Hand forces exerted by long-term care staff when pushing wheelchairs on compliant and non-compliant flooring

The SAFEST review: a mixed methods systematic review of shock-absorbing flooring for fall-related injury prevention

“…Push and pull tasks have been explored in biomechanical studies, highlighting the increased forces required to move wheeled equipment [36,102,103]. The biomechanical literature complements our findings, and highlights the important interactions between equipment types, flooring materials, and pushing forces required, indicating the potential for risk mitigation strategies to help prevent adverse events.…”

Shock-absorbing flooring for fall-related injury prevention in older adults and staff in hospitals and care homes: the SAFEST systematic review

“…Further biomechanical studies have been conducted on pushing tasks involving floor-based lift devices and wheelchairs. 25,127,150 One of these studies demonstrated increased pushing forces for a novel underlay (Sorbothane™, Sorbothane, Leyland, UK) that was not evaluated by any of the studies in the present review and is not in widespread use as a flooring material. 127 Both carpet and novel underlay (SmartCells) have been shown to increase the pushing forces required to initiate and sustain a manual wheelchair and floor-based lift; however, the addition of carpet has been shown to be more influential than a novel underlay to the measured hand forces.…”

“…127 Both carpet and novel underlay (SmartCells) have been shown to increase the pushing forces required to initiate and sustain a manual wheelchair and floor-based lift; however, the addition of carpet has been shown to be more influential than a novel underlay to the measured hand forces. 25,150 Long-term care staff's subjective ratings of pushing difficulty across different flooring conditions were all low for wheelchairs and motor-driven lifts (< 3 points on a 5-point scale), 25,150 and higher for conventional lifts on carpet with or without shock-absorbing underlay. 25 It is considered significantly more difficult to wheel objects across carpet than across vinyl on concrete subfloors, 25,150 and, although the introduction of a novel underlay did not significantly influence subjective difficulty ratings for wheelchairs and motor-driven lifts, 25,150 it did for conventional lifts.…”

“…25,150 Long-term care staff's subjective ratings of pushing difficulty across different flooring conditions were all low for wheelchairs and motor-driven lifts (< 3 points on a 5-point scale), 25,150 and higher for conventional lifts on carpet with or without shock-absorbing underlay. 25 It is considered significantly more difficult to wheel objects across carpet than across vinyl on concrete subfloors, 25,150 and, although the introduction of a novel underlay did not significantly influence subjective difficulty ratings for wheelchairs and motor-driven lifts, 25,150 it did for conventional lifts. 25 For conventional lifts, 25 carpet with or without the novel shock-absorbing underlay exerted forces above recommended tolerance limits.…”

A comparison of floor surfaces for injury prevention in care settings: impact forces and horizontal pulling force required to move wheeled equipment

“…One possible solution could be to use larger wheels; ideally the wheels, furniture and floor surfaces should be considered together as a system. Lachance et al, found that novel shock-absorbing flooring increased the initial and sustained forces required to push floor-based lifts and subjective ratings of difficulty compared to concrete flooring, and that compared to a conventional lift, a motor-driven lift substantially reduced initial and sustained push forces and perceived difficulty of pushing for all four floors assessed and both resident weights [34]. It is also interesting to note that other floor constructions, for example suspended wooden flooring, can have a similar level of compliance to the floors tested in this study and have the potential to provide significant protection against fall injuries [47][48].…”