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Guest D, Gous G, Butcher A, Mackenzie A, Guest G, Young A, Crundall D. Developing a taxonomy of hazards and hazard mitigation strategies for Motorised mobility scooter users. ACCIDENT; ANALYSIS AND PREVENTION 2024; 195:107423. [PMID: 38081092 DOI: 10.1016/j.aap.2023.107423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Revised: 11/24/2023] [Accepted: 12/03/2023] [Indexed: 12/30/2023]
Abstract
The increased use of motorised mobility scooters (MMSs) presents a road safety challenge as using a MMS has risks for the user, pedestrians, and other road users. In relation to enhancing MMS driving safety, much of the training and available literature focuses on training vehicular control. Equally important is the need to investigate higher-order cognitive skills involved in driving MMSs, particularly hazard perception. Through a large questionnaire study with MMS users, we develop a taxonomy of the types of hazard MMS users encounter when crossing roads and strategies that are used to negotiate these hazards. Whilst MMS experience modulated hazard perception and strategy use, a core set of hazards and strategies were identified that have policy and practice implications for training interventions and the built environment. Exploration of the advantages and disadvantages of MMS use indicated its impact on various wellbeing outcomes as well as some potential barriers to use.
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Lyons JG, Mian HM, Via GG, Brueggeman DA, Krishnamurthy AB. Trends and epidemiology of knee extensor mechanism injuries presenting to United States emergency departments from 2001 to 2020. PHYSICIAN SPORTSMED 2023; 51:183-192. [PMID: 34965844 DOI: 10.1080/00913847.2021.2024775] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVES Injuries to the native extensor mechanism (EM) of the knee are potentially disabling and often require surgical treatment. Large-scale, updated epidemiological data on these injuries is lacking. The objective of the current study was to examine recent trends in EM injuries presenting to United States (US) Emergency Departments (EDs) over the last 20 years using a nationally representative sample. METHODS This study retrospectively analyzed the National Electronic Injury Surveillance System (NEISS) database to identify cases of EM injuries (defined as either a quadriceps tendon rupture, a patella fracture, or a patellar tendon rupture) presenting to EDs in the US from 2001 to 2020. RESULTS During the study period, an estimated 214,817 EM injuries occurred in an at-risk population of 6,183,899,410 person-years for an overall incidence rate of 3.47 per 100,000 person-years. Patella fractures (PFs) were the most common injury type, representing 77.5% of all EM injuries (overall incidence rate: 2.69), followed by patellar tendon ruptures (PTRs; 13.5%; incidence: 0.48) and quadriceps tendon ruptures (QTRs; 9%; incidence: 0.31). Demographic characteristics and mechanisms of injury differed between injury types. Annual incidence rates increased significantly during the study period for all EM injury types, with PTRs demonstrating the largest relative increase (average annual percent increase: PF, 2.8%; PTR, 7.2%; QTR, 5.3%). Accounting for population growth yielded an increasing incidence of all EM injuries combined from 3.65 in 2001 to 4.9 in 2020. The largest relative increases in incidence rates were observed in older age groups. CONCLUSION Extensor mechanism injuries of the knee are increasing in the US, which likely reflects an aging and more active population. These types of injuries are associated with substantial functional impairment and recent increases in incidence rates highlight the need for injury prevention and management strategies.
