2/26/2013. Agenda: Access Considerations: Ramp Use. Vehicle Access: Structural Modifications & Height Considerations

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Martin Potter
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1 Wheelchair Configuration as it Relates to Transportation and the Driving Task 29 th International Seating Symposium March 8, 2013, Nashville, TN Wes L. Perry, ATP, CDRS, MSBME C. Dan Allison Jr., MS OTR/L, ATP, CDRS Services, Research, and Training in Rehabilitation Engineering and Assistive Technology Agenda: Wheelchair equipment and vehicle technology considerations as they pertain to... Vehicle access Wheelchair transport Driving Wheelchair and occupant securement The presentation will also include a comparison of WC19 versus related ISO standards. Vehicle Access: Structural Modifications & Height Considerations Raised roof and doorway Clearance height (additional ~4 to 12 ) Lowered floors Clearance height & changes eye level Approximate doorway clearances * Ford full-size van: ½ Minivans (side entry): 52 ½ 56 ½ Wheelchair considerations Overall seat height ~ rear seat height and cushion thickness Use of recline or tilt Easily removable or flip-back headrest Access Considerations: Ramp Use From the wheelchair equipment perspective Wheel configuration for efficient propulsion Appropriate COG setting Consider use of Anti-tips Grade aids Propulsion assist wheels From the vehicle perspective Kneeling Specialty equipment * Reference: Vehicle Access: Wheelchair Considerations Wheelchair width Wheelbase must fit on the ramp or platform Overall width must clear the passageway Note: Lift arms are often the limiting factor Wheelchair length Fitting on the platform Footrests clearing the rollstop Wheelchair weight Lift or ramp capacity Access Considerations: Maneuverability From the wheelchair perspective Turning radius Length relative to propulsion/power wheels Frame length Hanger length and angle Footprint (overall width and length) Caster configuration Legrest configuration From the vehicle perspective Van>minivan, MV-1>other (truck, Element, PT Cruiser, Scion) Consider a rear entry minivan 1

2 Vehicle Access: Transfer Issues Wheelchair equipment considerations Seat height Set at the appropriate height for vehicle transfers Consider power elevating seat Removable or flip-back armrests Wheel size (height above seat) and position Seat cushion type Vehicle Equipment: Access Transfer seats Platforms Other specialty equipment Self-loading of manual wheelchair Consider weight Folding-frame vs Rigid Unoccupied wheelchair transport Will the equipment fit? Consider clearance of docking device How much does it weigh? Lift capacity vs. vehicle limits Durability Additional note on overall weight Gross Vehicle Weight Rating (GVWR) Revised Payload Capacity For example 1050 to 1600 pounds for most current loweredfloor minivans * * This is improved compared to past figures Driving Equipment: Primary Controls Primary driving controls are operated while the vehicle is in motion and directly affect control of the vehicle. Steering Accelerator Brake Driving Equipment: Steering Controls Modified effort Different wheel sizes Control extensions 2

3 Driving Equipment: Gas/Brake Controls Mechanical Hand Controls Steering column vs. floor-mounted Action of movement Push/90 pull Push/rock Push/pull Push/twist High-Tech Primary Controls Lower strength and ROM More freedom of placement Driving Equipment: Secondary Controls Other in-vehicle functions are termed secondary controls. Examples include Turn signals Lights/Dimmer switch Horn Gear shifter Park Brake Driving Equipment: Secondary Controls Adaptations include Physically modifying the existing interface Switch access Direct select Audible scanning Voice Failing to consider seating and positioning at the same time as driving rehabilitation can lead to the creation of new barriers to access but more critically can lead to driving errors, which can have much more severe consequences than physical control errors in a stationary environment. For Driving Two issues that need to be considered 1) The environmental constraints of fitting a person and their wheelchair into a motor vehicle. 2) Achieving a functional seating position that allows for; a stable, dynamic, relaxed posture from which the person is able to engage in the occupation of driving Access for the Driver: Wheelchair Considerations An inch can be as far as a mile when it comes to vehicle access and control. Height Eye ellipse Length Distance from controls Visibility issues Width Behind-the-wheel access Offset to controls Seatbelt issues!!! 3

Knee Clearance & Mechanical Hand Controls Wheelchair equipment considerations Front seat height Front caster and fork size Leg length and hanger angle Presence of power positioning Cushion thickness

position or posture they adopt is critical in terms of their ability to perform everyday tasks.

4 Knee Clearance & Mechanical Hand Controls Wheelchair equipment considerations Front seat height Front caster and fork size Leg length and hanger angle Presence of power positioning Cushion thickness From the vehicle equipment perspective Some controls offer more clearance Newer right-angle designs Push-rock, Push-pull, Push-twist Seating and Positioning For people who use wheelchairs; the position or posture they adopt is critical in terms of their ability to perform everyday tasks. This is especially true and magnified for wheelchair drivers Proximal Stability = Distal Mobility A further challenge The dynamic nature of the driving environment Maximizing accuracy of movement of the vehicles controls by the human user in the presence of unexpected acceleration (and deceleration). Movement and acceleration of the vehicle can cause reduction in performance in all human movement, especially when trunk and limb strengths are reduced. Think about being in your own vehicles Visualize with me Driving from a wheelchair Your left hand on the gas/brake Your right hand on the spinner knob at 2:00 o clock You go into a left hand curve a little hot (fast) What happens???????? Postural Stability This proximal stability I keep bringing up, it s impact is so critical; so what can we do? Tilt back and dump seat (back and seat closer together), to squeeze and stabilize driver If on a ROHO or similar cushion, may need postural support as well Torso support belt (IMEC) May even consider a 4 or 5 point harness Postural Stability Lateral supports many options available, both wheelchair and vehicle mounted 4

Wheelbase and Seating System Stability Given the dynamic nature of the vehicle environment, stability of the wheelbase and seating system is essential for driving.

four-post Use of power seating features Consider the wheelchair suspension Adjustments Equipment options (e.g. stabilizers) Wheelbase vs.

