Wheelchair stability: important,measurable and modifiable

In the United States, each year there are over 36000 wheelchair-related injuries that are serious enough to require the wheelchair user to seek attention at an emergency room, and there are about 50 wheelchair-related deaths. Most of these injuries are due to tips and falls. Of non-institutionalized users of manually propelled wheelchairs, 47% will have sustained injuries due to instability incidents by the time they have used their wheelchairs for 11 years. Static stability can be simply measured using a tilting platform and the procedures of the International Organization for Standardization. Dynamic stability can be evaluated by observing the user negotiate an obstacle course, using an ordinal scale to score each task. A number of easily modifiable parameters that affect wheelchair stability have been documented. The challenge for clinicians, researchers and manufacturers is to find ways to enhance wheelchair safety without unduly interfering with performance or maneuverability.