Real-World Wheelchair Transportation Safety: A Study of Wheelchair User Attitudes, Knowledge, and Behavior When Riding Fixed-Route Transportation

Catherine Armstrong, BA and Mary Ellen Buning, PhD

University of Pittsburgh, Injury Risk Assessment and Prevention Laboratory
Department of Rehabilitation Science and Technology, Pittsburgh, PA, USA


Many wheelchair users rely on fixed-route transportation (public buses), either instead of or in addition to private vehicles and paratransit. While most buses in the fleets of transit systems are equipped with wheelchair tiedowns and occupant restraints (WTORS), there are barriers to the efficient, and comfortable use of these devices that are unique to or more prevalent in fixed-route transportation. A 35-question survey was administered to 283 wheelchair users in a national sample who ride fixed-route transit to discover the most common and formidable barriers to the use of WTORS. Preliminary results show that the greatest obstacles include insufficient bus operator training, attitudes of bus operators toward wheelchair users, malfunctioning, poorly-fitting, or missing tiedowns and restraints, use of wheelchairs and scooters that are not designed to be used as seats in motor vehicles, and lack of education among wheelchair-users. Results will allow researchers, transportation managers, and advocates to better target their efforts at improving transportation for wheelchair users so that they address these barriers.

Key Words: Wheelchair transportation, buses, wheelchair securement, occupant restraint


The Americans with Disabilities Act that was passed in 1990, requires that buses be equipped with a wheelchair lift or ramp, at least two wheelchair stations, wheelchair tiedowns, and vehicle-mounted occupant restraints. However, thirteen years after ADA’s passage, wheelchair users who ride buses still encounter many obstacles to their safe, efficient, and hassle-free transportation (1, 2, 3). Three broad types of barriers present challenges to wheelchair users who ride in city buses as well as cars, school buses, and paratransit vans. 1: Wheelchairs are not designed to be safe to use as motor vehicle seats, so they do not offer as much crash protection to the wheelchair users who remain seated in them during travel. 2: WTORS have been designed to fit all types of wheelchairs and body sizes, but this universality has resulted in decreased safety, cumbersome use, poor fit for the wheelchair user, and avoidance of using the systems. 3: Wheelchairs and scooters are often of varying shapes and sizes, causing them to be difficult to secure.

A survey of public transit and paratransit agencies (2), revealed that drivers have a general lack of awareness of whether to and how to accommodate and secure the variety of wheelchairs, resulting in improper securement of and denial of transportation to wheelchair users who are entitled to it. This study focuses on the specific obstacles to accessible transportation that are unique to the fixed-route transit environment. Improving the accessibility of fixed route transit systems would make the experience of wheelchair users safer, more efficient, and less stressful, making it more likely that wheelchair users will opt to use the bus instead of more costly paratransit services.


The objectives of this research study were to 1: Discover the wheelchair transportation accessibility barriers that are unique to fixed route transportation, and 2: Determine the relationship between barriers and variables such as type of wheelchair, age of wheelchair user, and size of public transit system that may have an effect on these barriers.


A survey using HTML forms was placed on the web server of the Department of Rehabilitation Science and Technology at the University of Pittsburgh and linked to WheelchairNet, a prominent wheelchair website. Adults in the US who sit in wheelchairs while riding fixed-route transportation completed the survey via their web browser. They provided both quantitative and qualitative responses to questions addressing their attitudes, knowledge, and experiences regarding the use of WTORS and public buses in general. The 35 questions were multiple-choice, check-all-that-apply, or open-ended, and many questions provided an edit field for additional comments from the participants. Participants were recruited through wheelchair-related web message boards, listserves, newsletters, and advertisements on websites. Participants are a demographically diverse sample, with both urban and rural areas represented. 27.9% of the sample use manual wheelchairs, 53% use power wheelchairs, 4.9% use power scooters, and 2.5% use other devices.


Of the 283 subjects who completed the survey, 27.2% ride the bus every day, 31.1% at least once per week, 16.6% at least once per month, and 23.3% less than once per month. Of great importance is the fact that 88.3% of respondents never transfer from their wheelchairs to a bus seat. All 283 participants sit in their wheelchairs at least some of the time during bus transit.

