(Electric Scooters
for Disabled People)
by the National Institute for
Rehabilitation Engineering
The National Institute for Rehabilitation
Engineering (NIRE) is a non-profit organization which operated clinics
to design, dispense and fit customized assistive equipment from 1967 through
1996. Working with disabled people and their own doctors and therapists,
these NIRE clinics assisted hundreds of people having severe and permanent
motor impairments. The N.I.R.E. pioneered the development and use of power
wheelchairs and MOTORIZED SCOOTERS.. During these years, a great deal
was learned concerning USER SAFETY. This paper explains many safety issues
and is intended to assist Motorized Scooter users, new and old. PERMISSION
is herewith granted for the free copying and distribution of this ©
paper, provided all copies are complete and unaltered and that The NIRE
is fully credited as the source.
THIS PAPER is for disabled people using,
or considering the use of a Motorized Scooter as an alternative
to a power wheelchair. It is said that "knowledge is power"
and this is especially true for electric scooter users ... because of
the safety issues. The user who knows about and understands the various
safety issues will enjoy more varied uses of his scooter, and more peace
of mind, than the person who must limit his uses out of fear of being
injured. Motorized scooters are seen by some people as offering advantages
over power wheelchairs. This may be true for some people - but not for
others. Serious safety questions must be considered in choosing one or
the other.
MOTORIZED SCOOTERS vs POWER WHEELCHAIRS
Comparisons are between "light, foldable
power wheelchairs" and "motorized scooters." Both have
small wheels in front - the typical wheelchair has two small casters in
front, on opposite sides - the typical scooter has one small, steerable
wheel centered in front. Both have similar outdoor-use limitations. Heavy
duty outdoor, stand-up, and stair-climbing wheelchairs cannot be compared
with any type of motorized scooter.
Comparative Costs: Motorized Scooters
typically cost less than light-weight, foldable, Power Wheelchairs. The
scooter may cost up to twenty percent less to buy. Ongoing maintenance
costs, however, are about the same for both.
Transportability & Storability:
Both types of vehicles can be partially disassembled and folded for compact
storage, or transportation in the trunk of a car. Scooter and wheelchair
weights may be comparable or the wheelchair may be slightly heavier depending
on its construction. Both vehicles carry a storage battery. Only the wheelchair
can be transported in a van with the user seated in it. This is not feasible
for a scooter.
Appearances: Motorized Scooters appear
quite different than Power Wheelchairs. The scooters are usually smaller
and lighter-weight. Scooters may be favored by some people because they
look, to others, more like recreational vehicles than medical equipment.
Some people - mostly those with mild disabilities - have the option
of choosing either a motorized wheelchair or a motorized scooter. (Those
with more severe disabilities must pass on the scooter and take the wheelchair.)
Comparative Features: Most power
wheelchairs have at least four wheels; some have more. Some have
small wheels in front and large wheels in back ... and are better suited
for indoor use. Others have large wheels in front and smaller ones in
back ... and are better suited for outdoor use. The wheels are widely
spaced, opposites usually being on opposite sides of the wheelchair. This
gives the wheelchair increased stability and safety, lessening the likelihood
of rollover accidents. Motorized scooters often lack this stability.
Most power wheelchairs are propelled by two
motors, one on each side. One motor drives one wheel and the other motor
drives the other wheel. Power wheelchairs are steered by the user, using
his fingers to move a small control stick forward, backward, left, or
right to control speed and direction of travel. People so severely disabled
that they cannot reliably operate the small joystick control can be fitted
with high-technology (quadriplegic) controls that sense changes in breath
... or eye movements ... to steer and control the power wheelchair. Special
quadriplegic controls require intensive mobility and safety training for
each user. They are available for power wheelchairs, only - not for motorized
scooters. In addition to the special controls available for severely
disabled people, power wheelchairs can be dispensed with electric user-controlled
elevating legrests, back and head supports, etc. - not available to scooter
users. Wheelchairs often feature removable sides to facilitate sideways
transfer in and out, via a sliding transfer board - not available to
scooter users. The use of four wheels stabilizes the wheelchair to
make such transfers safe for the severely disabled wheelchair user. Scooters
often have only 3 wheels and lack such stability.
Most motorized scooters have
three wheels and use mechanical steering. The typical design has two widely
spaced wheels in the rear, across from each other. A single or double-width
wheel is in front, attached to a tiller, handlebar or steering wheel.
The entire scooter looks a little like a child's tricycle - a major difference
being that the scooter has smaller wheels. A child's tricycle has a saddle
seat which is unsuitable for most disabled people. The scooter has a larger
seat which gives much more support than a saddle seat on a tricycle. The
scooter seat may or may not have armrests and/or a back support. Often,
the seat has to be customized for a particular user. If possible,
order a scooter offering 4-wheel stability. Some are available!
