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Individuals using wheeled mobility devices (WMDs) often use them as motor vehicle seats during transportation. Wheelchair occupant restraint systems (WORSs), consisting of upper torso and pelvic restraints, are usually mounted to the structure of transit vehicles to secure individuals within their wheelchair seats. This preliminary study attempts to evaluate the use and satisfaction of currently installed vehicle-mounted WORSs for individuals using WMD as seats in motor vehicles. A survey was conducted among 33 adults who use their WMD to travel in motor vehicles. Results from the survey showed that upper torso and pelvic restraints installed in private vehicles are quick, comfortable, and easy to use. However, WORS installed in mass transit and paratransit are often uncomfortable to wear, difficult to reach, and time-consuming to use. This preliminary study documents the growing need for developing alternative WORS that are safe, comfortable, and that allow independent usage for wheelchair occupants while traveling in a motor vehicle. [ABSTRACT FROM AUTHOR]

Safety of motor vehicle seats is of great importance in providing crash protection to the occupant. An increasing number of wheelchair users use their wheelchairs as motor vehicle seats when traveling. A voluntary standard requires that compliant wheelchairs be dynamically sled impact tested. However, testing to evaluate the crashworthiness of add-on wheelchair seating systems (WCSS) independent of their wheelchair frame is not addressed by this standard. To address this need, this study developed a method to evaluate the crash-worthiness of WCSS with independent frames. Federal Motor Vehicle Safety Standards (FMVSS) 207 test protocols, used to test the strength of motor vehicle seats, were modified and used to test the strength of three WCSS. Forward and rearward loads were applied at the WCSS center of gravity (CGSS), and a moment was applied at the uppermost point of the seat back. Each of the three tested WCSS met the strength requirements of FMVSS 207. Wheelchair seat-back stiffness was also investigated and compared to motor vehicle seat-back stiffness. [ABSTRACT FROM AUTHOR]

When designing wheelchairs for use as motor vehicle seats, special design criteria must be followed to assure the crash safety of the wheelchair user. Failure of seating system components under crash loading conditions could lead to serious injury or fatality. In this study, seat and seat-back loading in a frontal crash are explored using computer simulation techniques. A previously validated simulation model consisting of a powerbase wheelchair and a seated 50th-percentile male test dummy subjected to a 20g/30mph frontal impact were used for the study. Since such a wide range of seating systems are available, parametric analyses were conducted to evaluate the influence of surface stiffness and seat-back angle on wheelchair seat and back loading. Seat loading varied with stiffness, ranging from 819-3,273 lb., while seat-back loading was found to be between 1,427-2,691 lb., depending upon back stiffness and recline angle. [ABSTRACT FROM AUTHOR]

Automotive seats are tested for compliance with federal motor vehicle safety standards (FMVSS) to assure safety during impact. Many wheelchair users rely upon their wheelchairs to serve as vehicle seats. However, the crashworthiness of these wheelchairs during impact is often unknown. This study evaluated the crashworthiness of five combinations of wheelchair back support surfaces and attachment hardware using a static test procedure simulating crash loading conditions. The crashworthiness was tested by applying a simulated rearward load to each seat-back system. The magnitude of the applied load was established through computer simulation and biodynamic calculations. None of the five tested wheelchair back supports withstood the simulated crash loads. All failures were associated with attachment hardware. [ABSTRACT FROM AUTHOR]

A survey and observational study was conducted with 29 people who remain seated in their wheelchair when driving (21) or riding as a front-row passenger (8) in their personal vehicle. Each subject was observed and surveyed in their own personal vehicle that has been modified for use by occupants seated in wheelchairs. Our survey obtained responses on issues related to occupant restraint (seat belt) system usage, wheelchair securement device usage, and perception of personal safety while riding in a vehicle. Usability and accessibility issues related to seat belt and automated (docking) wheelchair securement technology were revealed, suggesting that wheelchair-seated occupants travel with a higher risk of serious injury in vehicle crashes than front-row occupants seated in original equipment manufacturer (OEM) vehicle seats and using OEM seat belts. Study results also indicate the need for improved torso support for many wheelchair-seated drivers to maintain a posture that allows for effective vehicle control. Study results demonstrate the need for innovative passive restraint technologies that provide postural support during normal vehicle operation and improved occupant restraint during crash conditions for people who drive while seated in their wheelchairs.

Ease of use, comfort, security, and independent use of three types of wheelchair securement systems were evaluated in a large accessible transit vehicle by 20 wheelchair and scooter users. The securement systems included a 4-point tie-down system, a prototype autodocking system, and a prototype rear-facing wheelchair passenger (RF-WP) system. Study participants took a 15-minute city ride and completed a survey. Participants responded positively to the autodocking and RF-WP systems that were quicker and easier to use and allowed more independent use than the 4-point tie-down system (p < 0.001). There was concern regarding the RF-WP system that rear-facing travel made it more difficult to see upcoming stops and was less comfortable than a forward-facing ride and that the system may damage wheelchair wheels during use. The majority of participants preferred using an autodocking system because it allowed secure and independent forward-facing travel. Participants found it undesirable, however, that a wheelchair-mounted docking adaptor was needed to use the autodocking system. Study results indicate a need for improved securement systems for forward-facing use that do not require a wheelchair adaptation and can be easily and independently used by wheelchair and scooter users.

In the fields of telehealth and telemedicine, phone and/or video technologies are key to the successful provision of services such as remote monitoring and visits. How do these technologies affect service accessibility, effectiveness, quality, and usefulness when applied to rehabilitation services in the field of telerehabilitation? To answer this question, we provide a overview of the complex network of available technologies and discuss how they link to rehabilitation applications, services, and practices as well as to the telerehabilitation end-user. This white paper will first present the numerous professional considerations that shape the use of technology in telerehabilitation service and set it somewhat apart from telemedicine. It will then provide an overview of concepts essential to usability analysis; present a summary of various telerehabilitation technologies and their strengths and limitations, and consider how the technologies interface with end users' clinical needs for service accessibility, effectiveness, quality, and usefulness. The paper will highlight a conceptual framework (including task analyses and usability issues) that underlies a functional match between telerehabilitation technologies, clinical applications, and end-user capabilities for telerehabilitation purposes. Finally, we will discuss pragmatic issues related to user integration of telerehabilitation technology versus traditional face-to-face approaches.

A method was developed to assess the reach capability of people seated in wheelchairs for purposes of establishing design and placement requirements for safety belts used by vehicle occupants who are seated in wheelchairs. The method uses simple technology and is intended to be readily implemented in the field. Participants use a marker to draw their acceptable reach zone on a vertical surface placed adjacent to the wheelchair. A pilot study with 10 wheelchair users showed that the method generates easily interpreted data quickly. Even with a small number of participants, the results from the pilot study provide useful information for designers of restraint systems for wheelchair-seated vehicle occupants.