JMA Journal

Table 1. Patients in the Case Series ⁽³²⁾.

From: Complete Republication: Fall Injury while the Parent Is Operating a Bicycle with an Infant in a Baby Carrier

Age (month)	Injury	AIS (Head)	Outcome	Length of hospital stay	Sequelae	Bicycle operator	Position of other children riding together	Circumstance of injury	Collision with other vehicles	Method of carrying infant
3	Epidural hematoma, parietal bone fracture	2	ICU	3 days	−	Mother	Front and back seats	Traveling	Bicycle	Front
5	Subdural hematoma, cerebral contusion, parietal bone fracture	3	ICU	13 days	Partial paralysis	Mother	Back seat	Traveling	Car	Back
5	Minor head injury	1	Discharged	−	−	Mother	Back seat	When dismounting	−	Front
6	Minor head injury	1	Discharged	−	−	Mother	Unknown	Traveling	−	Front
7	Minor head injury	1	Discharged	−	−	Mother	Unknown	Traveling	−	Front
7	Minor head injury	1	Discharged	−	−	Mother	Unknown	Traveling	Bicycle	Front
9	Minor head injury	1	Discharged	−	−	Mother	Unknown	Traveling	Bicycle	Front
10	Minor head injury	1	Discharged	−	−	Mother	Unknown	Traveling	Bicycle	Front

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Table 2. Fall Experiment ⁽³²⁾.

From: Complete Republication: Fall Injury while the Parent Is Operating a Bicycle with an Infant in a Baby Carrier

Method of carrying infant	Attempt	Maximum acceleration [G]	HIC	Maximum impact load [N]	Percentage relative to 95% risk of skull injury (%)
Back	1st	599	6,489	6,984	272
	2nd	632	6,627	Not measurable	Not calculable
	3rd	449	3,901	8,920	347
	4th	404	2,998	Not measurable	Not calculable
Front	1st	61	118	5,801	226
	2nd	58	151	Not measurable	Not calculable
	3rd	40	53	7,103	276

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Table 3. SWOT Analysis for Injury Prevention ⁽³²⁾

From: Complete Republication: Fall Injury while the Parent Is Operating a Bicycle with an Infant in a Baby Carrier

	Helmet for infants	Highly adhesive baby carrier	Child seat for infants	Bicycle trailers	Passage of regulations
Strengths	Development is feasible based on the current designs for child helmets.	Development is feasible based on the current designs for baby carriers.	Development is feasible based on the current designs for child seats.	Commonly used overseas and minimally affects riding instability	Most effective for injury prevention
Weaknesses	Risk of increasing cervical spine instability and airway compression in infants	Risk of load increase from the parent’s trunk on the infant at the time of the fall	Heavy reinforcement of the device may increase instability during bicycle riding.	Insufficient bicycle roads in Japan	Might deprive parents with a young child of their means of transport (i.e., compensatory strategies are needed)
Opportunities	Potential to develop a new technology for product creation	Potential to develop a new technology for product creation	Potential to develop a new technology for product creation	Potential to develop a new market for this product	Can aid child care if compensatory measures are provided
Threats	Incorrect use of the product can be harmful to infants (e.g., airway compression)	Use of the carrier is complicated. Also, incorrect use may cause harm to infants (e.g., compromised chest wall movement)	Instability may increase the risk of accidents.	Insufficient bicycle parking spaces in Japan	Caregivers’ objections and financial issues

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