Smart Nursing Wheelchairs: A New Trend in Assisted Care and the Future of Multifunctional Integration.

As a significant technological innovation in the fields of medicine and geriatric care, smart care wheelchairs offer a novel approach to providing high-quality care services and improving the quality of care. The aim of this review article is to examine the development, applications and prospects of smart nursing wheelchairs, with particular emphasis on their assistive nursing functions, multiple-sensor fusion technology, and human-machine interaction interfaces. First, we describe the assistive functions of nursing wheelchairs, including position changing, transferring, bathing, and toileting, which significantly reduce the workload of nursing staff and improve the quality of care. Second, we summarized the existing multiple-sensor fusion technology for smart nursing wheelchairs, including LiDAR, RGB-D, ultrasonic sensors, etc. These technologies give wheelchairs autonomy and safety, better meeting patients' needs. We also discussed the human-machine interaction interfaces of intelligent care wheelchairs, such as voice recognition, touch screens, and remote controls. These interfaces allow users to operate and control the wheelchair more easily, improving usability and maneuverability. Finally, we emphasized the importance of multifunctional-integrated care wheelchairs that integrate assistive care, navigation, and human-machine interaction functions into a comprehensive care solution for users. We are looking forward to the future and assume that smart nursing wheelchairs will play an increasingly important role in medicine and geriatric care. By integrating advanced technologies such as enhanced artificial intelligence, intelligent sensors, and remote monitoring, we expect to further improve patients' quality of care and quality of life.

Development, reliability, and validity assessment of a fall concerns scale for people who use wheelchairs and scooters (FCS-WC/S).

PURPOSE: To evaluate the psychometric properties of a Fall Concerns Scale for people who use Wheelchairs and Scooters (FCS-WC/S). MATERIALS AND METHODS: Developed by fall prevention experts, FCS-WC/S underwent refinement through interdisciplinary reviews and focus groups with researchers, clinicians, and individuals who use WC/S full-time. The psychometric evaluation involved adults who used WC/S for ≥1 year and had ≥1 fall in the previous 3 years, recruited between April and September 2022. RESULTS: The FCS-WC/S evaluates fall concerns among people with various health conditions who use WC/S full-time across 33 daily activities. One hundred and twenty-four participants responded to the baseline survey. A subgroup of 63 people repeated the FCS-WC/S a week later. The FCS-WC/S demonstrated excellent internal and good test-retest reliability (α ≥ 0.90, ICC = 0.86-0.9), as well as concurrent validity (Spearman's rho = 0.72) with the Spinal Cord Injury Falls Concern Scale (SCI-FCS). It effectively differentiated fear of falling levels from an established measure (ORs 4.1, 25.8, 46.7). Factor and parallel analysis revealed three factors, two of which were retained for further analysis. CONCLUSIONS: Preliminary findings support FCS-WC/S validity and reliability for assessing fall concerns among individuals with various conditions who use WC/S. Further scale construction analysis is recommended.

Measuring concerns about falling among full-time wheelchair and scooter users is crucial due to its potential negative impact on activity curtailment, which in turn may affect community participation and quality of life.Most validated tools, except for the Spinal Cord Injury-Falls Concern Scale, designed for manual wheelchair users with spinal cord injury, are primarily tailored for individuals who ambulate, highlighting the need for assessment tools specifically designed for full-time wheelchair and scooter users.Using the Spinal Cord Injury-Falls Concern Scale as a foundation, the Fall Concerns Scale for people who use Wheelchairs and Scooters was developed to measure fall concerns among full-time wheelchair and scooter users, irrespective of their specific health conditions.The Fall Concerns Scale for people who use Wheelchairs and Scooters has a good potential to offer clinicians a valid and reliable tool to systematically screen fall concerns across various health conditions, with further large-scale studies needed to validate the tool across a wider range of health conditions.

Perceptions and assessment of a novel robotic wheelchair transfer system.

