The adjustable back angle itself doesn't recline far enough to need anything for my head. When I'm rocked back on my anti tippers in a tilted position I prefer to be against a wall because I have neck issues. If I combine the reclined angle with rocking back on my anti tippers I have to be against something.

I'll see if I can get some photos to demonstrate the angles, the on the fly adjustments are not drastic but enough to change up muscles groups being used as well as opening or closing hip angle some. Rocking back on to the anti tippers would be more like tilt in space option. How far you tilt back can be adjusted by the anti tippers height. I will never be removing my anti tippers due to some balance issues and cervical instability.

In addition to the quickie q7, quickie gt (which has slightly less angle options than q7), the new Ki mobility rogue offers adjustable on the fly back angle. Manuals with full recline are typically bulky, heavy chairs. I've never seen the option on a custom ultralight, but that doesn't mean it isn't out there. But to balance such a tall back requires a different set up such as far back cog which can be difficult to push and harder on the shoulders.