Cross 5 XL Prescription form 75188K 017-05-08 Reference: Name: Tel: Date: version is marked with The measurements given can vary ±% Short frame Seat width (cm) Seat depth 36-4 (-49*)cm Measured from back post (*Triangular back support) Long frame Seat width (cm) Seat depth 4-48 (-55*)cm Measured from back post (*Triangular back support) 47,5 1313111 55 1313117 50 1313113 57,5 1313119 5,5 1313115 60 131311 47,5 131311 55 1313118 50 1313114 57,5 131310 5,5 1313116 60 13131 Black -01 Moss green -95 Yellow -99 Frame colour Cross back 3A Dark blue -93 Coral -96 Pearl grey -94 Heather purple -97 Type Lumbar angle standard +7 Triangular -8 - +18 Back Support Height 3-45 cm (std 40 cm) height cm Lumbar angle Back Support Height High 38-51 cm (std 46 cm) height cm Back Support Angle -5 - +0 (std + ) angle angle Cover Comfort Tidy Cross back Cross back, widened Continuosly adjustable 30-45 cm. 35 cm Continuosly adjustable 30-45 cm. 35 cm Extends the width 5 cm height: cm height: cm Cover standard Cover comfort tubes for hard shell back support, ECS tubes for hard shell widened back support, ECS (max chair width 55 cm) angle -5 - +15 Push handles Push handles Detachable, height adjustable Continuosly adjustable 30-45 cm 35 cm Continuosly adjustable 37-4 cm 37 cm Extends the back support width by 5 cm + = 9 between back and seat Bow handle Detachable, height adjustable (for seat and back support system ECS, see separate prescription form at www.etac.com) angle
Seat Seat upholstery Adjustable seat depth 6 cm Solid seat, detachable With angled brake handle With extension arm, foldable Single-hand brake Brakes Red Black With angled brake handle Drum brakes g supports Black Detachable/swing-away with locking device (not for bow handle) Yes No With larger grip Elevating leg supports Mod 1 without calf support Mod 3 without calf support Mod with calf support foldable, adjustable in angle, depth and sideways Mod 3 with calf support foldable sideways in height two positions. From 40 cm seat width (with two leg supports) Options for Mod 1 and Mod 3 without calf support Attachment for calf support Attachment for calf-support, foldable Calf support Tube, standard length Foot support one piece Foot supports Flip-up, adjustable Tube, short length(-8 cm) only for short/narrow leg support Tube, long length (+10 cm) Flip-up, adjustable in angle g supports Others Amputee support adjustable in height, angle, depth and sideways Amputation weight, can be combined with Amputee support Plaster leg support with fixed 0 knee angle. Support plates are adjustable Material Plush Grey hygiene 0 4 6 Rear wheels with quick release Pneumatic high pressure 1 --- Pneumatic high pressure 1 Pneumatic high pressure 1 Pneumatic high pressure 1 --- --- --- Solid Solid Solid Solid --- Aluminium Aluminium Aluminium Aluminium --- Handrims Stainless steel Stainless steel Stainless steel Stainless steel Cellular rubber Cellular rubber Cellular rubber Cellular rubber --- Vinyl coated (not with solid tyre) Vinyl coated Vinyl coated Vinyl coated ---
Single hand-drive (not with drum brakes) 0 Handrims on ght 4 ft 4 (100x30 mm) solid 7 (175x45 mm) semipneumatic Castors 5 (15x30 mm) solid (max 135 kg user weight) 8 (00x35 mm) semipneumatic 6 (150x30 mm) solid 8 (00x50 mm) semipneumatic 6,5 (165x30 mm) solid 8 (00x30 mm) pneumatic Front fork attachment Widened (moves castor 3 cm to the side for foot propulsion) Camber angle 0 Rear 0 4 6 Pos A 46 48,5 51 53 B 44 46,5 49 51 Rear seat height (cm) C 4 44,5 47 49 D 40 4,5 45 47 E 38 40,5 43 45 F 36 38,5 41 43 G 34 36,5 39 - --- Extra short front fork Castor height 4 * 34-39,5 cm cm 5 ** 36-44,5 cm cm Position Short front fork 6 40-45,5 cm cm 1 6,5 41-46,5 cm cm Front seat height (cm) 1 3 5 ** 43-49 cm cm 6 45-50 cm cm * Max 100 kg user weight ** Max 135 kg user weight Medium 3 6,5 46-51 cm cm front fork 8 48-5 cm cm 8 x1 (pneumatic) 46,5-50,5 cm cm Long front fork 6,5 50,5-55,5 cm cm 8 5,5-56,5 cm cm Fork thickness 3 mm 4 mm 1 G 0 Cambervinkel Balance position For alternative seat height/seat angles, see Manual Cross 1 1 3 4 5 6 G F E D C B A 1 3 4 5 6 F E D C B A 1 3 5 E C A balance position 1-6 (standard pos 4) 3
