels 13 Footrest
6 Castors 14 Armrest, side support
7 Caregiver brakes 15 Tilt plate
8 User brake
2.6 Delivery Inspection/Installation
ALWAYS DO THE FOLLOWING ON DELIVERY:
- Check that the seat does not have any visible damage.
- Any shipping damage must be reported immediately to
the transport company.
Then follow the instructions in the unpacking instructions that
come with the delivery. This can be supplemented with further
instructions depending on the wheelchairs equipment.
2.7 Symbols / Markings
The following markings are on the wheelchair.
Model label. Shows that the model is HD Balance, as well as
the drive wheel size and the seat width of the wheelchair.
Parking brake. Shows how
the sleeve on the brake lever is
moved to activate the parking
brake.
Transport bracket. Marks the
attachment points for transport.
Max user weight. Shows the
maximum allowable user weight
for the wheelchair.
Attention required.
Wheelchairs with accessories or
alternate adaptations that can
carry increased or diererent risks
are marked with this symbol.
Read the attached document
95706-1, Special design and
accessories. Also see document
95707-1, Risk information about
special congurations and
accessories (www.hdrehab.com).
Scales. Indicates the angle of the backrest in relation to
the seat (1), the seat tilt angle (2), knee joing positin (3),
armrest positin (4), and seat depth (5). The scales are used
in conjunction with the user card, where the recommended
settings are recorded. See section 4.7 User Card.
CE marking. Shows that the wheelchair is a CE marked
medical device and who the manufacturer is. SN stands for
serial number and REF for reference number.
HD Rehab AB
Tryelslingan 4
181 57 LIDINGÖ, SWEDEN MD
SN
REF
12 3 4 5
Diagram 1. Labels for wheelchair identication
Diagram 2. The parts of the wheelchair
322580 6031017
10-99999 60310
3225 8 0 6031017
10-99999 60310
13
10
1
5
1
2
3
7
9
4
14
8
11
12
6

8HD Balance | Manual
3. FUNCTIONS AND SETTINGS
3.1 Brakes
HD Balance can be supplied with two dierent types of brakes;
combined service and parking disc brakes (1 in Diagram 3) and user
brake (2 in Diagram 3).
COMBINED SERVICE AND PARKING BRAKE
The brake levers are located under the push bar/push handles
operated by caregivers from behind the chair. The brakes are
operated by pressing the brake levers (1 in Diagram 4) against the
push bar/push handles. Hold the brake levers slightly pressed to
achieve a braking eect for example when moving downhill.
The parking brake is activated by pressing the brake levers up
against the push bar/push handles. In this position, move the
locking sleeve (ain Diagram 5) forward so that the brake lever is
locked in the brake mode, see Diagram 5. NOTE: Make sure the
locking sleeve is pushed forward suciently so that it sits securely.
- Adjustment of the disc brakes should only be undertaken by a qualied technician. Information is
available in“Technical information”, art. no. 95720-1.
PARKING BRAKE / USER BRAKE
This brake works directly against the tire.
- If the wheelchair is equipped with pneumatic wheels, it is important that the tires are kept inated for
the wheel lock to function properly. The recommend air pressure is indicated on the tires. Normally the
air pressure is 300 kPa.
To brake, move the brake levers forward from the wheels. To release the brakes, move the brake levers
back towards the wheels.
Adjustment of the user brakes must be performed by qualied personnel. Instructions are in the
technical manual.
- Parking brakes are not suitable for use when the wheelchair is on a surface that slopes more than 7°.
Diagram 3.
1
2
Diagram 4.
1
Diagram 5.
1
2
aa

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HD Balance | Manual
3.2 Wheels
HD Balance is equipped with either 24”, 20” or 16” drive wheels depending on model and design.
Drive wheel tires are solid polyurethane as standard and equipped with quick releases. The castors are
175mm as standard but can be changed to other alternatives.
