Wednesday, September 30, 2020
Wheeled Mobility Devices Used as Seats in Motor Vehicles – what do we need to know?
Last week we looked at ISO standards – the history behind these and how they apply to wheelchairs. This week we are looking at one particular standard – ISO 7176-19:2008 - Wheeled mobility devices used as seats in motor vehicles. This standard is similar to the ANSI/RESNA WC19 standard, the recommended standard in North America, often referred to as WC19. The standards surrounding wheelchairs and their safety for use as seats in vehicles is something therapists need to be aware of when prescribing wheelchairs for those who need to remain seated in their wheelchairs when traveling in a vehicle. The ISO 7176-19 is deemed the minimum standard for wheelchairs that are used as seats in vehicles, while the ANSI/RENSA WC-19 has additional components to optimise wheelchair users safety.
When we purchase a vehicle, we are presented with information as to how safe that car is likely to be in the event of an accident, for example a particular car may have an ANCAP (Australasian New Car Assessment Program) star rating telling us how well the car performed under crash testing, with a five star rating being a safer vehicle. Manufacturers reduce the risk of death and injury in motor vehicle crashes using a systems approach to occupant protection, in which the vehicle, the vehicle seat and occupant restraint system (ie seat belt) each to contribute to a safety system.
For wheelchair users who remain seated in the wheelchairs while travelling in their vehicles, a similar systems approach is also used, incorporating the wheelchair restraint system in the vehicle, the wheelchair and seating itself, and again the occupant restraint system.
The wheelchair restraint system and the occupant restraint system are installed into vehicles by a person certified to complete the modifications to the relevant standard, with the modifications completed being appropriate to the wheelchair used – for example use of a hoist and tie down system that is rated for the type of chair used, with a power wheelchair requiring different specifications to a manual chair.
The safety of wheelchair users while travelling in a vehicle is dependent on the wheelchair restraint and seat belts being used appropriately, for failure to do so can result in injury in situations where occupants seated in the standard vehicle seat may not be harmed at all. Potentially a wheelchair that is not restrained properly in a vehicle can tip over if the vehicle turns sharply, or a seat belt that is not applied correctly can mean the occupant can come out of their seat and injure themselves on the interior of the vehicle if the vehicle stops suddenly.
Photo 2 source https://education.nsw.gov.au/public-schools/astp/contractors/safety-requirements
The use of these restraints is complemented by use of a wheelchair that meets the ISO7176-19 or WC19 standard to reduce the risk of injury to the end user. The test for this standard is to subject the chair a forward facing crash test at 50km/hr with a 70kg crash test dummy. This test is typically tested with the seating system associated with this chair, however after market seating products can be tested by the WC20 standard to establish their safety under crash conditions. Chairs that meet the WC19 often use tie down points on the chair, these being four permanently labelled, easily accessible securement point brackets, however docking systems such as Ezi-lock and Dahl are also an option for some users. Other aspects of the ISO 7176-19 and WC19 standards include use of seating systems that allow the seat belt to be positioned effectively and that there are that there are no sharp edges on the chair that may cause damage to either tie down points or the vehicle occupant restraint system.
A person remaining in their wheelchair seat is often seen as a convenient means of travel, however use of the vehicle’s standard seat is considered the safest option for a person to travel. Prior to considering vehicle modifications, questions to consider are
- How well can the person transfer in/out of their wheelchair? Can they safely transfer into the manufacturer installed car seat? This may involve use of a mobility vehicle to allow the person (and their chair) to be transferred up into the vehicle, where they can then transfer into the standard car seat and their chair be restrained for unoccupied travel.
- For young children, or those who require assistance to transfer, the risk of injury to the carer when transferring the child/person in/out of the car seat needs to be weighed up against the risk of travelling in the wheelchair – where for many people, the risk of injury during the transfer outweighs the potential risk from travelling in their wheelchairs.
If travelling in a wheelchair has been established to be the safer solution for the end user, considerations for the wheelchair include
- What standard has the chair been certified to? Has the chair been certified for occupied travel? Some chairs are only certified for un-occupied travel, meaning it is not intended that the end user remain in the chair while travelling in a vehicle. Information as to what standard the chair has been tested to is included in each chair’s user manual, or can be obtained from the dealer or supplier.
- If a docking system is to be used, has the docking system been tested for the model of chair you are considering?
- Chairs that are custom built, eg custom manual wheelchairs, may not be certified for crash testing, but may have the features that the standards recommend. The benefits and challenges of these chairs need to be discussed with the end users to ensure that they are making an informed choice about the crash testing status of these chairs.
- The pelvic positioning belts and/or harnesses used as positioning aids on the seating system are not intended for use as a vehicle restraint, although may be used in addition to the vehicle restraint system to ensure the user maintains an optimal position while travelling in their vehicle.
- While travelling in the vehicle, ideally the end user requires access to a head support to prevent injury to their neck in the event of an accident. For some users, this may be installed as part of the vehicle modifications (eg for those driving their vehicles) however others may require a head support attached to their chair as part of their seating system. When the head support is attached to the wheelchair, consideration needs to be given to how it is mounted – for example if mounted to the back support, the back support needs to be of sufficient height for the mounting to be effective.
When the wheelchair is in the vehicle
- The wheelchair needs to be restrained using the appropriate restraint system – for example use of tie downs attached to the identified tie down points on the chair.
- The person travelling in the wheelchair then also needs to be restrained using a certified three-point belt, to ensure they remain in their chair in the event of an accident. Some wheelchair manufacturers offer the ability to fit a vehicle certified hip belt that a shoulder belt may attach to in a vehicle for ease of fitting.
A person being able to use their wheelchair as a seat in a vehicle can be the difference between being able to access the community or needing to stay home, and use of standards can help keep wheelchair users as safe as possible while travelling in their chairs.
For further information please see
ANSI/RESNA WC19 - http://wc-transportation-safety.umtri.umich.edu/crash-tested-product-lists/wheelchairs
RESNA Position Statement on Wheelchairs used as Seats in Motor Vehicles - https://www.resna.org/Portals/0/Documents/Position%20Papers/RESNAPositiononWheelchairsUsedasSeatsinMotorVehicles.pdf
Vehicle modifications
Mobility Engineering Australia - https://www.mobilityengineering.com.au/
Low Volume Vehicle Technical Association - https://www.lvvta.org.nz/documents.html#standards
Safety Ratings of Motor Vehicles - https://rightcar.govt.nz/safety-ratings
Rachel Maher
Clinical Education Specialist
Rachel Maher graduated from the University of Otago in 2003 with a Bachelor of Physiotherapy, and later gained her Post Graduate Diploma in Physiotherapy (Neurorehabilitation) in 2010.
Rachel gained experience in inpatient rehabilitation and community Physiotherapy, before moving into a Child Development Service, working with children aged 0 to 16 years.
Rachel later moved into a Wheelchair and Seating Outreach Advisor role at Enable New Zealand in 2014, complementing her clinical knowledge with experience in NZ Ministry of Health funding processes.
Rachel joined Permobil in June 2020, and is passionate about education and working collaboratively to achieve the best result for our end users.