OBJECTIVES: Wheelchair transfers risk injury to users and caregivers. Conventional transfer devices are injury-prone and time inefficient. The Powered Personal Transfer System (PPTS), utilizing a modified Electric Powered Wheelchair (EPW) and a hospital bed, provides a no-lift solution for bed-to-wheelchair transfers. Objective 1: Assess PPTS workload compared to existing methods. Objective 2: Evaluate PPTS EPW in daily mobility tasks. Objective 3: Perform Rehabilitation Engineering and Assistive Technology Society of North America (RESNA) wheelchair standards testing for PPTS EPW stability and performance. METHODS: Fifteen professional and family caregivers, experienced in assisting EPW users, performed transfers between the bed and EPW using the PPTS. Subsequently, participants drove the PPTS EPW providing ratings on the ease of performing mobility tasks. Wheelchair testing was conducted following RESNA standards. SETTING: : Simulated bedroom in a laboratory setting. RESULTS: Participants reported low workload demands for employing the PPTS and indicated a preference for the PPTS over existing transfer devices/methods. Ease of performing everyday mobility tasks was not significantly different between the modified PPTS and the commercially available original manufacturer equipment EPW (p > 0.05). RESNA wheelchair standards testing confirmed that the PPTS EPW preserves functionality, stability and performance when compared to similar commercially available EPWs. CONCLUSION: The PPTS demonstrated promise in offering a practical, low demanding, and safe solution for transfers. It has the potential to enhance user and caregiver safety by reducing the incidence of caregiver injuries associated with assisting in transfer tasks. In addition to its efficiency and ease of use, it is an advancement in assistive technology for wheelchair transfers.

Athlete identity in para-sport: A comparative study of athletes with congenital and acquired disabilities.

BACKGROUND: Identity development explores how individuals perceive themselves based on their life experiences, including their current self and aspirations. Athlete Identity has been studied using a 4-factor framework across various sports and ability groups. However, there is limited research on how individuals with physical disabilities perceive themselves as athletes and how an acquired disability impacts identity compared to a congenital disability. OBJECTIVE: To test the validity of the 4-Factor Model of Athlete Identity and to determine if athletic identity differs between para-athletes who have congenital versus acquired disabilities. METHODS: Secondary analysis of cross-sectional data from the National Wheelchair Basketball Association. Participants consisted of 408 individuals (8 years and older) who play wheelchair basketball (n = 315 male; 29.13 ± 13.89 yrs; M ± SD) who responded to a brief online questionnaire including basic demographics and the 10-item Athlete Identity Measurement Scale (AIMS). RESULTS: No significant differences in total AIMS scores were found between participants with congenital disabilities and participants with acquired disabilities. Age was a significant covariate. Eigenvalue analysis of the AIMS scores shows that 2 factors describe this population of athletes. CONCLUSIONS: Disability acquisition is not associated with total AIMS scores. Athletic identity is weaker in older participants suggesting a more inclusive self-schema as one ages. The 4-factor model of Athletic Identity is not applicable in this population. Continued research into the intersection of athlete and disability identity is warranted. ABSTRACT PRESENTED: North American Society for the Psychology of Sport and Physical Activity, 2019.

mHealth learning strategies to support behaviour change in individuals using wheelchairs and/or scooters: a systematic review.

PURPOSE: The purpose of this systematic review of the literature is to build understanding of the key elements and recommendations for the design of mHealth technology for individuals using wheelchairs and/or scooters and identify key features associated with the use of mHealth to support healthy behaviour changes for this population. MATERIALS AND METHODS: Eight major electronic databases were systematically searched to identify mobile health (mHealth) interventions, which targeted adult WC/S users. Independent reviewers used Endnote and Covidence to manage articles meeting review criteria and to exclude duplicates. A quality assessment was conducted on each included article. RESULTS: Nine articles describing studies with diverse study designs met criteria to be included in this review. Several interactive application intervention features, such as participant collaboration and goal setting, and key technical features to support mHealth app development and utilisation were identified. Results found intuitive and simple designs of mHealth apps, with the ability to customise to support learning styles and preferences, support usability and acceptability by participants. CONCLUSIONS: More research is needed to evaluate best practices to support initial training of end-users, mHealth apps' ability to support long-term behaviour change and maintenance, and the understanding of active ingredients in complex interventions that include mHealth apps. Both interactive mHealth application intervention and technical features support healthy behaviour change among individuals using wheelchairs and scooters.