Alternatively, the wheelchair can be equipped with pneumatic tires.
HOW TO REMOVE THE WHEELS:
- Press the lock button (1) on the top (Balance 24”) alternatively the bottom (Balance 16 “) of the wheel
bracket, see Diagram 6.
- Remove the wheel
HOW TO MOUNT THE WHEEL:
- Insert the wheel axle (2) in the casing (3) on the wheel bracket, see Diagram 7.
- Press the lock button (1, Diagram 6) on the top (24”) and bottom (16”) of the wheel attachment.
- Press the wheel so that the three pins on the hub t into the three holes in the brake disc.
- Release the lock button and check that the wheel is secured by pulling on it.
- Make sure the lock button has slid out and that the wheel is xed.
- Be careful not to allow the user’s ngers/hands to go into the wheels.
3.3 Antitip device/tipping bar
Antitip devices are standard equipment on HD Balance and should always be used. The antitip devices
can be set in three positions by means of a snap lock, see Diagram 8. The snap lock is unlocked by
lifting the pin (1, Diagram 8). It is also possible to turn up the antitip devices temporarily to assist in
passing over a curb or similar obstacle, see Diagram 9.
The antitip device can also be used as a tipping bar, i.e. provides resistance to the operator’s foot when
the wheelchair is tipped back on the rear wheels. The antitip devices are slightly dierent between the
16” and 24” models.
- Always ensure that the snap lock locks rmly into place so that the antitip device is locked.
- Make sure that correct model of antitip device is used for the wheelchair.
Diagram 6. The lock button
for the wheel on the 24” model.
1
Diagram 7. Wheel axle (2)
and sleeve (3).
2
3
Diagram 8. The three modes
of the antitip device, which are
set with a snap lock.
3
positions
1
Diagram 9. Antitip device in
angled position.

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3.4 Push bar
HEIGHT ADJUSTMENT OF THE PUSH BAR:
- Grip the push bar (a in diagram 10) with one hand.
- Press in one snap lock (1 in diagram 11) and pull the push bar up on
the same side.
- Hold the bar up and push the second snap lock (2).
- Set the push bar to the desired position.
- Ensure that both snap locks have sprung out into the holes.
- Check brake and control cables run freely and are not subject to
damage. They should run along the back tube.
3.5 Separate operating handles
The wheelchair can alternatively be equipped with separate operating
handles (b), Diagram 10.
HANDLE HEIGHT ADJUSTMENT:
- Loosen the screws, 1 & 2 in Diagram 11.
- Move the operating handles vertically to the desired position and
tighten the screws.
- Make sure the screws are securely tightened.
- Check brake and control cables run freely and are not damaged.
They should run along the back tube.
3.6 Covers / Cushions
Seat and back cushions are attached to the wheelchair with Velcro and are therefore easily removable
and interchangeable. Alternative cushions and upholstery come, for example, with incontinence
protected upholstery.
- Check cushions regularly per the maintenance directions. Worn out cushions can cause pressure sores.
POSITIONING OF SEAT CUSHION
- Align the cushion over the seat plate and place it straight down. The cushion is slightly higher at the
front and has a label at the rear. The underside is black and smooth.
- Make sure the cushion is secure.
REMOVING THE SEAT CUSHION:
- Take the front edge of the cushion and pull straight up.
POSITIONING OF BACK CUSHION:
- Attach the straps (1) in the upper part of the back cushion around the
exi-back’s tubes (2) with Velcro as shown in Diagram 12. If a hard back
is used, attach the Velcro to the back of this.
- Fold the cushion straight forward and press rmly against the back
plate according to Diagram 13.
- Make sure the cushion is secure.
REMOVAL OF BACK CUSHION:
- Take hold of the lower edge of the cushion and pull up.
- Loose the straps.
REMOVABLE COVER
Both the seat and back cushions’covers are tted with a zipper for easy
removal and recovering. Washing instructions are on the label.
