Recommendations on Standards for the Design of Medical Diagnostic Equipment for Adults with Disabilities, Advisory Committee Final Report

Studies of Wheeled Mobility Devices and Transferring Abilities

Accessible medical equipment needs to facilitate safe transfers that accommodate the largest possible portion of people with disabilities, including people who use wheeled mobility devices. The safest and most easily accessible transfers are those with no or very little horizontal and vertical distance between the seat of the wheelchair and the transfer surface. Specifically, transferring to a higher surface applies greater exertion of the upper limbs.¹

A study of wheeled mobility devices, including manual wheelchairs, power wheelchairs, and scooters examined the seat height of 495 users. The height was measured as the vertical distance from the floor to the lowest point of the seating surface of the mobility device, while the occupant was seated in the device. Thus, the surface of the mobility device was in a compressed state. The study noted that a range of 17 inches -25 inches accommodates the vast majority of wheeled mobility device users, while continuing to exclude 6% of manual wheelchair users whose devices are lower than 17 inches. Increasing the low end to 19” height excludes many users, specifically over 30% of female manual chair users and over 15% of male manual chair users.²

There is limited information on the ability of people with disabilities to transfer to a height different from the height of their wheeled mobility device. The Impact of Transfer Setup on the Performance of Independent Transfers: Final Report provides an analysis of the effect of height, horizontal gap, placement of armrests, and placement of grab bars on a person’s ability to transfer. The study noted that 86% of wheeled mobility device users could transfer to heights that were 2 inches above and below the height of their wheeled mobility device. However, this study was not representative of the diversity of wheeled mobility device users. Individuals were explicitly excluded from the study if they had significant upper extremity pain or injury that affects the ability to perform transfers, or had an active or recent history of pressure sores. Furthermore, the vast majority of subjects in the study were men.³ Numerous research studies as well as anecdotal reports from people with a variety of mobility disabilities (spinal cord injury, cerebral palsy, polio, traumatic brain injury, etc.) have detailed and reinforced that fact that people who live with disability experience a greater prevalence of and earlier onset of age related conditions such as arthritis, pain contractures, weakness, deconditioning, and shoulder injuries etc.⁴

^1.The Impact of Transfer Setup on the Performance of Independent Transfers: Final Report. Presentation to US Access Board. Washington, DC. 2011

^2. D’Souza, Clive and Edward Steinfeld, IDeA Center. Analysis of Seat Height for Wheeled Mobility Devices. 2011.

^3. The Impact of Transfer Setup on the Performance of Independent Transfers: Final Report. Presentation to US Access Board. Washington, DC. 2011

^4. Jensen, M.P., Molton, I.R., Groah, S.L., Campbell, M.L., Charlifue, S., Chiodo, A., Forchheimer, M., Krause, J.S., & Tate, D. (2011). Secondary Health Conditions in Individuals Aging with SCI: Terminology, Concepts, and Analytic Approaches. Spinal Cord, 50(5): 373-378.

Groah, S.L., Charlifue, S., Tate, D., Jensen, M.P., Molton, I.R., Forchheimer, M., Krause, J.S., Lammertse, D.P., & Campbell, M. (2012). Spinal Cord Injury and Aging: Challenges and Recommendations for Future Research. American Journal of Physical Medicine & Rehabilitation, 91(1): 80. doi: 10.1097/PHM.0b013e31821f70bc. Available from: http://journals.lww.com/ajpmr/Abstract/2012/01000/Spinal_Cord_Injury_and_Aging__Challenges_and.10.aspx. Accessed December 18, 2012.

Turk M. Secondary conditions and disability. In: Field MJ, Jette AM, Martin L (eds). Workshop on disability in America. A new look. Summary and background papers. Board on Health Sciences Policy, Institute of Medicine of the National Academies, The National Academies Press: Washington DC, 2006, pp. 185–193.

Kemp, B.J., & Mosqueda, L. (Eds.) (2004). Aging with a Disability: What the Clinician Needs to Know. Baltimore, MD: Johns Hopkins University Press.

Kailes, J. (2000). Health, Wellness and Aging with Disability, KAILES - Publications, http://www.jik.com/resource.html, jik@pacbell.net This email address is being protected from spambots. You need JavaScript enabled to view it. .

Kailes, J. (1995). "Midlife Cripdom: Getting Fewer Miles per Gallon?" The Disability Rag 16(4).

Kailes, J. (2001). Aging with Disability - Good News and Bad News. Western U-View. XX: 17.