The Role of Armrest Design in Positioning of Belt Restraints on Wheelchair-Seated Drivers Nichole L. Ritchie 1 , Miriam A. Manary 1 , Linda Van Roosmalen 3 , Lawrence W. Schneider 1,2 1 University of Michigan Transportation Research Institute 2 University of Michigan Department of Biomedical Engineering 3 Department of Rehabilitation Science & Technology, University of Pittsburgh ABSTRACT Eighteen wheelchair-seated drivers were observed while moving into position to drive their personal vehicle. The ease-of-use and positioning of the belt restraint system by the wheelchair-seated driver were evaluated and compared for two different configurations of the wheelchair armrests: closed-front and open-front. Closed-front wheelchair armrests made belt donning more difficult and interfered with proper belt fit when compared to open-front armrests, indicating that armrest design is important to improved transportation safety for wheelchair-seated drivers. Results of this study will be used to make recommendations to wheelchair manufacturers and prescribers for designing and ordering appropriately configured armrests for people who intend to drive while seated in their wheelchair. KEYWORDS Wheelchair-seated drivers, seatbelt positioning, wheelchair transportation safety, wheelchair armrests BACKGROUND In a recent University of Pittsburgh survey of 596 wheelchair users in 45 states, it was found that 26% of the respondents remained seated in their wheelchairs while driving personal vehicles and that these wheelchair-seated drivers had a significantly higher frequency of crash involvement than individuals who transfer to the vehicle seat (1). Also, a study of vehicle crashes involving one or more wheelchair-seated occupants by the University of Michigan Transportation Research Institute (UMTRI) reported that, of 22 wheelchair-seated occupants involved in crashes, 7 individuals (nearly one third) died from crash-related injuries. The majority of these crashes were minor to moderate in severity and would not have resulted in fatal injuries to occupants using the vehicle seats and restraint systems (2). As part of an effort to improve transportation safety and crash protection for wheelchair–seated travelers, Section 19 of ANSI/RESNA Wheelchair Standards/Volume 1, also known as WC19, was developed to establish design and frontal-impact performance requirements for wheelchairs intended for the use as seats by passengers in motor vehicles (3). In addition to requiring the wheelchair to demonstrate crashworthiness in a 48-kph frontal sled impact test when secured by a four-point, strap- type tiedown system, this standard requires evaluation of wheelchairs with regard to accommodation of vehicle-anchored lap/shoulder belt restraints (Annex E of WC19). This is because the effectiveness of belt restraints in protecting occupants in frontal crashes depends on good contact of both lap and shoulder belts with skeletal regions of the occupant prior to the collision, so that the belts will provide restraint as soon as possible after onset of the impact. A properly placed lap belt is positioned low on the pelvis near the thigh-abdominal junction and a properly positioned shoulder belt will travel over the middle of the outboard shoulder and across the center of the chest. If belt restraints are not initially in contact with the body, the likelihood of serious injuries from belt loading and occupant contact with vehicle interior components is increased. Using the procedures of WC19 Annex E, the wheelchair is rated on factors related to the ease of using and positioning lap/shoulder belt restraints in an optimal location relative to the occupant and