Diagram 10. Push bar and
separate operating handles.
a
b
Diagram 11. The snap locks
(push bar) alternatively the
screws (separate operating
handles) position.
12
Diagram 12. Fastening
straps around the exi-frame.
1
1
2
Diagram13.

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HD Balance | Manual
3.7 Seat tilt & Recline function
Diagram 16 shows the wheelchair in back reclined and seat tilted position.
- The controls should be handled with moderate force and must
always be used one at a time, never at the same time.
- Never hang items on the levers.
SEAT TILT
The seat tilt is controlled by the green lever on the right side of the
push bar (or right push handle), 1 in Diagram 14. As standard, the
seat can be tilted between 0-20° in about 10 steps. Increased seat tilt
is available as an alternative (longer tilt bar), providing up to 30° of
tilt. Be aware that the tilt risk is slightly higher with increased tilt.
It is also possible to allow for negative tilt (forward), up to -5°.
- The seat will not tilt forward as standard; this must be actively selected when ordering or be adjusted by
competent sta later. If a forward bias is required, special attention must be paid to the user as there is a
risk that the user slides o the chair. It is particularly important when users are left alone.
HOW TO OPERATE THE SEAT TILT:
- Grip the push bar/operating handles with both hands.
- Release the tilt lock by pressing the green lever down gently and hold it down. Pay attention when the lock
is released, depending on the seat’s position a dierent amount of force is required to resist movement.
- Set the desired angle by tilting the seat unit and then releasing the green lever.
- Make sure that the tilt lock locks properly by trying to tilt the seat without pressing the lever.
TILT LOCK
The seat angle adjustment mechanism and the tilt lock are tted
with an adjustable brake, see Diagram 15. Brake (1) is adjusted with a
screwdriver to the desired resistance.
This adjustment should be performed by qualied personnel.
BACK RECLINE
The back angle is controlled by the gray lever on the left side of the
push bar (or left operating handle), 2 in Diagram 14. By default the
back can be angled 30° (90-120°) continuously. A gas spring provides
supporting force when lifting up, but it also makes the back heavy to
recline if no one is sitting in the chair.
HOW TO OPERATE THE RECLINE FUNCTION:
- Grip the push bar/operating handles with both hands.
- Release the lock by pressing the gray lever downwards and hold it down.
- Set the desired recline angle by pushing on the push bar and then releasing the gray lever.
- Risks exist for some accessories when changing back angle, for example pinching towards a tray table
when raising the back. Similar risks also exist for belt, pommel, and hemiplegic armrest.
Diagram 14. Controls for the
seat tilt (1) and recline func-
tions (2).
12
Diagram 15. The tilt lock’s
adjustable brake (1) that
controls the inertia of the seat
angle movement.
1
Diagram 16. Three positions. Maximum recline, maximum seat tilt, and both recline and tilt in their maximum positions.

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3.8 Backrest Height
The backrest height can be adjusted approximately 5 cm in the tracks where the exi-back is secured.
This requires a 10mm key, diagram 17, which is located under the front seat’s cross tube.
As an alternative for tall users there is an extended back that is 10cm higher than standard
HEIGHT ADJUSTMENT OF THE BACKREST:
- Loosen the four nuts, 1 in Diagram 18, a few turns.
- Push the exi-back up or down to the desired height.
- Tighten the nuts securely.
- Make sure the brake cables are not damaged when the back is moved.
If the back needs to be even higher, the four clamps the exi-back/
back plate is attached to are moved upward along the back frame
tubes. This makes the back position a further 30mm higher. Steps:
- Loosen the four back clamps by loosening the screws, 2 in Diagram
19, a few turns.
- Push the back clamps carefully along the back frame tube to the
desired position. Some risk of damage to the paint nish exists.
Note that the top position for the push bar becomes unusable because
the snap hole is covered.