Utilizing evidence to develop mHealth applications (apps) support best practices, participant satisfaction, and usability.mHealth apps are feasible to support health behavior change for wheelchair and/or scooter users, with considerations for customization to support diverse learning preferences and needs.Active learning strategies (e.g., goal setting, self-assessment, collaborative learning), within or in conjunction with the app, support behavior change.

Handrim kinetics and quantitative ultrasound parameters for assessment of subacromial impingement in wheelchair users with pediatric-onset spinal cord injury.

BACKGROUND: Most manual wheelchair users with pediatric-onset spinal cord injury (SCI) will experience shoulder pain or pathology at some point in their life. However, guidelines for preservation of the upper limb in children with SCI are limited. RESEARCH QUESTION: What are the relationships between manual wheelchair handrim kinetics and quantitative ultrasound parameters related to subacromial impingement in individuals with pediatric-onset SCI? METHODS: Subacromial impingement risk factors including supraspinatus tendon thickness (SST), acromiohumeral distance (AHD), and occupation ratio (OR; SST/AHD) were measured with ultrasound in 11 manual wheelchair users with pediatric-onset SCI. Handrim kinetics were acquired during the stroke cycle, including peak resultant force (FR), peak rate of rise of resultant force (ROR) and fractional effective force (FEF). Variability of handrim kinetics was computed using the coefficient of variation and linear regression was performed to assess correlations between handrim metrics and quantitative ultrasound parameters. RESULTS: Peak resultant force significantly increased 1.4 % and variability of FEF significantly decreased 8.0 % for every 0.1 cm increase in AHD. FEF decreased 3.5 % for every 0.1 cm increase in SST. Variability of peak resultant force significantly increased 3.6 % and variability of peak ROR of resultant force significantly increased 7.3 % for every 0.1 cm increase in SST. FEF variability significantly decreased 11.6 % for every 0.1 cm increase in SST. Peak ROR significantly decreased 1.54 % with every 10 % increase in OR. FEF variability significantly decreased 1.5 % with every 10 % increase in OR. SIGNIFICANCE: This is the first study to investigate relationships among handrim kinetics and shoulder structure in manual wheelchair users with pediatric-onset SCI. Associations were identified between subacromial impingement risk factors and magnitude and variability of wheelchair handrim kinetics. These results indicate the critical need to further explore the relationships among wheelchair handrim kinetics, shoulder joint dynamics, and shoulder pathology in manual wheelchair users with pediatric-onset SCI.

[Structural Design and Analysis of Portable Intelligent Wheelchair for Knee Rehabilitation].

Objective: In order to address the issues of inconvenience, high medical costs, and lack of universality associated with traditional knee rehabilitation equipment, a portable intelligent wheelchair for knee rehabilitation was designed in this study. Methods: Based on the analysis of the knee joint's structure and rehabilitation mechanisms, an electric pushrod-driven rehabilitation institution was developed. A multi-functional module was designed with a modular approach, and the control of the wheelchair body and each functional module was implemented using an STM32 single-chip microcomputer. A three-dimensional model was established using SolidWorks software. In conjunction with Adams and Ansys simulation software, kinematic and static analyses were conducted on the knee joint rehabilitation institution and its core components. A prototype was constructed to verify the equipment's actual performance. Results: According to the prototype testing, the actual range of motion for the knee joint swing rod is 15.1°~88.9°, the angular speed of the swing rod ranges from -7.9 to 8.1°/s, the angular acceleration of the swing rod varies from -4.2 to 1.6°/s², the thrust range of the electric pushrod is -82.6 to 153.1 N, and the maximum displacement of the load pedal is approximately 1.7 mm, with the leg support exhibiting a maximum deformation of about 1.5 mm. Conclusion: The intelligent knee joint rehabilitation wheelchair meets the designed functions and its actual performance aligns with the design criteria, thus validating the rationality and feasibility of the structural design.

Effects on tissue oxygenation in the gluteal region with a smart pressure redistribution wheelchair cushion compared to a pressure relief manoeuvre.