Accessories Cross With detatchable arm support plate, length 5 cm, height adjustable Massive moulded plate, length 5 cm, height adjustable With detatchable arm support plate, length 35 cm, height adjustable Massive moulded plate, length 38 cm, height adjustable right 730-1 left 730- right 7349-1 left 7349- right 517-1 left 517- left 6379-1 left 6379- right 731-1 left 731- right 7350-1 left 7350- right 5173-1 left 5173- right 6380-1 left 6380- Cover arm support Fits arm support with massive moulded plate Dark grey plush, detachable, length 5 or 38 cm Padded 5 cm Quantity pcs 68-60 Padded 38 cm Quantity pcs 683-60 Gel 5 cm Quantity pcs 640-60 Gel 38 cm Quantity pcs 641-60 Hemi Detachable cover, dark grey plush, sideways angle adjustable Fits with long arm supports 731-1/ and 7350-1/ Detachable cover, dark grey plush Fits with long arm supports 5173-1/ and 6380-1/ right 7313-60-1 left 7313-60- right 5770-60-1 left 5770-60- pad wide and soft Fits arm support with massive moulded plate 8x40 cm, to be mounted on arm supports pcs 6873 Side support Thigh support Soft pad Black, adjustable in height To be mounted on short or long arm supports, front attachment is included. Limitations: 4 wheel, not in B1-, C1-, D1-, E1-, F1-, G1- wheel, not in C1-, D1-, E1-, F1-, G1 0 wheel, not in E1-, F1-, G1 For thigh support, velcro attachment right 5189-1 left 5189- Short right 7391-1 Short left 7391- Long right 739-1 Long left 739- right 8488-1 left 8488- Mudguard Carbon fibre, adjustable in height and depth to fit rear wheel position right 7397-1 left 7397- Width expansion kit Extends rear wheels, brakes and arm supports 5 mm on each side (not together with drum brakes) 7533 4
Tray Tray Hemi/ Communication Seat extension Cross back 3A To be mounted on long arm supports, transparent Tip up right/left Extends the seat depth up to 7 cm at rear, in combination with triangular back support Etac / Cross 5 XL / www.etac.com Seat width cm 45 4419 47,5 5731 50 4601 5,5 600 55 601 57,5 60 60 6907 right 735-1 left 735- Seat width 47.5-60 cm 6977 Seat cushion Comfort wedge Seat cushion Tidy Dark grey plush, 56 cm long, anatomically shaped, cut to individual seat depth Increases the contour. To be placed in the pocket of the inner front upholstery Wipeable Seat width cm 45 634-60 47,5 6374-60 50 666-60 5,5 640-60 55 641-60 57,5-60 64-60 Seat width cm 45 80715 47,5-60 80779 Seat width cm 45 6310-63 47,5 63103-63 50 63104-63 5,5 63105-63 55 63106-63 57,5-60 63107-63 ECS seat- and backsupport Calf support cover Calf strap Padding for calf strap The seat- and back support system offers products and covers in different kinds of upholstery and fabrics (see separate prescription form at www.etac.com) Dark grey plush For elevating leg support model 3 Black Dartex For elevating leg support model 3 Detachable, adjustable in length Quantity pcs 676-60 Quantity pcs 676-63 Seat width cm 45-47,5 5358 50-5,5 5359 55-60 606 0 cm 6845 30 cm 6846 40 cm 6847 Foot support extension Mounted on foot support Seat width cm 45-47,5 Quantity pcs 50799 50-57,5 Quantity pcs 50800 Heel strap Adjustable in length right 4458 left 4458 Positioning belt Two-part with snap-lock. alt. attachment points on wheelchair frame 5668 5
Head support Curved, padded. Adjustable in height, depth, sideways and angle. grey hygiene 83-65 dark grey plush 83-60 45 819 55 8133 Head support attachment For Cross back 3A, mod 4 47,5 8130 57,5 8134 50 8131 60 8135 5,5 813 Head support bracket For bow handle 5795 wedge Dark grey plush Short 15 cm Quantity pcs 6301-60 Long 30 cm Quantity pcs 63013-60 Side cushion Provides gentle lateral support. Used when the trunk support is too stabilising. (Combined with arm support and, if necessary, side stop) ght 63171-60-1 ft 63171-60- Side stop Straight or angled. Combined with wedge or side support cushion. Creates a more distinct stop and holds the wedge or side support cushion in place. Adjustable, swing-away and detachable Settable and detachable Straight pcs 8136 Widening 15 mm pcs 8137 Widening 30 mm pcs 8173 0 ght 8141-1 0 ft 8141- -15 ght 8180-1 -15 ft 8180- -45 ght 8181-1 -45 ft 8181-0 pcs 814 +15 pcs 8143-15 pcs 8144-45 pcs 8145 Dartex, fixed, adjustable in height, depth and width Quantity pcs 7395 PUR, fixed, adjustable in height, depth and width Quantity pcs 7917 PUR, swing away, adjustable in height and depth Medium right 7915-1 Medium left 7915- Large right 7916-1 Large left 7916- Anti-tip Telescoping, flip-up Quantity pcs 756 Cane holder right 737 left 737 Grey with logo Yellow with logo Spoke guard Other spoke guards see www.etac.com 0 550-8 0 550-9 5503-8 5503-9 4 5504-8 4 5504-9 Tetra quick release adapter Quantity st 4051-01 6
Locking strap Of folded chassis 7151 Toolkit 5174 For sizes see www.etac.com 9009 Gloves Item no Bags Cellular phone holder 9010 Etac Box 03, 334 4 Anderstorp Sweden Tel +46 371 58 73 00 Fax +46 371 58 73 90 www.etac.com 7