3.9 Setting the Flexi-Back
Guide for setting the exi-back:
1. Before the user sits in a wheelchair;
a. Release the velcro straps.
b. Make sure the back cushion is properly positioned in the seat. See
instructions under Covers / Cushions.
c. Loosen the nuts for height adjustment of the exi-back.
2. Positioning of the user;
a. When lifting, tilt the wheelchair’s seat unit backwards. In many
cases it is also helpful to recline the backrest slightly.
b. Position the user well into the wheelchair, between the exi-
frame’s side tubes. This is required to form the exi-back to the
user’s back.
3. With the user sitting in the wheelchair;
a. Set the seatback at the desired height.
b. Adjust the velcro straps according to the user’s back.
c. Tighten the nuts for the seat back height adjustment.
Diagram 17. The tool, which
is located underneath the seat’s
cross tube.
Diagram 18. The nuts for the
back height adjustment.
11
Diagram 19. The screws for
adjusting the height of the back
clamps.
2
2

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HD Balance | Manual
3.10 Adjustable seat/seat depth
Seat depth is controlled by a lever (1) under the seat’s left side, see
Diagrams 20 & 21, and can be set to seven dierent positions.
DEPTH SETTING:
- Move the lever (1) outward and hold it out.
- Slide the seat plate to the desired position.
- Release the lever and slide the seat plate slightly so that the lever
snaps in to a locked position.
- Check that the seat plate is securely locked.
The seat plate can be pulled out, for maintenance reasons by
pulling the locking catch (2 in Diagram 21) down at the same time
as the lever (1) is moved outwards. This is only done in for the
purpose of maintenance.
- Make sure that the seat plate locks in position when it is put back.
3.11 Armrests
STANDARD ARMRESTS
Armrests are located in separate brackets on both sides of the seat,
see Diagram 22, and can be adjusted vertically and horizontally. They
consist of the following components:
1 Armrest pad (1 in Diagram 23)
2 Side support (2)
3 Locking button (3)
4 Locking lever (4)
HEIGHT ADJUSTMENT:
- Push button (3, Diagram 23) and hold it down.
- Set the desired height. The tube is marked with 1 cm intervals.
- Release and push/pull the arm pad until the lock snaps in place.
Maximum setting range is 9 cm.
DEPTH SETTING:
The arm pad can be adjusted to six depth settings as standard. If the
chair has a special conguration such as a wider exible back, the
furthest back positions cannot be used.
- Press the locking lever, (4) in Diagram 23, and set the desired position.
- Release the locking lever.
- Make sure the plate is locked in position by pulling a bit on it.
Diagram 20. The lever (1) for
seat depth adjustment is located
under the left side of the seat.
1
Diagram 21. The locking
clasp (2) and the lever for seat
depth adjustment (1) as seen
from below.
2
1
1
4
3
2
Diagram 23. Armrest parts.
Diagram 22. The armrests are
inserted into the brackets on each
side of the seat frame.

14 HD Balance | Manual
3.12 Leg rest
ANGLE ADJUSTABLE LEG RESTS
Angle adjustable leg rests are standard on HD Balance. They can
be angled between 90° (straight down) and 180° (straight out)
with 10° steps (10 positions).
Components see Diagram 24:
1 Locking lever for removal of leg rests
2 Angle control, release button
3 Leg rest tube
4 Cap, outside
5 Padding, inside
6 Knee joint
7 Turnable link
8 Snap lock, footrest
ANGLING OF LEG RESTS
- Grip the leg rest tube as far down as possible (1 in Diagram 25). Lift
slightly to ease the load on the locking mechanism.
- Push button on the outside of the knee joint (2 in Diagram 25) and
move the leg rest to the desired position (3 in Diagram 25).
- Release the button and move the leg rest in either direction so that
leg angle mechanism snaps into the locked position.