OBJECTIVE: The study examines the effects of the air-bladder offloading mode of a smart pressure redistribution wheelchair cushion on tissue oxygenation in the gluteal tissue of non-disabled participants. The hypothesis is that the cushion's offloading mode, which involves sequentially deflating its five air-bladders one at a time for a specific duration, would improve tissue oxygenation during sitting. METHODS: Two procedures were conducted. The first compared the cushion's offloads to a loaded control (LC) with the cushion on static mode, and the second compared the cushion's offloading mode to a standard manual offload performed by the participant. Three trials of each procedure were performed in randomized order. Tissue oxygenation was continuously monitored with three oxygenation parameters analysed: oxygen saturation (SO2), oxygenated haemoglobin (OxyHb), and deoxygenated haemoglobin (DeoxyHb). Data recordings were segmented in each step of the offloading sequence for analysis. A paired t-test was performed for comparisons with significance considered at α = 0.05. Ten healthy adults participated in the study. IMPACT: Results showed that as the air bladders deflated over time, the three evaluated parameters changed, affecting oxygenation even when other tissue areas were offloaded. The results indicated that the cushion's sacral offload had the greatest impact on improving tissue oxygenation among the five air-bladders in all ten subjects (p < 0.05). Furthermore, SO2 during the cushion's offload in the sacral region was similar to a manual offload. The study results suggest that the cushion could benefit tissue oxygenation, especially for individuals unable to change positions independently. Further research is needed to determine its effectiveness for wheelchair users.

The cushion's offloads, which involved deflating its five air-cell bladders one at a time for a specific duration, improved tissue oxygenation in the gluteal region of non-disabled individuals while seated.The cushion's offload in the sacral region had the greatest impact on improving tissue oxygenation among the five air-bladders in all ten subjects.This cushion could be an alternative for users who have limitations in performing pressure relief manoeuvres for the prevention of pressure injuries.A cushion that enhances tissue oxygenation while the user remains seated allows longer sitting periods, improving their quality of life, regardless of their ability to perform pressure relief manoeuvres.

Para table tennis improves psychological/mental and cardiovascular health in individuals with spinal cord injury.

BACKGROUND: Although rehabilitation exercise is known to be beneficial for cardiovascular and mental health, it remains a daunting challenge for patients with spinal cord injury (SCI) who rely on wheelchairs for mobility. OBJECTIVE: This study aimed to examine the effectiveness of a 4-week para table tennis program in enhancing self-efficacy and health outcomes in adults with SCI. METHODS: A total of 39 SCI patients were included and divided into the experimental group (n = 18, a 4-week para table tennis training program) and the control group (n = 21). Frequency domain indices of heart rate variability (HRV) were used to evaluate the function of the autonomic nervous system. RESULTS: Following para table tennis training, there was a significant reduction in the physical stress index (PSI, P < 0.001), accompanied by shifts in autonomic regulation of vagal dominance. Additionally, the para table tennis training led to significant improvements in vessel state, differential pulse wave index, atrial elasticity, eccentric constriction power, remaining blood volume, and self-efficacy (all P < 0.05). CONCLUSION: Para table tennis training results in favorable changes in sympathetic tone, enhanced self-efficacy, improved cardiovascular well-being, and an overall positive transformation in HRV.

Driving Assistance System with Obstacle Avoidance for Electric Wheelchairs.

A system has been developed to convert manual wheelchairs into electric wheelchairs, providing assistance to users through the implemented algorithm, which ensures safe driving and obstacle avoidance. While manual wheelchairs are typically controlled indoors based on user preferences, they do not guarantee safe driving in areas outside the user's field of vision. The proposed model utilizes the dynamic window approach specifically designed for wheelchair use, allowing for obstacle avoidance. This method evaluates potential movements within a defined velocity space to calculate the optimal path, providing seamless and safe driving assistance in real time. This innovative approach enhances user assistance and safety by integrating state-of-the-art algorithms developed using the dynamic window approach alongside advanced sensor technology. With the assistance of LiDAR sensors, the system perceives the wheelchair's surroundings, generating real-time speed values within the algorithm framework to ensure secure driving. The model's ability to adapt to indoor environments and its robust performance in real-world scenarios underscore its potential for widespread application. This study has undergone various tests, conclusively proving that the system aids users in avoidance obstacles and ensures safe driving. These tests demonstrate significant improvements in maneuverability and user safety, highlighting a noteworthy advancement in assistive technology for individuals with limited mobility.

