Spatial consumption and risk of lower back disorder during assisted toilet transfers on board an aircraft Public Deposited

http://ir.library.oregonstate.edu/concern/graduate_thesis_or_dissertations/c247dw18s

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  • A major barrier to air travel for people with disabilities is the general lack of accessible lavatories on board commercial passenger aircraft. A primary reason for this lack of greater accessibility is related to space. To design an airplane lavatory that is accessible, minimizes the risk of injury to both the transferor and transferee to the extent possible, and is still consistent with the restrictive spatial requirements of airplane environments requires a broader understanding as to how the relative angle of the wheelchair to the toilet affects assisted toilet transfers. This study investigated how the wheelchair-to-toilet angle affects both the spatial consumption required for assisted toilet transfers and the risk of injury to the transferor and transferee. Twenty-nine participants (transferors) were motion captured in a laboratory environment while conducting assisted toilet transfers using a pivot transfer technique at relative wheelchair-to-toilet angles of 0º, 45º, 90º, and 180º. A 95th percentile male dummy represented the transferee. A novel, three-dimensional computer-based spatial mapping technique was developed to compute the spatial volume requirements of assisted toilet transfers from the motion capture data. The wheelchair-to-toilet angle directly affected the total spatial volume needed to conduct an assisted toilet transfer. The total rectangular area required to perform an assisted toilet transfer using a pivot transfer technique progressively increased as the wheelchair-to-toilet angle rose from 0º to 180º. However, the three-dimensional volume required for an assisted transfer differs between transfer angles, is non-rectangular, and varies in spatial area over the height of the transfer volume. The wheelchair-to-toilet angle also affected the magnitude of the transferor's kinematic risk factors for lower back disorder. Eight of the fourteen analyzed kinematic risk factors for lower back disorder were affected. Of these risk factors, the wheelchair-to-toilet angle primarily affected the transferor's odds of being at high risk of lower back disorder through its effect on the transferor's maximum load moment arm. Surprisingly, the magnitude of the transferor's maximum load moment arm was inversely related to the wheelchair-to-toilet angle. After accounting for the effects of the wheelchair-to-toilet angle and the direction of assisted transfer, associations were also found between the transferor's kinematic risk factors for lower back disorder and the transferor's standing height. The results of this study suggest that accessible lavatories can be designed for use in constrained environments by designing the lavatory to support assisted transfers at a single optimal wheelchair-to-toilet angle. The results further suggest that, in using a pivot transfer technique, the 180º orientation is an optimal transfer orientation. Finally, it is suggested that transferors short in stature and physically capable of conducting assisted transfers should be preferentially selected to assist in assisted transfers, as they are predicted to have a lower risk of lower back disorder than taller transferors. This study investigated how the wheelchair-to-toilet angle affects both the spatial consumption required for assisted toilet transfers and the risk of injury to the transferor and transferee. Twenty-nine participants (transferors) were motion captured in a laboratory environment while conducting assisted toilet transfers using a pivot transfer technique at relative wheelchair-to-toilet angles of 0º, 45º, 90º, and 180º. A 95th percentile male dummy represented the transferee. A novel, three-dimensional computer-based spatial mapping technique was developed to compute the spatial volume requirements of assisted toilet transfers from the motion capture data. The wheelchair-to-toilet angle directly affected the total spatial volume needed to conduct an assisted toilet transfer. The total rectangular area required to perform an assisted toilet transfer using a pivot transfer technique progressively increased as the wheelchair-to-toilet angle rose from 0 to 180 degrees. However, the three-dimensional volume required for an assisted transfer differs between transfer angles, is non-rectangular, and varies in spatial area over the height of the transfer volume. The wheelchair-to-toilet angle also affected the magnitude of the transferor's kinematic risk factors for lower back disorder. Eight of the fourteen analyzed kinematic risk factors for lower back disorder were affected. Of these risk factors, the wheelchair-to-toilet angle primarily affected the transferor's odds of being at high risk of lower back disorder through its effect on the transferor's maximum load moment arm. Surprisingly, the magnitude of the transferor's maximum load moment arm was inversely related to the wheelchair-to-toilet angle. After accounting for the effects of the wheelchair-to-toilet angle and the direction of assisted transfer, associations were also found between the transferor's kinematic risk factors for lower back disorder and the transferor's standing height. The results of this study suggest that accessible lavatories can be designed for use in constrained environments by designing the lavatory to support assisted transfers at a single optimal wheelchair-to-toilet angle. The results further suggest that, in using a pivot transfer technique, the 180º orientation is an optimal transfer orientation. Finally, it is suggested that transferors short in stature and physically capable of conducting assisted transfers should be preferentially selected to assist in assisted transfers, as they are predicted to have a lower risk of lower back disorder than taller transferors.
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