Wheelchair-related accidents caused by tips and falls among noninstitutionalized users of manually propelled wheelchairs in Nova Scotia.

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.