Community-based wheelchair caster failures call for improvements in quality and increased frequency of preventative maintenance

Anand Mhatre,Mark Schmeler,Jon Pearlman,Benjamin Krider,John Fried

doi:10.1038/s41393-021-00689-3

Abstract

Study designSecondary data analysis of wheelchair failures and service repair logs from a network of wheelchair suppliers.ObjectiveTo determine the frequency of wheelchair caster failures and service repairs across wheelchair manufacturers and models and investigate the relationships between them.SettingWheelchair caster failures and service repairs occurred in the community.MethodsReported caster failure types were classified based on the risk they pose for user injuries and wheelchair damage. Caster failures experienced by users of tilt-in-space and ultralightweight manual wheelchair models and Group 2, 3 and 4 power wheelchair models between January 2017 and October 2019 were analyzed using Chi-Square tests for independence. Correlational analysis of failures and service repairs was performed.ResultsA total of 6470 failures and 151 service repairs reported across four manufacturers and five models were analyzed. Failure types were significantly associated with manufacturers and models, respectively. Users of tilt-in-space wheelchairs, who require greater seating support, experienced twice the proportion of high-risk caster failures than the ultralightweight manual wheelchair users. Similarly, Group 3 and 4 power wheelchair users, who have complex rehabilitation needs, experienced 15-36% more high-risk failures than Group 2 users. Service repairs negatively correlated with high-risk manual wheelchair caster failures.ConclusionsWheelchair users who have greater seating and complex rehabilitation needs are at a higher risk for sustaining injuries and secondary health complications due to frequent caster failures. The study findings call for significant reforms in product quality and preventative maintenance practices that can reduce wheelchair failures and user consequences.

Highlights

Wheelchairs are the primary means of mobility and independence for nearly 70% of people with spinal cord injuries in the United States [1, 2]
Based on a recent report from the Veterans Health Administration, about 40% of wheelchair repairs took more than a month for completion, during which veterans suffered physical and financial hardships [10]
This study aims to perform secondary data analysis of community caster failures across manufacturers and models of wheelchairs reported in the Wheelchair Repair Registry (WRR) [19] and explore their relationships

Summary

Introduction

Wheelchairs are the primary means of mobility and independence for nearly 70% of people with spinal cord injuries in the United States [1, 2]. These assistive devices do not yet meet the user needs fully. 45-63% wheelchairs in use experience one or more failures and/or repairs in a 6-month period and one-third of the failures result in adverse user consequences, including injuries and bruises [4, 6, 7]. Failures are associated with pressure injuries, hospitalization and reduction in self-perceived health [11] It follows that failures negatively impact wheelchair user’s health and can lead to personal and public health burdens

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