¹Université Laval, Québec, Canada
²Centre interdisciplinaire de recherche en réadaptation et intégration sociale (CIRRIS), Québec, Canada

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Background: In the event of a fire, evacuating people with reduced mobility in a long-term care facility can slow down the evacuation process significantly. It can also be challenging due to the low caregiver-to-patient ratio [1]. In addition to this challenge, the evacuation of individuals with reduced mobility in emergency situations poses a significant risk of back and upper limb injuries for healthcare workers [2]. The use of equipment (e.g.- chair stretcher) to facilitate vertical and horizontal movement of individuals is clearly beneficial in emergency situations [3]. However, a few pieces of equipment have been designed specifically for people with reduced mobility that are sufficiently adaptable to their individual needs (bedridden, wheelchair-bound, etc.) and can be operated by a single person. The aim of the study is to test a prototype three-position evacuation stretcher designed specifically for moving people with reduced mobility in emergency situations.

Method: Thirteen participants from the academic community were invited to use a prototype stretcher with two modes of transport (1) Securing a wheelchair to the stretcher; (2) chair stretcher position to move a 55 kg dummy vertically and horizontally. Each participant was asked to perform three tasks: to move the stretcher horizontally over a 25-meter course at a free and fast pace, and to descend two stairs of 12 steps each at a free pace. Two hand force measuring handles (Kistler 9809A) and 17 inertial measurement units (MVN Link, Xsens) were used to extract maximum and average hand force values relative to the pelvic coordinate system, as well as average trunk lean and arm elevation angles. A static joint force estimation model (3DSSPP software, VelocityEHS) was used to calculate maximum and average values of L5/S1 compression and shear forces. Data were entered into a two-way repeated measures analysis of variance (mode x task). The p-level of significance was set at p<0.05.

Results: There were no differences in the variables between the two modes of transport, nor were there any interactions between the factors (p>0.05). Greater maximum L5/S1 compression forces, anterior-posterior shear forces, and resultant hand forces were observed in the stairway (p<0.05). Horizontal movement at a fast pace resulted in greater resultant hand force values than at a free pace (p<0.05).

Discussion: The design of a stretcher that converts horizontal to chair position and can be moved horizontally and vertically by a single person proved to meet the needs identified for moving persons with reduced mobility. The results of this study showed that the integration of a wheelchair into the stretcher did not require any additional effort during the tested transfers.

Conclusion: Improvements to be made in the next iteration of the design should focus on reducing the amount of effort required to maneuver the prototype downstairs and improving mechanisms to facilitate mode switching.

References

[1] Sahebi A, Jahangiri K, Alibabaei A, Khorasani-Zavareh D. Factors Influencing Hospital Emergency Evacuation during Fire: A Systematic Literature Review. Int J Prev Med. 2021 Oct 26;12:147. DOI: 10.4103/ijpvm.IJPVM_653_20
[2] Dini G, Rahmani A, Montecucco A, Kusznir Vitturi B, Zacconi S, Manca A, Blasi C, Linares R, Morganti M, Bragazzi NL, Razzino A, Durando P. Occupational Injuries and Their Determinants Among Healthcare Workers in Western Countries: A Scoping Review. Med Lav. 2025 Feb 21;116(1):16664. DOI: 10.23749/mdl.v116i1.16664
[3] Lavender SA, Hedman GE, Mehta JP, Reichelt PA, Conrad KM, Park S. Evaluating the physical demands on firefighters using hand-carried stair descent devices to evacuate mobility-limited occupants from high-rise buildings. Appl Ergon. 2014 May;45(3):389-97. DOI: 10.1016/j.apergo.2013.05.005