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

Abstract

Study design Secondary data analysis of wheelchair failures and service repair logs from a network of wheelchair suppliers. Objective To determine the frequency of wheelchair caster failures and service repairs across wheelchair manufacturers and models and investigate the relationships between them. Setting Wheelchair caster failures and service repairs occurred in the community. Methods Reported 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. Results A 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. Conclusions Wheelchair 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.

Older Wheelchair Users Recommend Age-Friendly Design Improvements to a Wheelchair Maintenance App: Mixed Methods Development Study

“…Preventative maintenance reduces the frequency of wheelchair failures and breakdowns, thus preventing adverse health consequences to older users [ 7 , 16 , 17 ]. To encourage maintenance practices and compliance, we are leveraging the existing capabilities of smartphones and sensors and developing an mHealth app called WheelTrak.…”

“…Unfortunately, although wheelchairs play a significant role in the lives of older adults and people with locomotor disabilities, they are known to break down frequently. Cross-sectional study findings over the past 2 decades show that approximately 45% to 88% of wheelchair users experience wheelchair part failures every 6 months owing to failures of wheelchair casters, rear wheels, brakes, frames, and seating systems [2][3][4][5][6][7]. Comparatively, in low-and middle-income countries, where rehabilitation services are scarce and outdoor environments are adverse, part failures occur every 2 to 3 months [8][9][10][11][12][13].…”

“…Community-based and secondary data analysis studies [ 7 , 16 , 17 ] and the World Health Organization’s guidelines [ 18 ] recommend preventative wheelchair maintenance to avoid failures that can lead to breakdowns, which make the wheelchair dysfunctional. A randomized controlled trial with 216 manual wheelchair users found that active checkups and maintenance in 12 months led to no wheelchair accidents in the treatment group [ 17 ].…”

Accelerated wear testing shows that thermoplastic bushings could be a cost-effective and durable alternative to traditional bearings for wheelchair caster use

“…7 , 9 , 10 Recent wheelchair failure data collection studies have found that caster stem bearings fracture within 2 years of use in adverse environments as well as in resourced settings. 11 , 12 Models like Matching Person and Technology highlights that a lack of consideration for an individual’s needs can lead to improper use, total abandonment, or injury. 13 These premature and frequent failures of wheelchair caster bearings can be attributed to a lack of consideration of individuals’ specific environments during product design, testing, and assessment.…”

“…Cost-reduction engineering practices in the wheelchair industry may have led to design and selection of low-cost, substandard caster parts that experience different failure modes including seized bearings, damaged bolts, fractured wheels and forks and worn-out tires and fasteners. 10 , 11 Stem and axle bearings are subjected to rapid fatigue and stress as wheelchairs are exposed to corrosion, shocks, high temperatures, and dirt especially during use in adverse environments. 14 , 15 Bearing fractures can lead to a cascade of high-risk failures with caster stems, bolts, and forks as they experience stresses higher than the ultimate tensile strength of their materials.…”