Forces, moments, and accelerations acting on an unrestrained dummy during simulations of three wheelchair accidents.

To determine the magnitude and distribution of the forces, moments, and accelerations acting on an individual sitting in a wheelchair during three possible accidents occurring while negotiating a sidewalk curb, experimental trials were performed in a bioengineering laboratory using a 50th percentile Hybrid III dummy seated in a standard wheelchair. A ramp was designed with an adjustable incline to allow the wheelchair to reach the edge of a sidewalk height platform at the desired forward speed of 2.5 miles per hour (comfortable walking speed). The wheelchair velocity was monitored via an optical pickup. Three types of accidents were simulated: (1) a wheelchair hitting straight into a curb; (2) a wheelchair falling forward straight off a curb; (3) a wheelchair falling diagonally off a curb. Each experiment was repeated three times. Each run was photographed using high-speed cameras and videotaped from three perspectives: frontal, lateral, and overhead. The results were averaged and compared with published injury Assessment Values (IAV) and Head Injury Criteria (HIC). Of significance were the following results. In the straight into a curb experiments, the wheelchair remained upright and the dummy seated. Low magnitude forces (23-73 N), moments (1-12 Nm), and accelerations (0.2-1 G) were recorded at the neck and head. The HIC was low at 0.3. These results were of no clinical significance. In the straight off a curb experiments, properly attached footrests prevented the wheelchair from toppling over but did not prevent the dummy from falling off the wheelchair. Forces (187-4,176 N), moments (3-178 Nm), and accelerations (131-206 G) of great magnitude were recorded at the head and neck when the dummy fell off the wheelchair. These values were above IAV. The HIC was 960. In the diagonally off a curb experiments, both the wheelchair and the dummy fell sideways. High-magnitude forces (274-2,313 N), moments (4-110 Nm), and acceleration (140-236 G) were recorded in the head and neck regions. The HIC was 975. These values were close to IAV and may signify potential serious injuries.

[1]  C. Long,et al.  Splenic rupture and splenectomy due to fall from wheelchair. , 1983, Archives of Physical Medicine and Rehabilitation.

[2]  J. Hsu,et al.  FRACTURES CAUSED BY FALLING FROM A WHEELCHAIR IN PATIENTS WITH NEUROMUSCULAR DISEASE , 1992, Developmental medicine and child neurology.

[3]  J. Gurwitz,et al.  The Epidemiology of Adverse and Unexpected Events in the Long‐Term Care Setting , 1994, Journal of the American Geriatrics Society.

[4]  R L Kirby,et al.  NONFATAL WHEELCHAIR-RELATED ACCIDENTS REPORTED TO THE NATIONAL ELECTRONIC INJURY SURVEILLANCE SYSTEM , 1994, American journal of physical medicine & rehabilitation.

[5]  R L Kirby,et al.  Static and dynamic forward stability of occupied wheelchairs: influence of elevated footrests and forward stabilizers. , 1989, Archives of physical medicine and rehabilitation.

[6]  R L Kirby,et al.  WHEELCHAIR-RELATED ACCIDENTS CAUSED BY TIPS AND FALLS AMONG NONINSTITUTIONALIZED USERS OF MANUALLY PROPELLED WHEELCHAIRS IN NOVA SCOTIA , 1994, American journal of physical medicine & rehabilitation.

[7]  Ordinal and timed balance measurements: reliability and validity in patients with stroke , 1993 .

[8]  R Lee Kirby,et al.  Fatal Wheelchair-related Accidents in the United States , 1990, American journal of physical medicine & rehabilitation.

[9]  R L Kirby,et al.  Adding loads to occupied wheelchairs: effect on static rear and forward stability. , 1996, Archives of physical medicine and rehabilitation.

[10]  R P Gaal,et al.  Wheelchair rider injuries: causes and consequences for wheelchair design and selection. , 1997, Journal of rehabilitation research and development.

[11]  D. Vlahov,et al.  Epidemiology of falls among patients in a rehabilitation hospital. , 1990, Archives of physical medicine and rehabilitation.

[12]  R L Kirby,et al.  "Bedside" test of static rear stability of occupied wheelchairs. , 1989, Archives of physical medicine and rehabilitation.

[13]  U Boenick,et al.  [The dynamic stability of wheelchairs]. , 1987, Biomedizinische Technik. Biomedical engineering.