Wheelchair Restraint Regulations You Must Know

It is quintessential for a caregiver, nursing professional or a family member of a wheelchair user to know the latest wheelchair restraint regulations in North America. 

Needless to mention, the regulations can be applied elsewhere on the planet as well. The goal here is to ensure the safety, comfort and general well being of a wheelchair user. 

Knowing the wheelchair restraint regulations is a must if the condition of your loved one or a patient is severe, and as a result, they are going to be wheelchair-bound for the rest of their life. 

They may not be able to read up on this subject on their own. It is you who must take the lead and grasp the safety rules set by medical professionals. 

That being said, I would like to thank you for making the effort to read this post. Make sure you check out the resources (research papers) shared further in this post.

What does the phrase “wheelchair restraint regulations” mean? 

Wheelchair restraint regulations are guidelines and standards put in place to ensure the safety and security of individuals who use wheelchairs. These regulations apply to various modes of transportation such as airplanes, buses, trains, and taxis. 

The purpose of these regulations is to provide a secure and comfortable environment for individuals who use wheelchairs to travel.

The Federal Aviation Administration (FAA) has established specific regulations for the use of wheelchairs on airplanes. Airlines must provide seat belts and other restraint systems that can be used to secure wheelchairs during takeoff, landing, and turbulence. 

Airlines must also have procedures in place to ensure that the wheelchair is properly secured before takeoff and during the flight.

Furthermore, the Americans with Disabilities Act (ADA) also provides guidelines for the use of wheelchairs on public transportation, including buses and trains. These regulations require public transportation providers to make their vehicles accessible to individuals with disabilities. 

Public transportation providers must provide securement systems, such as straps and tie-downs, to secure wheelchairs during the trip.

Here is a list of some of the most common wheelchair restraint regulations:

Seat Belts: All individuals in wheelchairs must use a seat belt while traveling in a vehicle. This helps to prevent injuries in the event of an accident.

Lap Belts: Wheelchair users must also use a lap belt to secure their hips and lower torso.

Shoulder Belts: Shoulder belts are used to secure the upper torso of the person using a wheelchair.

Wheelchair Tie Downs: The wheelchair itself must be tied down to the vehicle floor using tiedown straps to prevent movement during transit.

Anchor Points: All vehicles used for the transportation of people in wheelchairs must have designated anchor points where the tiedown straps can be attached.

Compatibility: The tiedown system must be compatible with the wheelchair being used to ensure maximum safety.

Occupant Restraint System: The occupant restraint system must be tested to ensure it meets safety standards.

Occupant Restraint Instructions: The vehicle must have clear instructions for the proper use of the occupant restraint system.

Securement Devices: The vehicle must be equipped with securement devices that are designed to hold the wheelchair in place during transit.

Regular Maintenance: Regular maintenance must be performed on the tiedown system to ensure it is functioning properly.

It is important to note that these regulations vary from country to country, so it is essential to check the specific regulations for your region. By following these guidelines, the safety of individuals who use wheelchairs can be ensured while traveling in vehicles.

Some important tips for caregivers taking care of a wheelchair user

1. Make sure the patient has an opportunity to free themselves from the restraint

According to a document published by the Centers for Medicare & Medicaid Services, a patient has the right to free themselves at will. As a caregiver or a nurse, you must make sure that the patient does not feel trapped or helpless at any point. 

Needless to mention, in certain situations, you must tighten the screws to keep the patient in place. Especially when the immediate physical safety of the patient or a staff member is at risk. Apart from that, keep the restraints loose and comfortable. 

2. Ask the patient before adopting a new restraining method

Before you go ahead and purchase the newest wheelchair lap belt or similar medical equipment, make sure you take the needs and desires of the patient into consideration. 

If the patient is capable of communicating rationally, talk to them about what makes them get out of the wheelchair abruptly. Find out the thing that is bothering them. Pick the right restraining equipment only after you have all the information in hand.

3. Place the latch close to patients hands

Physical restraint belts can also lead to asphyxial deaths. According to a report by the Department of Rehabilitation Science & Technology, the University of Pittsburgh, Pennsylvania, incorrect use of physical restraint equipment can lead to long-term complications and indirect adverse effects.  

A massive number of patients living in nursing homes lose their lives as a result of strangulation due to physical restraint belts. Most people die while being restrained to a wheelchair or a bed. 

The same report also states that placing the latch close to a mentally unstable patient may lead to further injury. In this case, it is advised to keep them under supervision. Also, the physical restraint belt should only be used for a limited number of hours a day.


These are the three main wheelchair restraint regulations every caregiver or a family member of a wheelchair user must know. 

By the way, the Rehabilitation Engineering & Assistive Technology Society of North America (RESNA) has a useful resource on this subject. Click here to gain access to the free booklet provided by RESNA. I don’t work for RESNA just sharing as I thought it would be useful.


  1. My 88 yo mom broke her leg 2-1/2 months ago. Because of dementia she doesn’t realize or remember she can’t stand well. She’s fallen 4 times since. I’m told a wheelchair restraint is out. So it’s better to fall and injure herself? I’m confused.

    1. Hi Stuart,
      I hear what you’re saying.But I don’t think it is fair to tie down a dementia affected person whole day.
      This article has some good tips for preventing falls and fractures in elderly.

    2. Stuart, I am in a similar situation w/ my 86 yr old Mom. She is wheelchair bound also but will lean over to do something and fall out of her wheelchair. They have alarms they can attach to your Mom and the wheelchair maybe this will help?

  2. It is absurd to make a general rule regarding wheelchair seatbelts. Patients who repeatedly unbuckle their seatbelts and rise from their wheelchair in circumstances where they are great risk of falling and injuring or re-injuring themselves and are therefore immediately placed back in the wheelchair by rehab/nursing home staff when they leave or attempt to leave the wheelchair without proper supervision should be restrained by use of belt that they cannot open. This is especially true in cases where multiple risk factors are present, the patient is incapable of understanding their situation and a caregiver with a healthcare proxy requests such restraint. Arguments based on preserving a patient’s “dignity” and “freedom to assume the risks of everyday life” make no sense whatsoever in these cases.

  3. My husband is a high fall risk. He fell today. The nursing home doesn’t want to use the wheelchair brakes, they say it’s restrictive. How can that be restrictive??

    1. Hi Wiitak. Yes, wheelchair brakes can be considered a restraint if they prevent a resident from moving freely, such as when left on for a resident who can’t release them independently. Find out what type of brakes are installed on your husbands wheelchair. Maybe, consider switching to the non restrictive ones. Let me know, if you need help finding them online

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