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Affiliation(s)
- Joseph G Lyons
- Department of Orthopaedic Surgery, Wright State University Boonshoft School of Medicine, Dayton, OH, USA
| | - Humza M Mian
- Department of Orthopaedic Surgery, Wright State University Boonshoft School of Medicine, Dayton, OH, USA
| | - Garrhett G Via
- Department of Orthopaedic Surgery, Wright State University Boonshoft School of Medicine, Dayton, OH, USA
| | - David A Brueggeman
- Department of Orthopaedic Surgery, Wright State University Boonshoft School of Medicine, Dayton, OH, USA
| | - Anil B Krishnamurthy
- Department of Orthopaedic Surgery, Wright State University Boonshoft School of Medicine, Dayton, OH, USA
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Kirby RL, Smith C, Mortenson WB, Battalova A, Hurd L, Hobson S, Jang S, Emery R. Qualitative experiences of new motorised mobility scooter users relevant to their scooter skills: a secondary analysis. Disabil Rehabil Assist Technol 2023; 18:89-96. [PMID: 35442822 DOI: 10.1080/17483107.2022.2063422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
OBJECTIVE To explore the experiences of new motorised mobility scooter users from the perspectives of the assessment and training of scooter skills. DESIGN Descriptive secondary analysis of qualitative data. SETTING Community. PARTICIPANTS 20 New users of motorised mobility scooters. INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES Directed qualitative analysis of up to four semi-structured interviews over the course of the first year of scooter use, to identify themes and sub-themes that could inform recommendations regarding assessment and training protocols. RESULTS We identified two themes. The first related to potential new content. As one example of the sub-themes, there were many excerpts that dealt with the use of skills in various combinations and permutations that were used to carry out activities during everyday life and participate in society. These excerpts suggested the importance of training skills in combination to facilitate skill transfer (or generalizability). The second theme is related to enhancements of existing content. As one example of the sub-themes, there were several excerpts that dealt with scooter security. These excerpts led to the recommendation that removing and inserting the scooter key should be added to the assessment criteria for the "turns power on and off" skill of the Wheelchair Skills Test (WST) and its questionnaire version (WST-Q). CONCLUSIONS The experiences of scooter users over the first year of receiving a scooter appear to be relevant to the assessment and training of scooter skills and suggest themes for further study. Clinical trial registration number: NCT02696213 IMPLICATIONS FOR REHABILITATIONThe experiences of new scooter users are highly relevant to the assessment and training of scooter skills.These experiences suggest both potential new content and enhancements of existing content to the Wheelchair Skills Program Manual.
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Affiliation(s)
- R Lee Kirby
- Division of Physical Medicine and Rehabilitation, Department of Medicine, Dalhousie University, Halifax, Canada
| | - Cher Smith
- Department of Occupational Therapy, Nova Scotia Health Authority, Halifax, Canada
| | - W Ben Mortenson
- Department of Occupational Science and Occupational Therapy, The University of British Columbia, Vancouver, Canada
| | - Alfiya Battalova
- School of Kinesiology, The University of British Columbia, Vancouver, Canada
| | - Laura Hurd
- School of Kinesiology, The University of British Columbia, Vancouver, Canada
| | - Sandra Hobson
- School of Occupational Therapy, University of Western Ontario, London, Canada
| | - Sharon Jang
- Department of Occupational Science and Occupational Therapy, The University of British Columbia, Vancouver, Canada
| | - Richelle Emery
- Vancouver Coastal Health - Community Care, Vancouver, Canada
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Navarro SM, Vakayil VR, Solaiman RH, Keil EJ, Cohen MW, Spartz EJ, Tignanelli CJ, Harmon JV. Risk of hospital admission related to scooter trauma injuries: a national emergency room database study. BMC Emerg Med 2022; 22:150. [PMID: 36050639 PMCID: PMC9438147 DOI: 10.1186/s12873-022-00711-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Accepted: 08/24/2022] [Indexed: 11/21/2022] Open
Abstract
Background We investigated key risk factors for hospital admission related to powered scooters, which are modes of transportation with increasing accessibility across the United States (US). Methods We queried the National Electronic Injury Surveillance System (NEISS) for injuries related to powered scooters, obtaining US population projections of injuries and hospital admissions. We determined mechanism of injury, characterized injury types, and performed multivariate regression analyses to determine factors associated with hospital admission. Results One thousand one hundred ninety-one patients sustained electric-motorized scooter (e-scooter) injuries and 10.9% (131) required hospitalization from 2013 to 2018. This extrapolated to a US annual total of 862 (95% CI:745–979) scooter injuries requiring hospitalization, with estimated annual mortality of 6.7 patients per year (95% CI:4.8–8.5). The incidence of hospital admissions increased by an average of 13.1% each year of the study period. Fall (79 [60%]) and motor vehicle collision (33 [25%]) were the most common mechanism. Injury locations included head (44 [34%]), lower extremity (22 [17%]), and lower trunk (16 [12%]). On multivariable analysis, significant factors associated with admission included increased age (OR 1.02, 95% CI:1.01–1.02), torso injuries (OR 6.19, 2.93–13.10), concussion (25.45, 5.88–110.18), fractures (21.98, 7.13–67.66), musculoskeletal injury (6.65, 1.20–36.99), and collision with vehicle (3.343, 2.009–5.562). Scooter speed, seasonality, and gender were not associated with risk of hospitalization. Conclusion Our findings show increased hospital admissions and mortality from powered scooter trauma, with fall and motor vehicle collisions as the most common mechanisms resulting in hospitalization. This calls for improved rider safety measures and regulation surrounding vehicular collision scenarios.