TURNING OUT LEG RESTS
The leg rests can be angled out by about 90 degrees for better
access in and out of the chair. In order to angle them out, grip the
knee joint from above and push in the locking lever (1 in Diagram
26), then turn the leg rest (2 in Diagram 26).
REMOVAL OF LEG RESTS
- Grip the knee joint from above and press in the locking lever (1 in
diagram 27).
- Lift straight up until the leg rest is loose (2 in diagram 27).
- The leg rest can then be lifted out without the user’s legs needing to
be stretched (3 in diagram 27).
Alternatively, the leg rest can rst be turned out and then lifted o.
MOUNTING LEGRESTS
- Grip around the knee joint press in the locking lever (1 in diagram 28) .
- Move the knee joint just above the bracket on the wheelchair.
- Align the hole with the peg on the seat frame and slide it down (2 in
diagram 28) .
- Turn the knee joint so that it points straight ahead and ensure that
the locking pin clicks in.
Diagram 24.
2
1
3
8
4
5
6
7
Diagram 25. Angling of legrest.
1
2
3
Diagram 26. Turning out legrest.
1
2
Diagram 27. Removal of legrest.
1
2
3
Diagram 28. Mounting legrest.
1
2

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HD Balance | Manual
FIXEDANGLE LEG RESTS
Alternatively, the wheelchair can be equipped with xed-angle leg
rests. These are available with dierent angles.
MOUNTING FIXEDANGLE LEG RESTS
- Align the hole in the knee joint over the peg and let the knee joint slide
down, see Diagram 29. It may be easier if the lever (1) is moved forward.
- Release the lever (1) and rotate the leg rest to point straight ahead, make
sure that the locking pin clicks in and locks the knee joint (Diagram 30).
REMOVAL/ANGLING OF FIXEDANGLE LEG RESTS
- Grip the leg rest and move the lever (1) forwards.
- Turn out/lift o the leg rest.
AMPUTEE LEG REST
For information about use and mounting of the amputee leg rest,
see separate User manual/Assembly instructions.
3.13 Footrest
FOLDUP FOOTPLATE
Footplates can be folded up to facilitate entry and exit, see Diagram 31a.
HEIGHT SETTING FOOT REST
Press the snap lock, (2) in Diagram 32, and move the footrest tube
to the desired position.
DEPTH SETTING OF FOOT PLATE
The foot plate depth can be adjusted in 3 mounting positions.
- Remove the two screws and washers (1), see diagram 31b.
- Remove the footplate and place it back in the desired position.
- Screw the footplate in place with the screws and washers.
Note that the footplate is available in two sizes, one size for seat
widths 38 and 42, one size for seat widths 46 and 50. The foot
plate is adjusted in depth to suit the seat width (diagram 31b).
ANGLE SETTING OF FOOTRESTS
- Loosen the lock nut (3), see Diagram 32.
- Tilt the foot plate to the desired position.
- Tighten the lock nut securely
3.14 Calf support
DEPTH SETTING OF CALF SUPPORT
- Loosen the lock nut a few turns (4 in Diagram 32).
- Slide the calf plate to the desired position.
- Tighten the nut securely.
HEIGHT ADJUSTMENT CALF SUPPORT
The height of the calf support is adjustable along the leg rest tube.
Loosen the knob (5 in Diagram 32), then pull the calf support to the
desired position and tighten the knob.
LATERAL ADJUSTMENT CALF SUPPORT
As of spring 2015 the calf support can also be adjusted laterally.
- Loosen the screw a few turns (6 in Diagram 32).
- Slide the calf support pad to the desired position.
- Tighten the screw.
Diagram 30. Fixed-angle
legrests in place.
1
Diagram 29. Mounting of the
xed-angle legrests.
1
Sw 38 and 46
Sw 42 and 50
1
Diagram 32. Footrest and calf support.
Diagram 31b. Footplate adjustment.
Diagram 31a. Folding up the footrest.
