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Data-driven framework for adverse manual wheelchair event risk classification and prevention.

Anand Mhatre1, Muyun Zhao1, Theresa Berner1,2

  • 1Division of Occupational Therapy, School of Health and Rehabilitation Sciences, College of Medicine, The Ohio State University, Columbus, OH, USA.

Disability and Rehabilitation. Assistive Technology
|April 20, 2026
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Summary

This study combined Failure Mode and Effects Analysis (FMEA) and natural language processing (NLP) to identify high-risk manual wheelchair components and scenarios, aiming to reduce user falls and injuries. Findings highlight casters, belts, brakes, and frames as critical components needing attention for improved wheelchair safety.

Keywords:
Adverse eventfailure mode and effect analysisnatural Language processingrisk assessmentsafetywheelchair

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Area of Science:

  • Biomedical Engineering
  • Rehabilitation Engineering
  • Human Factors Engineering

Background:

  • Manual wheelchairs are prone to component failures, leading to adverse incidents like falls and injuries.
  • Existing research lacks systematic frameworks to identify high-risk scenarios and root causes across diverse manual wheelchair models.

Purpose of the Study:

  • To develop a risk classification framework by integrating Failure Mode and Effects Analysis (FMEA) with natural language processing (NLP).
  • To propose guidelines for reducing risks associated with manual wheelchair use.

Main Methods:

  • Analysis of 752 adverse incidents reported by NHS WestMARC (2020-2025) across five manual wheelchair models.
  • Application of FMEA to calculate severity, occurrence, and criticality scores for wheelchair components.
  • Utilization of NLP to identify contextual risk factors and relative risk (RR) metrics for falls and injuries.

Main Results:

  • Tilt-in-space, ultralight, and paediatric models showed slightly elevated risks of falls/injuries post-failure (RR=1.08-1.29).
  • NLP identified transfer incidents, outdoor navigation, and belt misuse as key contextual factors.
  • High-risk components included casters, belts, brakes, frames, and the wheelchair system itself, based on FMEA criticality scores.

Conclusions:

  • The integrated FMEA-NLP framework effectively identifies high-risk manual wheelchair scenarios and components.
  • Findings support a tiered prevention strategy encompassing design improvements, user training, and regular servicing.
  • Integrating NLP and FMEA into incident reporting can enhance clinical practice, policy, and product design for greater wheelchair safety.