The respondents use a wide variety of wheelchair securement devices. Participants reported using four-point tiedowns (58.7%), automated docking systems (2.8%), wheel-rim pin securement (6.4%), manual clamps to frame (11.2%), and other devices (7.4%). 29 participants or 10.9% commented that buses in their transit system vary on the type of securement equipment available. Of the 58.7% of participants that report using four-point tiedowns, only 56.2% are always secured with all four tiedowns. 14 participants commented that they felt securement of their wheelchairs was not necessary, and 6 participants commented that using all four tiedowns was unnecessary.

Alternate text description: This Histogram shows the distribution of Wheelchair securement type over 5 types of devices. Shown as percentages they are: 4-point tie down =58.7, automated docking =2.8, wheel-rim pin securement =6.4, manual clamps to frame =11.2 and other devices =7.4.

38.9% of participants use wheelchairs that are somewhat difficult to secure, and 12.4% use wheelchairs that are very difficult or impossible to secure. 15.5% of participants commented that their wheelchairs do not have easily accessible securement points, and an additional 2.5% commented that their wheelchairs/scooters do not fit the wheelchair station dimensions well and are thus difficult to secure.

The bus operator provides assistance with WTORS to 79.5% of participants, while 15.6% are assisted by a traveling companion, 11.0% receive assistance from a fellow bus passenger, and 12.7% never wish to be secured and or restrained. Since almost 80% of respondents receive assistance from the bus operator, it is crucial that operators are well-trained in using WTORS. However, 53.6% of participants report that bus operator training is insufficient, and 44.4% report that operators have difficulty securing their wheelchairs.

18.4% of participants report that they encounter malfunctioning WTORS at least once per week. 14.5% encounter them at least once per month, and 24.7% encounter malfunctioning equipment less than once per month. However, since not all participants ride the bus every week, these numbers probably under-represent the true number of malfunctioning WTORS found on public buses. In addition, 10 participants commented that restraints are too filthy to use, and 14 participants commented that the restraints cause them pain or injury.

The following reasons for non-use of WTORS were cited: The bus operator does not know how to operate the equipment properly (24.3%), the bus operator is unwilling (32.5%), the wheelchair user is in a hurry and does not want to take the time (17.3%), the equipment is unreliable (6.4%), the WTORS do not fit comfortably (25.4%), the equipment is unsafe (7.8%), using WTORS is not important (8.9%), and the securement and restraint process invades personal space (6.7%).

To summarize, bus-riding wheelchair users encounter a vast array of obstacles to safe and efficient transportation. These barriers include insufficient bus operator training, poor attitude of bus operators toward wheelchair users, inoperable lifts, malfunctioning WTORS, wheelchairs that are not designed with safe and easy securement in mind, and insufficient education among wheelchair users as to the importance of using WTORS. Since the study is ongoing, further data analysis will to be carried out to determine any correlations between these barriers and variables such as age of user, size of transit system, and type of wheelchair. Once these correlations are determined, advocacy efforts can be targeted at making bus transportation safer, more efficient, and more comfortable for wheelchair users.


  1. Armstrong, CM; van Roosmalen, L; Manary, M; & Bertocci, GE. (2003). User preferences on wheelchair integrated restraint design. The Proceedings of the Annual RESNA Conference, Atlanta, GE, RESNA Press.
  2. Foreman, C & Hardin, J. (2002). The Challenges Of Wheelchair Securement: Searching
    For Solutions. Tampa, FL, The Center for Urban Transportation Research: 1-8.
  3. van Roosmalen, L; Bertocci, GE; Hobson, DA & Karg, P. (2002). Preliminary evaluation of wheelchair occupant restraint system usage in motor vehicles, Journal of Rehabilitation Research and Development, Vol 39-1.

Study Contact:
Catherine Armstrong, BA at:
Injury Risk Assessment and Prevention Laboratory, Department of Rehabilitation Science & Technology
5044 Forbes Tower, Pittsburgh, PA 15260