Recently, I took a power wheelchair for a test drive through downtown Toronto, Ontario. Within a two hour period, I had hit at least 2 doorways, and narrowly missed the ankles of more than one person with my footrests (thankfully being Canadian they jumped out of the way of my rampaging chair with a cheerful “sorry”). This experience made it very clear the challenges associated with driving a power wheelchair- especially in a tight space. The following blog series will focus on the danger associated with operating power mobility devices, and how we can reduce that danger and improve access to power wheelchairs.
It is important to understand the risks associated with power wheelchair use in order to find ways to minimise risks while maximising the independence of users. It is, however, difficult to measure the prevalence of collisions incurred by power wheelchair users. Statistics are difficult to obtain, as there is no central reporting centre for power wheelchair accidents. There are some research studies that have been done to evaluate the incidence of collisions for power wheelchair users.
Many of these studies are focused on the use of power mobility devices in an institutional setting. Here is a brief summary of the results of some of these studies:
- Frank et al. (2000) found that within 4 months of receiving a power mobility device, 13% (15 out of 113) of people surveyed reported at least one accident, including tipping from chairs and falls during transfers.
- Mortenson et al. (2005) report that The Vancouver Coastal Health (VCH) residential facility which has 82 residents using power wheelchairs, reported 16 incidents of property damage in one year from power wheelchair use. This is a conservative estimate, as the author notes that only serious accidents were reported. There were likely far more minor incidents that were not reported.
- Reed, Yochum and Schloss (1993) reported that 30% of long-term care residents surveyed felt that other drivers within the facility drove unsafely.
Clearly, within an institutional setting, many power wheelchair users have difficulty safely navigating their environment. In such institutions, there is a very high density of power wheelchair users, along with narrow corridors and many obstructions in hallways which present challenges to drivers. One major factor identified as contributing to decreased safety in high density areas is a lack of conformity between drivers. Mortenson et al. (2005) write that a lack of driving rules for wheelchair drivers in an institution can result in animosity between and towards power wheelchair drivers. For example, not designating a regulated side of the hallway to drive on increases the likelihood of collision and creates an atmosphere of blame and animosity towards power wheelchair drivers (Mortenson et al., 2005).
Measuring statistics only in institutions provides an incomplete view of the magnitude of the prevalence of collisions among power mobility device users. Many wheelchair users that live in the community also suffer accidents, and when navigating through traffic the consequences can be catastrophic. Mortenson et al. (2005) found that six out of ten interviewed power wheelchair drivers report that driving in the community is more difficult than diving in an institution. A survey of wheelchair users by Arthanat et al. (2009) found that the usability of power wheelchairs in the community is low. 40-50% of those surveyed reporting that usability was moderate to very low in the community. The difficulty in navigating in the community with a power wheelchair has been observed by multiple surveys.
- Navigating a wheelchair in traffic is a large hazard of navigating within the community. LaBan & Nabity (2010) found that sixty fatal accidents occurred between a motorized vehicle and a wheelchair in one year. Of these accidents, 94% involved a power wheelchair.
- Chen et al. (2011) surveyed 95 active community wheelchair users about the number of collisions experienced. 52 (54.7%) of wheelchair users reported experiencing at least one collision, and 16 (16.8%) reported experiencing 2 or more collisions within a three year period.
- A report from Edwards and McClusky (2010) of Australian power mobility device users found that one-fifth of respondents (21%) reported having an accident in the previous year when using their device. The most commonly reported accidents were caused by running into doors and walls, the device tipping over, being hit by a car or knocking into/over objects such as shop displays.
- Arthanat et al. (2009) found that 52.8% of wheelchair users surveyed had experienced at least one accident (collision or fall) that resulted in injury.
Clearly, the issue of accidents in power wheelchair driving is prevalent. It is important to start a conversation regarding the risks and rewards of power wheelchair use! If you have experienced a collision in your power wheelchair, or know someone who has, leave a comment!
Arthanat, S., Nochajski, S. M., Lenker, J. A., Bauer, S. M., & Wu, Y. W. B. (2009). Measuring usability of assistive technology from a multicontextual perspective: the case of power wheelchairs. The American Journal of Occupational Therapy, 63(6), 751.
Chen, W. Y., Jang, Y., Wang, J. D., Huang, W. N., Chang, C. C., Mao, H. F., & Wang, Y. H. (2011). Wheelchair-related accidents: relationship with wheelchair-using behavior in active community wheelchair users. Archives of physical medicine and rehabilitation, 92(6), 892-898.
Edwards, K., & McCluskey, A. (2010). A survey of adult power wheelchair and scooter users. Disability and Rehabilitation: Assistive Technology, 5(6), 411-419.
Frank AO, Ward J, Orwell NJ, McCullagh C, Belcher M. Introduction of a new NHS electric powered indoor/outdoor chair (EPIOC) service: benefits, risks and implications for prescribers. Clinical Rehabilitation. 2000;14:665–673. [PubMed]
Mortenson, W. B., Miller, W. C., Boily, J., Steele, B., Odell, L., Crawford, E. M., & Desharnais, G. (2005). Perceptions of power mobility use and safety within residential facilities. Canadian Journal of Occupational Therapy, 72(3), 142-152.