The scooter's handlebar, tiller or steering
wheel is used for manually steering the scooter. Because the scooter has
only 3 functional wheels, it can turn over if the user leans heavily forward
and/or to one side. This can happen while riding, especially if a tilted
or uneven incline is encountered. Or, the scooter can fall over when stopped,
when the user transfers in or out. These characteristics of the motorized
scooter limit its safe use to people with full use of at least one arm
and hand, who have strong trunk muscles and can sit upright with little
body support, and who can efficiently and safely transfer in and out of
the scooter's seat. Scooter users can include people with conditions
such as arthritis, cerebral palsy, Parkinson disease, multiple sclerosis,
etc. in early stages with mild impairment.
Necessary HAND & ARM MOBILITY for Safe
Scooter Use - Many motorized scooters are mechanically steered using
a handlebar (two hands required) similar to a bicycle. Braking while driving
is mechanical, usually requiring the user to squeeze one or two braking
handles, using one hand or both hands. The parking brake, a necessity
for safety, is also mechanical and requires at least one normal arm and
hand. Safe operation of some models may require normal mobility of BOTH
arms and hands. Other models use a steering "tiller" or "wheel"
which can be operated with one good arm and hand. Note: If the free
arm and hand are disabled, then braking and other controls must be on
the tiller or steering wheel so all are operable hand and arm used to
steer the scooter.
Necessary BODY STRENGTH and MOBILITY for
Safe Scooter Use - The first need is for a user to be able to safely
transfer in or out of the scooter seat - alone and unaided. To
do this, the person must be able to walk unaided, or to walk with a walker,
cane or crutches. Wheelchair users have a problem in that transferring
between a wheelchair and a scooter, alone and unaided, is very risky and
often leads to serious falls. A second need is stability while sitting
on the scooter seat for long periods of time and while bouncing and tilting
as one drives. A third need is for sufficient body mobility and flexibility
to maintain balance as the scooter tilts and bounces along, especially
on outdoor sidewalks and pavements. Scooters are not safe to use on
soil or grass.
Where Can Motorized Scooters be used safely?
INDOOR TRAVEL is safest, with flat and level floors. Notes:
Deep-pile carpets can present immediate mobility and safety problems and
can, sometimes, cause equipment problems due to carpet fibers entering
the wheel bearings, gears or pulleys. Low-cut carpets and rugs usually
cause no problem except that they can be stained by oil or dirt falling
from the scooter. Scooters usually travel well in malls, public buildings,
food stores, etc. - and in any and all indoor areas having flat, level
and hard floors. OUTDOOR TRAVEL requires more caution. Generally, travel
is safe on outdoor sidewalks and pavements ... PROVIDED the small front
wheel of the scooter does not encounter raised slabs, potholes or debris.
Also ... PROVIDED the sidewalk or pavement does not tilt to the left or
right (which could cause the scooter to roll over). NOTES: Know how
steep a grade your particular scooter can safely traverse, up and down,
with the particular user's height and weight. Then, safely ride up or
down inclines within these limits ... but always directly UP or DOWN an
incline - NEVER across an incline! GRASS and SOIL are not good places
to be on a motorized scooter because (a) you are more likely to fall and
be hurt ... and (b) grass and soil can damage the equipment and can damage
rugs and floors when brought home. WET grass and soil are especially
dangerous - and it is a good idea to NOT use a motorized scooter outdoors
when it is raining or when the ground is wet or icy.
CAUTIONS: Choosing and buying a motorized
scooter must be taken as seriously as choosing and buying a power wheelchair.
To ensure USER SAFETY, it is essential that the user choose and
procure a motorized scooter in ways comparable to procuring a power wheelchair.
Note: In the USA, most scooter manufacturers and vendors are
honest, caring and reputable. They know their products and are needed
for ongoing maintenance and technical support. However, they do not have
the training and experience of physicians and occupational therapists.
Hence, help should always be sought from these professional resources
before a disabled person buys a motorized scooter or power wheelchair.
RECOMMENDED SCOOTER PROCUREMENT PROCEDURES
- Have medical screenings for eyesight
and seizures. Be sure your corrected vision is 20/40 or better,
in one or both eyes. If not, then obtain glasses or other correction
before using any motorized vehicle. If subject to unexpected fainting
or seizures, do not drive any powered vehicle.
- Know your medical diagnosis and prognosis.
You need this information for your ongoing safety. Your functional condition,
today, may be compatible with safe use of a motorized scooter. But,
how long will this last? When will the scooter become unsafe for your
use? If the prognosis is for rapid disability progression, it may be
better to obtain a power wheelchair - not a motorized scooter. Or, if
the scooter is safe for you to use, now, then, how often do you need
to be re-evaluated by a physician or therapist to ensure it continues
to be safe for you to use the scooter? Are you willing to stop using
the scooter when your worsening condition makes it unsafe for you?