Securement Equipment and Issues to Consider Manual tiedown straps Transport brackets Consider use of webbing straps Securement Equipment Issues: Seat belts Wheelchair issues related to seat belt fit

Front-end Stabilizer for drivers (EZ Lock) Footrest clearance and/or split footrests The Update: Volume 4 Wheelchairs and Transportation WC18: Wheelchair Tiedown and Occupant Restraint Systems

5 Wheelbase and Seating System Stability Given the dynamic nature of the vehicle environment, stability of the wheelbase and seating system is essential for driving. Stability from the docking device Mechanical link between the seating system and wheelchair Single vs. four-post Use of power seating features Consider the wheelchair suspension Adjustments Equipment options (e.g. stabilizers) Wheelbase vs. seating suspension Arm Support considerations Before Allowing proper seat belt placement Allowing access to driving controls Alleviating fatigue Arm rest was not compatible in vehicle After Securement Equipment and Issues to Consider Manual tiedown straps Transport brackets Consider use of webbing straps Securement Equipment Issues: Seat belts Wheelchair issues related to seat belt fit Armrest interference Wheelchair length and position of driver Wheelchair height and position of driver Power docking stations Bracket availability Impact on a manual wheelchair Footrest clearance Front-end Stabilizer for drivers (EZ Lock) Footrest clearance and/or split footrests The Update: Volume 4 Wheelchairs and Transportation WC18: Wheelchair Tiedown and Occupant Restraint Systems (WTORS) for Use in Motor Vehicles WC19: Wheelchairs Used as Seats in Motor Vehicles WC20: Wheelchair Seating Systems for Use in Motor Vehicles WC18: WTORS for Use in Motor Vehicles Adds: A new symbol for a compliant product Adds: Several informative annexes that give information on how to procure, measure or account for events during testing, e.g., the excessive foot movement of ATDs during crash testing 5

WC19: Wheelchairs Used as Seats in Motor Vehicles Increases: Emphasis on improving belt restraint use and fit Introduces: The concept of UDIG (Universal Docking Interface Geometry) for wheelchairs

6 WC19: Wheelchairs Used as Seats in Motor Vehicles Increases: Emphasis on improving belt restraint use and fit Introduces: The concept of UDIG (Universal Docking Interface Geometry) for wheelchairs Wheelchairs for children as small as 26 lbs More explicit about designing wheelchairs for docking systems, including UDIG UDIG can be integrated into wheelchair design or an add on component WC20: Wheelchair Seating Systems for Use in Motor Vehicles Applies to complete wheelchair seating systems comprised of seat, back support and attachment hardware. Does not apply to a seating system with an integrated frame in which seat and back cannot be separated Wheelchair and Occupant Securement: Wheelchair Standards ANSI/RESNA WC19 vs. ISO Scope of wheelchairs covered Design and performance requirements Pass/fail criteria Will the next chair you prescribe; 1. Allow access into the clients desired vehicle? 2. Does the client and/or caregiver know how to secure that wheelchair and the occupant? 3. Will the wheelchair fit in the drivers compartment if they plan to drive from their wheelchair? 4. Will the wheelchair accept a docking system? a) Will the roll out drivers seat still roll back in the drivers area for an able bodied person to drive from? 5. Will the occupant restraints fit the client properly: across the hips/sternum? 6. If the client has compromised trunk control, will the prescribed chair be able to accept laterals if used for driving? 7. Last but not least, will it be WC-19 compliant. The key is to know where to look! Lets look at some examples of things we have discussed 6

7 Resources ADED: The Association for Driver Rehabilitation Specialists National Highway Traffic Safety Administration National Mobility Equipment Dealers Association Nor-Cal Mobility: Vehicle Selection 101 (review article) Thank You! Additional resources for wheelchair transportation: The Rehab Engineering and Research Center on Wheelchair Transportation Safety School Transportation News Magazine Questions? 7

Wallaby Wheelchair. Item #s: WB1200-2GFR, WB1400-2GJB. Accessories WB ELR - Elevating Leg Rests WB Headrest Extension STDS833N - Anti-Tippers

Wallaby Wheelchair. Item #s: WB1200-2GFR, WB1400-2GJB. Accessories WB ELR - Elevating Leg Rests WB Headrest Extension STDS833N - Anti-Tippers by Wallaby Wheelchair Item #s: WB1200-2GFR, WB1400-2GJB Accessories WB ELR - Elevating Leg Rests WB 8021 - Headrest Extension STDS833N - Anti-Tippers EU Authorized Representative Drive Medical LTD Introduction