Kirby R L, Ackroyd-Stolarz S A, Brown M G, Kirkland S A, MacLeod D A
Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada.
Am J Phys Med Rehabil. 1994 Sep-Oct;73(5):319-30. doi: 10.1097/00002060-199409000-00004.
The purpose of this study was to document what proportion of noninstitutionalized users of manually propelled wheelchairs are affected by wheelchair-related accidents caused by tips and falls, determine the nature and severity of the resulting injuries, and, by comparison with an unaffected group, identify factors associated with the risk of such accidents. We administered a postal questionnaire to as many as possible of the estimated 2055 members of the target population in the province of Nova Scotia. Among the 577 appropriate respondents, 57.4% reported they had completely tipped over or fallen from their wheelchairs at least once, and 66.0% reported having partially tipped. Of the falls and tips that were reported, 46.3% were forward in direction, 29.5% backward and 24.2% sideways. Many of the accidents occurred outdoors or on ramps. A total of 292 injuries were reported by 272 (47.1%) respondents. Most of the injuries (84.3%) were minor (e.g., abrasions, contusions, lacerations and sprains). Of the 15.8% of injuries that were serious, the most common were fractures (10.6%) and concussions (2.7%). Factors that appear to be associated with an increased risk of accidents and injuries included younger age, male gender, paraplegia or spina bifida as the reason for wheelchair use, having had a wheelchair prescribed, some wheelchair features (lightweight, camber, adjustable rear-axle positions, a knapsack), daily use of a wheelchair, propelling the chair with both hands, use of the wheelchair for recreation, use of a sideways transfer (without a transfer board) and doing repairs themselves or having them done by the dealer. Factors associated with a decreased risk include multiple sclerosis, stroke or arthritis as the reason for wheelchair use, attendant propulsion and the use of a one-person assist for transfers. The results of this study, that wheelchair-related accidents caused by tips and falls are very common, that serious injuries are not unusual and that there is a pattern of risk factors, should be useful to wheelchair users, clinicians, manufacturers and regulatory bodies.
本研究的目的是记录手动轮椅非机构化使用者中因轮椅倾翻和摔倒导致的与轮椅相关事故的比例，确定由此造成的伤害的性质和严重程度，并通过与未受影响的群体进行比较，识别与此类事故风险相关的因素。我们向新斯科舍省目标人群中估计的2055名成员尽可能多地发放了邮政问卷。在577名合适的受访者中，57.4%报告他们至少有一次完全从轮椅上翻倒或摔倒，66.0%报告有部分倾翻。在报告的摔倒和倾翻中，46.3%是向前倾翻，29.5%是向后倾翻，24.2%是向侧面倾翻。许多事故发生在户外或斜坡上。272名（47.1%）受访者共报告了292起伤害。大多数伤害（84.3%）为轻伤（如擦伤、挫伤、撕裂伤和扭伤）。在15.8%的重伤中，最常见的是骨折（10.6%）和脑震荡（2.7%）。似乎与事故和伤害风险增加相关的因素包括年龄较小、男性、因截瘫或脊柱裂而使用轮椅、有医生开具的轮椅处方、某些轮椅特征（轻便、外倾、可调节后轴位置、背包）、轮椅的日常使用、双手推动轮椅、将轮椅用于娱乐、使用侧向转移（无转移板）以及自行修理或由经销商修理。与风险降低相关的因素包括因多发性硬化症、中风或关节炎而使用轮椅、由护理人员推动以及在转移时使用一人协助。本研究的结果，即因倾翻和摔倒导致的与轮椅相关事故非常常见、重伤并不罕见且存在风险因素模式，应对轮椅使用者、临床医生、制造商和监管机构有用。