2
3
5
4
6

16 HD Balance | Manual
4. ACCESSORIES
This section briey describes the accessories that are available for HD Balance. They are all CE labelled
and approved for use with the wheelchair. More information about the respective accessories is
available as information sheets. Instructions on how accessories are installed can be found in the
respective accessory installation instructions.
- Never use accessories that are not approved for HD Balance. The
wheelchair is then considered a custom product, read more in
2.2. General Safety Aspects.
4.1 Headrest / Neck rest
The headrest (Diagram 33) and neck rest (Diagram 34) each consist of
two parts: an extension tube (1, Diagrams 33 & 34) and a cushion with
a headrest tube (2). The cushion is slightly smaller on the neck rest
than on the headrest.
Set the tube in the bracket (3 in Diagrams 33 & 35) on the rear of the
back by sliding it down through the sleeve to the desired position and
tighten the knob (7, Diagram 35).
Note: Do not tighten too hard as the knob and bracket can be damaged.
LATERAL ADJUSTMENT:
If necessary, some models of headrests and neck rests can be adjusted
laterally to suit the user’s head position.
- Loosen the screws (6 in Diagrams 33 & 34).
- Move the headrest to the desired position and tighten the screws.
The cushion is shaped to provide support at the base of the skull so
that the head can be positioned in a balanced comfortable position.
LATERAL SUPPORT FOR THE HEADREST & NECKREST
Some models of headrests/neck rests can be equipped with one or
two removable lateral supports (4, Diagram 33) to increase lateral
stability. In this case the back of the main headrest is tted with 2
stand sleeves (5) to adjust the positions of the lateral supports.
- Do not hang things on the headrest/neck rest.
- Some users with particular/involuntary movements might risk to get
caught between the rest and the wheelchair. Individual assessments
must be done to determine what type of support is suitable.
4.2 Bag hook
The bag hook (1, Diagram 36) is mounted on the operating handle
tube (2) under the operating handle joint (3). The hook is clamped to
the pipe by tightening the screw (4).
On installation and use of the bag hook, ensure that the brake cables
(5) are not damaged.
- A maximum of 5kg total may be hung on the bag hook.
- When bags etc. are hung on the bag hook the risk increases of tipping
backwards. How much depends on the weight and the back-and seat
angle settings.
- It is the responsibility of the caregiver/user to check the risk of tipping
and to make sure the antitip devices are used.
Diagram 33. Headrest
with lateral supports.
1
2
6
4
5
3
Diagram 34. Neckrest.
1
2
6
Diagram 35. Headrest
mount.
37
Diagram 36. Bag hook
mounted.
5
3
1
2
4

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HD Balance | Manual
4.3 Thoracic support
The thoracic support, which is available in various models, is
mounted by inserting the hook (1 in Diagram 37 & 38) in the
thoracic support fastening (2) on the rear of the back and tightening
with the knob (3) in the desired position.
Note: Do not tighten too hard as the knob/bracket can be damaged.
The cover is removable and mounted with velcro. Washing
instructions are on the labels.
HEIGHT ADJUSTMENT
See separate installation instructions.
- Note that the use of the thoracic support requires thorough testing to
ensure the user receives good support and that the thoracic support
does not cause pressure that can lead to injury.
- Avoid placing the thoracic support near the user’s armpit since the
area is generally considered to be intimate and pressure sensitive.
4.4 Tray Table
The tray table, which is available in various models, is intended to
be used to put smaller things on and in some cases to position the
user by working as a support for the lower arms.
Installation is done by inserting the two pins (1, Diagram 39) on the
table top into the table bracket (2) on the outside of the armrests.
The table brackets can be easily adjusted for depth by sliding them
along the rail under the arm pad. Loosen the screws underneath,
slide the bracket along the track and tighten the screws in the
desired position.
Keep in mind that armrests should be placed at the same height
and depth so that the tray table sits evenly.
A version with lock is available. Push the button and hold to lock
and unlock the mechanism, see Diagram 40.
