Purchased at Akachan Honpo. I developed tenosynovitis soon after giving birth, and this item was very helpful at that time. Everything in the photos is included. Please check the photos for the condition of the tires, etc. If you would like additional photos, please comment. I have cleaned and sun-dried it. There is some wear and tear, as well as minor scratches and stains, so please only purchase if you understand that this is a used item.