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Affiliation(s)
- Sergio M Navarro
- Department of Surgery, University of Minnesota, 420 Delaware St SE, Minneapolis, MN, 55455, USA. .,Department of Orthopaedics Rheumatology and Musculoskeletal Sciences, University of Oxford Nuffield, Oxford, UK.
| | - Victor R Vakayil
- Department of Surgery, University of Minnesota, 420 Delaware St SE, Minneapolis, MN, 55455, USA
| | - Rafat H Solaiman
- Department of Surgery, University of Minnesota, 420 Delaware St SE, Minneapolis, MN, 55455, USA
| | - Evan J Keil
- Department of Surgery, University of Minnesota, 420 Delaware St SE, Minneapolis, MN, 55455, USA
| | - Matthew W Cohen
- Department of Surgery, University of Minnesota, 420 Delaware St SE, Minneapolis, MN, 55455, USA
| | - Ellen J Spartz
- Department of Surgery, University of Minnesota, 420 Delaware St SE, Minneapolis, MN, 55455, USA
| | | | - James V Harmon
- Department of Surgery, University of Minnesota, 420 Delaware St SE, Minneapolis, MN, 55455, USA
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Peters A, Versteegen MGJ, van Osch F, Janzing HMJ, Barten DG. Mechanism and severity of mobility scooter-related injuries. TRAFFIC INJURY PREVENTION 2022; 23:112-117. [PMID: 35044287 DOI: 10.1080/15389588.2021.1998469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 10/18/2021] [Accepted: 10/21/2021] [Indexed: 06/14/2023]
Abstract
OBJECTIVE As a result of an aging population, mobility scooter use is increasing in Western countries. Consequently, an increase in mobility scooter-related injuries (MSRIs) is observed. Yet there is a paucity of studies in the literature assessing MSRIs. The purpose of this study was to investigate mechanism, severity, and localization of injury of MSRIs in the emergency department (ED) of a Dutch level 2 trauma center over a 9-year period. METHODS This was a retrospective study of MSRIs in the ED of a teaching hospital in the Netherlands between January 2010 and December 2019. All patients with an MSRI were included, as long as they were the driver of the vehicle. Data were collected from electronic patient files. The primary outcomes were severity of injury, defined by the Abbreviated Injury Scale (AIS) and Injury Severity Score (ISS), and mechanism and localization of injury. RESULTS A total of 382 patients were identified. Of these, 208 (54.3%) were female and the median age was 76 years (interquartile range [IQR] = 67.0-83.0). The median Charlson Comorbidity Index (CCI) was 5.0 (IQR = 4.0-6.0). Three (0.8%) patients had an ISS ≥ 16. The median ISS was 3.0 (IQR = 1.0-5.0). The lower extremity was the most commonly injured body region (46.5%), followed by head injury (36.3%), external injury (31.6%), and upper extremity injuries. Fractures were most commonly observed in the shoulder (10.2%), hip (8.9%), and ankle (6.3%). Most crashes were single-vehicle accidents (87.2%) and the most common mechanism of injury was rollover of mobility scooter (49.3%). Almost half of the patients (44.1%) had a fracture and the admission rate was 28.2% with a median length of stay (LOS) of 10 days. Fifty (13.1%) patients required surgery, of which 58% were hip repair surgery. CONCLUSION In this cohort of MSRIs, mobility scooter users had a median age of 76 years and severe comorbidity was common. Based on ISS, patients had a mild injury profile. However, the relatively high admission and surgery rates reflect the potential serious consequences of MSRIs and the obvious vulnerability of this population.
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Affiliation(s)
- Annefleur Peters
- Department of Emergency Medicine, VieCuri Medical Centre, Venlo, The Netherlands
| | | | - Frits van Osch
- Department of Clinical Epidemiology, VieCuri Medical Centre, Venlo, The Netherlands
- School of Nutrition and Translation Research in Metabolism (NUTRIM), Maastricht University (UM), Maastricht, The Netherlands
| | - Heinrich M J Janzing
- Department of (General/Trauma) Surgery, VieCuri Medical Centre, Venlo, The Netherlands
| | - Dennis G Barten
- Department of Emergency Medicine, VieCuri Medical Centre, Venlo, The Netherlands
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