- Do research and obtain product literature
on the various make and model scooters available in your area. It is
better to consider only those products sold and serviced by medical
equipment dealers or manufacturers' representatives in your area. DO
NOT BUY FROM THEM, YET. Only get literature at this time. Rule out products
lacking local support. DO NOT buy by mail!
- Contact a Local Registered OCCUPATIONAL
THERAPIST (OTR) in your area, preferably in the Rehabilitation Department
at a hospital or rehabilitation center near you. Plan on and discuss
your need for two or three appointments: (a) for a preliminary wheelchair
clinic evaluation for a Motorized Scooter, if appropriate, or for a
Power Wheelchair. Ask that they have both appliances on hand for you
to try. Most of the testing will be by an OTR, under medical supervision
by a physician who specializes in rehabilitation medicine. (b) the same
OTR should be asked to schedule a visit to your home to inspect the
premises for equipment suitability and user safety. This can be without
any equipment - or, it may be with a scooter brought by the OTR - or,
the OTR may request a local scooter vendor to bring a particular model
scooter to your residence for on-site testing and user training. If
this on-site equipment testing is not done on the second appointment,
then a third appointment (c) should be made with the OTR and the vendor
for these purposes. It is strongly recommended that the final scooter
trials, before ordering, be done in the user's home with both the OTR
and the sales person present. If done at and in the residence, outside
test driving should also be done by the user in the actual scooter to
be ordered to assure safety and compatibility with the nearby pavements
and sidewalks.
- When a motorized scooter is being ordered,
be certain that one person is designated in writing, to be responsible
for the overall fit of the equipment, including all prescribed modifications,
adjustments and accessories (such as special grips, handles or reaching
tools, etc.) Usually, the responsible person is the local vendor or
dispenser. Sometimes, however, it is the clinic or therapist rather
than the vendor. This must be defined and detailed in writing. For user
safety and comfort, we recommend several VISION AIDS: (a) One
or two rear-view mirrors are recommended. For scooters having a handlebar,
it is simple and effective to buy and attach two inexpensive clamp-on
rear-view mirrors ... such as those sold for bicycles. One or two mirrors
can usually be attached in some way to a scooter having a tiller or
steering wheel. (b) In bright sunny climates where a lot of outdoor
daytime use is planned, we recommend that scooter users wear gradient-tinted
sunglasses, prescription or plain, as the eye doctor recommends. The
graduated tint (darker at top and lighter going down the lens) is best
colored gray or brown. Greens, blues and reds are best avoided.
- When the motorized scooter has finally
been ordered and is to be delivered, the user may be asked to visit
the dispenser's shop for final adjustments. This is fine. However, it
is recommended that final delivery be at the user's residence with both
the OTR and the vendor present. This facilitates final adjustments,
any additionally needed user training - especially outdoors, and also
needed technical training. The user and a family member, neighbor or
friend, should be shown - with the user - how to disassemble and store
the scooter and its detachable parts. How to re-assemble and adjust
everything; how and how often to recharge the battery; how and when
to perform equipment inspections and maintenance. SCHEDULES:
A schedule should be agreed upon for professional inspections and services
by the vendor. AND ... If the user has a progressive disability, a schedule
of periodic re-evaluations by the OTR should be agreed upon. These might
be once every 6 months or 3 months, for example, or once a year - as
the OTR feels best.
- Personalized equipment adjustments
should have been made by the vendor, with the knowledge and approval
of the OTR. Actual settings should be recorded in writing in a log,
with dates, for future reference. These settings would include these
items, plus others: (a) height of seat to place user's legs at correct
height for the foot rests; (b) height of manual steering control; (c)
location of hand braking control for driving; (d) locations of hand
parking brake levers; (e) location of seat rotation locking mechanism;
(e) location of controls for parking brakes, if any; (f) locations of
rear-view mirrors; etc. It is important to keep written records of all
user-settings so that any that become altered can easily be restored.
Sharing Motorized Scooters is risky,
at best, for all parties unless use of the shared scooter is limited to
strictly indoor use - and with other people present. If used by just one
person, always adjusted optimally for that person, the scooter can be
used with the least possible risk, indoors or outdoors - as discussed
in this paper. Unfortunately, when two or more people share use of the
same scooter, then the many settings are no longer optimized for each
user. This can lead to fatigue while riding , or even to falls or injuries.
For this reason, we recommend against sharing unless there are only two
people and both are the same size and weight, and both use all the same
adjustment settings.
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