Wheelchair Securement and Occupant Restraint: A Cross-Sectional Analysis of Use and Effect on Motor Vehicle Related Injuries

摘要

Objective: The goal of this project was to describe the characteristics related to motor vehicle transportation among wheelchair users, who remain in their wheelchair while in the vehicle. Particular focus was placed on identifying how these individuals utilize occupant restraint and wheelchair securement devices. Also, the study examined the epidemiology of motor vehicle related injuries, and reports on the relationship between these injuries and the identified use of occupant restraint and wheelchair securement systems.Methods: A 12-page survey was completed, via mail, by 336 wheelchair users, who self-reported that they remain seated in their wheelchair at least some point in their transportation use. These individuals were recruited through various nationwide disability related service and advocacy organizations, as well as through disability related internet message boards. Descriptive, chi-square and t-test analysis was completed using SPSS statistical software. Results: The results of this study show that traveling as a private vehicle passenger is the most common manner in which motor vehicle transportation is used by wheelchair occupants, with 70.2% of the sample population reporting to using this mode within the past month and 50.0% reporting this mode as their primary means of transportation. Limited significant difference existed in regard to subject's gender, age, disability or wheelchair type and the reported use of either an occupant restraint device or a wheelchair securement system. There were also limited significant findings seen in regard to the use of either an occupant restraint device or wheelchair securement system and the occurrence/severity of a motor vehicle crash, or non-crash related injury. Finally, in regard to motor vehicle related adverse events that resulted in an injury, descriptive statistics showed that there were limited events (crash: n = 15, non-crash: n = 71), with even less resulting in an injury requiring the need to seek medical attention (crash: n = 10, non-crash: n = 9).Conclusion: This study is one of the first efforts to describe the real-world transportation characteristics of wheelchair-seated passengers, as well as an examination of the relationship between the use of either occupant restraints or wheelchair securement devices and the occurrence of motor vehicle related injuries. These data demonstrate that private vehicles are the most widely used form of motor vehicle transportation, suggesting that research focused in this area may be beneficial. Also, limited significant findings were seen in regard to the relationships between the use of either an occupant restraint or wheelchair securement, independent of each other, and the occurrence of motor vehicle related injuries. These results may be interpreted in two ways 1) that these safety systems are not being used effectively, or 2) that use of an occupant restraint and wheelchair securement independent of one another may not reduce injury risk in a motor vehicle crash or non-crash incident. The analysis of the use of a 3-point occupant restraint, together with a forward facing wheelchair securement system, as recommended by the SAE J2249, may produce different results. It should also be noted that based on descriptive statistics alone, it is evident that for those individuals who were injured severely enough in a non-crash incident to require medical attention, there was limited reported usage of wheelchair securement and occupant restraints. These findings may suggest that the use of such devices may decrease the number of severe non-crash related injuries. Based on the limitations of this study and trends seen within the descriptive statistics, more research in this area is required to develop more inferential findings between the use of these devices and the occurrence of injuries related to motor vehicle transportation.