The majority of residents in long-term care require assistive devices for mobility, including wheelchairs and floor-based lifts. Long- term care staff are frequently required to push residents in wheelchairs throughout the care home, for example from their bedroom to the dining room during meal times, and transfer residents from their bed to the bathroom using floor-based lifts.
Compliant flooring and carpeting are being promoted as a means to reduce fall-related injuries in high-risk environments, such as long-term care. Despite the potential benefits of compliant flooring, there is concern that compliant flooring increases the effort required by long-term care staff to use rolling equipment, such as wheelchairs and floor-based lifts.
For those not familiar with compliant flooring, it is a type of safety flooring designed to decrease the stiffness of the ground and the forces applied to the body parts that impact the ground during a fall. Accordingly, compliant flooring is an intervention targeted at preventing the adverse consequences of fall events, including fall-related injuries.
Dr. Chantelle Lachance and colleagues recently published the results of two ergonomic evaluations (wheelchair, floor-based lifts) which report on the effects of flooring systems on hand forces required to push a manual wheelchair and two floor-based lifts (conventional and motor-driven). Fourteen female long-term care staff pushed these devices to determine how hand forces change based on the flooring system and resident weight. Eight conditions were used to test four flooring systems for two different resident weights.
Flooring systems (subfloor + overlay) tested:
- Concrete + Vinyl
- Concrete + Carpet
- Compliant Flooring + Vinyl
- Compliant Flooring + Carpet
Carpet overlay increased initial and sustained push forces compared to vinyl overlay by 22-49% over a concrete subfloor and by 8-20% over a compliant subfloor. Compliant subflooring increased initial and sustained push forces compared to concrete subflooring by 18-31% when under a vinyl overlap. In contrast, compliant flooring caused no change in initial or sustained push forces compared to concrete subflooring when under a carpet overlay.
Compliant flooring increased initial and sustained push forces and subjective ratings of pushing difficulty compared to concrete flooring. A novel motor-driven lift substantially reduced initial and sustained push forces and perceived difficulty of pushing for all four flooring systems compared to a conventional lift Participants exerted forces above published tolerance limits only when using the conventional lift on the carpet conditions.
In conclusion, these findings demonstrate significant increases in force created by pushing on carpet overlay and a compliant flooring subfloor. While softer floors may reduce injuries from falls to long-term care residents, manual wheelchairs may need to be modified or replaced and motor-driven lifts may need to replace conventional floor-based lifts to ensure staff safety.
Funding for this project was provided by grants from the Canadian Institutes of Health Research and AGE-WELL.
Lachance CC, Korall AMB, Russell CM, Feldman F, Robinovitch SN, Mackey DC. Hand forces exerted by long-term care staff when pushing wheelchairs on compliant and non-compliant flooring. Applied Ergonomics. 2018; 71: 95-101.
Lachance CC, Korall AMB, Russell CM. External Hand Forces Exerted by Long-Term Care Staff to Push Floor-Based Lifts: Effects of Flooring System and Resident Weight. Human Factors. 2016; 58(6): 927-943.