- When using a tray table there is a risk of pinching when the back is
lifted up from a reclined position.
- The tray table is not intended for heavy loads. Maximum load is 7kg.
- Restrictions may exist regarding the use of a tray table if it restrains
the user from getting out of the wheelchair, especially when using
the version with lock. Be aware of local regulations.
- Do not sit on the tray table.
Diagram 37. Thoracic
support and fastening
(circled).
2
3
1
Diagram 38. Thoracic
support mounted in the
fastening.
2
3
1
Diagram 39. Table mounting.
1
2
Diagram 40. Table lock
mechanism.
Push
3

18 HD Balance | Manual
4.5 Pommel
The pommel consists of (see Diagram 41):
1. Pommel cushion
2. Mounting prole
3. Mount with knob
The same mount is used for all pommel versions.
The pommel is attached by inserting the mounting prole into the
mount and securing with the knob. See Diagram 42.
SETTING DEPTH NOT AVAILABLE FOR SOME MODELS
- Open the cover on the underside of the pommel cushion
- Loosen the screw
- Move the pommel on the mounting prole to the desired position
and tighten the screw.
4.6 Positioning Belt / Harness
If there is a risk that the user can slide out of the chair a positioning
belt can be used.
The belt is available in two versions, a 2-point belt and a 4-point
harness. These are used with belt fasteners, Diagrams 45 & 46
2POINT BELT, DIAGRAM 43
The 2-point belt is attached to the two belt mounts, one on each
side. It is important that the brackets are placed correctly so that the
user’s position is good. Always have qualied personnel install them.
4POINT HARNESS, DIAGRAM 44
The 4-point harness is attached to the four belt mounts, two on each
side. It is important that the brackets are placed correctly so that the
user’s position is good. Always have qualied personnel install them.
- There may be special restrictions on use of the belt.
- Individually adapted information about the use of belt must be received from the prescriber for each user.
- Pay attention to the use of positioning belt. There is a risk that the user slides down in the chair and gets
stuck in the belt if it is incorrectly installed or poorly fastened. This can lead to impaired blood/oxygen
supply and risk of the user choking.
- Always make sure that the belt is securely fastened when used.
- If possible, tighten the belt when in an upright position. If the belt is tightened when the back is in a
reclined position it may cause pinching when the back is later raised.
- Be aware of loose belts, they can get caught in the wheels and cause a sudden stop or pinching.
Diagram 41. Pommel with
mount.
1
2
3
Diagram 42. Pommel
mounted on wheelchair.
Diagarm 45. Belt fastener.
Diagram 46. Belt fastener
attached (circled).
Diagram 43. 2-point belt.
Diagram 44. 4-point harness.

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HD Balance | Manual
4.7 User Card
A User Card is attached to the back
of the wheelchair and is used to
ensure the user’s seated position is
according to the recommendations
of the prescriber. The prescriber
(or other authorized person) can
communicate the recommended
settings for each individual patient.
Diagram 47 explains how the card
should be interpreted. The dierent
settings are read from the wheelchair
from the markings described in
section 2.7 Symbols / Markings.
5. TRANSPORT
5.1 Transport of wheelchair with patient in vehicles
HD Balance must be held in place in the vehicle with a 4-point belt
system, see Diagram 48, and the user must use a 3-point safety belt.
Both must be approved according to ISO 10542-2. All transportation
must be done with the wheelchair facing forwards. See Diagram 49.
When strapping down the wheelchair the rear tension device is attached to the intended mounts on
the wheel frame, see 1 in Diagrams 48 & 50. The front tension device is attached around the cross tube
of the wheel frame; see 2 in Diagrams 48 & 51. These attachment points are marked with the symbol
described in section 2.7 Symbols / Markings.
- No other attachment points than those specied may be used.
THE FOLLOWING MUST BE CONSIDERED BEFORE TRANSPORT:
- Tray table, thoracic support, and other accessories must be removed.
