Safety is a paramount concern. This starts with assuring that a wheelchair user works with the proper individuals, not only in purchasing a chair, but also in assuring that the caregivers and/or the wheelchair user knows how to operate the chair properly. There are 51.3 wheelchair deaths and 36,559 nonfatal wheelchair accidents per year reported in Umat and Kirby’s 1995 article on wheelchair related injuries. Being safe in the chair includes having a chair that fits the user properly to avoid pressure and other injuries. It also includes knowing how to transfer, reach, balance, and propel safely so that the wheelchair becomes an aid to independence and not a threat to health and well-being. The best way to assure safety and prevent injury is to make sure a trained individual teaches the wheelchair user and any involved caregivers how to properly and safely use the wheelchair.
Safety components may include brakes, anti-tippers, grade aids, and belts.
There are numerous brake systems available. The most common form is the push handle style (Fig. 2); the lever on this style can be lengthened to assist someone who is weak or who does not have the strength or reach to apply the conventional style. It is essential that the caregiver and wheelchair user are able to apply and disengage them properly.
Anti-tippers are another safety feature. These prevent backward tips in situations such as when wheeling up a grade. As mentioned earlier the footrest can act as a forward anti-tipper. Grade aids decrease the work of propelling up hill. They also prevent the individual from rolling backwards in such a situation. Belts at the chest or waist level can help a person to safely maintain position in their chair. However, at the same time a user must be careful because they decrease the ability to shift position and if not placed or applied properly can run the risk of slipping or choking. In addition to the components, safe use of a wheelchair lies in the proper set up of a chair for a person to maximize balance and minimize tipping.