The larger rear wheels usually have push-rims of slightly smaller diameter projecting just outside the tyre; these allow the patient to self drive the chair by pushing on them without any support from caretaker or attendant. These type of wheelchairs generally have brakes that bear on the tyres of the rear wheels, however these are solely a parking brakes and in-motion braking is provided by the patient’s palms bearing directly on the push-rims. These wheelchairs are usually called “Self Propelled”. Price vary according to customisation (wheels, mattress, railings etc)