- The headrest/neck rest must be used.
- Seat tilt and back recline must be positioned as upright as possible.
- The leg rests must be angled down as much as possible.
- Do not use too much tension. Tensioners should only be tightened so that the wheelchair is stable. Any
rocking may not be oset by tightening the straps tighter. Tensioning devices can create excessive loads
on the wheels and frame components and thereby damage the wheelchair.
- The user must always use the vehicles xed system of three-point safety belts. Any positioning/safety
belts that are mounted on the wheelchair and are usually used by the patient may not be used as
substitutes for seat belts when travelling in vehicles.
HD Balance is crash tested according to ISO 7176-19:2008 (see Section 9.1 there), which means that it
has been tested and passed the requirements of a standard test. The test simulates a frontal collision at
48 km/h with a test dummy weighing 79,2 kg. The standard species a minimum requirement for what
the wheelchair must withstand regarding transport in a vehicle.
Since an actual incident is likely to be dierent than the conditions at the time of testing, HD Rehab
does not accept any responsibility for the outcome of an accident in which HD Balance is involved.
Diagram 51. Front tensioning
during transport.
NAME. User’s name.
BACK ANGLE. Recommended
backrest angle.
SEAT TILT ANGLE. Recommended
seat tilt angle.
ARMREST HEIGHT. Recommended
setting for the armrests.
LEGRESTS. Recommended
setting for the legrests.
BACK SIDE. Other comments can be
written on the back side of the card.
Diagram 47. User Card
Diagram 48. Wheelchair
with straps mounted.
1
2
Diagram 49.
All transport must be forward facing.
Diagram 50. Rear
transport mount.
1
2

20 HD Balance | Manual
5.2 Weight of removable components
Wheel 24” 2,0 kg Leg rest 2,4 kg Seat cushion ca 1,1 kg
Wheel 16” 1,9 kg Armrest 1,1 kg Back cushion ca 0,8 kg
5.3 Folding the wheelchair for transportation
FOLDING OF WHEELCHAIR
- Tilt the seat unit to its most forward position.
- Remove the armrests and any accessories such as thoracic support and
pommel, as well as cushions.
- Remove the leg rests if it is advantageous.
- Grasp the push bar with one hand and pull the locking pin, (1) in
Diagram 52. The gas spring (2) then drops down from the mount (3) and
the backrest can be folded forward against the seat, see Diagram 53.
- The drive wheels may be removed to make the wheelchair even smaller.
REASSEMBLY AFTER FOLDING
- Raise the backrest.
- Pull the pin (1), and t the gas spring in the mount.
- Slip the pin through the gas spring’s mounting hole (4, Diagram 54)
and completely through both plates of the bracket (3, Diagram 52).
CHECKLIST AFTER TRANSPORTATION
- Make sure the pin (1) goes fully through the bracket (3), Diagram 52.
- Check that the wheels are securely fastened.
- Make sure the antitip devices are positioned correctly.
- Check the most important functions; brakes, seat tilt, back recline.
- If the pin is not properly mounted, the bracket can break and the
patient will be suddenly tipped backwards.
5.4 Transferring in and out of the wheelchair
Transferring in and out of the wheelchair can be done in dierent
ways depending on the user’s ability to actively participate. It can be
done with a lift, with help of one or two caregivers, or independently.
- The brakes must be locked before transferring in or out.
- Remove or fold in leg rests fully so they do not hinder. If
needed foot plates can be folded up.
- Seat tilt and back recline may need to be adjusted per the
particular needs of the user.
- Caregivers need to be mindful of their ergonomic positioning
when assisting.
Diagram 52. Locking pin for
folding.
1
2
3
Diagram 54. The gas
spring’s mounting hole.
4
Diagram 53. Folded.
Diagram 55. Transfer with lift
Diagram 57. Independent transferDiagram 56. Transfer with assistance