Is it safe to use other types of head-restraint and support devices when traveling in a motor vehicle?

If a wheelchair user’s head is restrained from forward movement by some type of headband or head-restraint system that goes around the front of the head, there is concern that the torso may move forward more than the head in a frontal crash, and that this differential movement between the head and torso could result in injury to the neck. Also, it has been demonstrated in frontal impact tests with child crash dummies that neck collars used to provide head support can cause increased bending moments (a “moment” is a rotational force around an axis) at the upper neck if the collar is too stiff. This does not mean that head restraints and neck collars should never be used in transit, since head control for some wheelchair users may be more important to injury risk than is the concern for neck injury in a crash situation. However, it does mean that the head-restraint system should be designed to break away at relatively low levels of force so as to reduce the possibility of neck injury in a crash situation. In addition, soft neck collars should be used to minimize the increase in upper-neck bending moments that can cause injury to the upper cervical spine.