Respiratory Muscle Training in Para-Athletes: A Systematic Review on the Training Protocols and Effects on Reported Outcomes.

CONTEXT AND OBJECTIVES: Respiratory muscle training (RMT) is considered an effective tool to improve cardiorespiratory limitations in athletes. The goals of this systematic review were to explore the role of RMT and its implementation within sport rehabilitation programs in para-athletes. EVIDENCE ACQUISITION: Several databases were searched until January 2024. Eligible studies were independently reviewed by 2 reviewers. Quality assessment was made using the PEDro scale and version 2 of the Cochrane Risk-of-Bias Tool for Randomized Trials. Eight studies (a total of 108 participants) were selected for the analysis. EVIDENCE SYNTHESIS: Five studies preferred using resistive loading, while 2 studies used normocapnic hyperpnea, and 1 study used threshold inspiratory muscle training. Respiratory functions (respiratory muscle strength and endurance, spirometry measures) and exercise performance were assessed as the main outcomes. Significant increases in respiratory muscle strength were reported in 5 studies. Two studies observed improvement in respiratory muscle endurance and 3 studies reported increased exercise capacity. CONCLUSIONS: This review suggests that although RMT can enhance respiratory muscle strength and endurance, it should not be considered the primary method for boosting the exercise performance of para-athletes. Additional research is necessary to explore the impact of various RMT techniques on different outcomes from the perspective of sport rehabilitation in para-athletes.

A user-inspired mobility experience of the future: a qualitative investigation.

Wheelchair users (WCUs) face additional challenges than non-WCU to multi-tasking (i.e. open doors, cook, use a cell-phone) while navigating their environments. While assistive devices have attempted to provide WCUs with mobility solutions that enable multi-tasking capabilities, current devices have been developed without the input of end-users and have proven to be non-usable. More balanced approaches that integrate the end-users' voices may improve current assistive technology usability trends. This study sought to empathically understand the lived experience of WCUs, their needs towards a mobility device, and their perceptions towards hands-free mobility. Full-time WCUs and care providers participated in semi-structured interviews examining wheelchair use and perceptions towards current and future mobility devices. Thematic analysis was used to analyze interview data. 9 WCUs (aged 32.1 ± 7.0 years; wheelchair experience 17.9 ± 11.6 years) and five care providers (years caring for WCU 3.75 ± 0.96 years) participated in the study. The most common disability type was spinal cord injury (WCUs: n = 3; care providers: n = 3). Qualitative analysis revealed four key themes: (1) Current wheelchair usage, (2) WCU and care provider perspectives, (3) Future wheelchair, and (4) Hands-free wheelchair. Accordingly, participants desire bespoke, light-weight mobility devices that can through tight spaces, access uneven terrain, and free the hands during navigation. This study provides meaningful insight into the needs of WCUs and care providers that assistive technology innovators can use to develop more usable assistive technologies. Amongst study participants, the concept of a hands-free mobility device appears to be usable and desirable.

Integrating end-users' voices into the development of assistive technology may improve current usability trendsWheelchair users desire access to their hands and the ability to multi-task while navigating their wheelchairsThe development of a hands-free mobility device may profoundly improve the quality of life of wheelchair users.

Telerehabilitation for New Wheelchair Evaluations: A Retrospective Study of Patient Characteristics.

The purpose of this paper was to describe the clinical and personal factors of persons with disabilities (PwD) seeking a new wheelchair evaluation via telerehabilitation compared to in-person appointments. This retrospective cohort analysis used the Functional Mobility Assessment and Uniform Dataset, which is a nationwide registry with ongoing enrollment at 31 clinical sites of PwD seeking a new wheelchair evaluation. PwD were stratified into either a Telerehabilitation Group or In-Person Group. There were 1,669 PwD in the Telerehabilitation Group and 10,284 in the In-Person Group. The Telerehabilitation Group had a higher mean age and higher percentage of Progressively Acquired Disabilities than the In-Person Group. This project lays the groundwork for future comparative effectiveness studies, which may influence telerehabilitation reimbursement policies for wheelchair services.

Muscle Changes during Direct Attack under Different Conditions in Elite Wheelchair Fencing.

Wheelchair fencing is a medium-distance combat sport in which the wheelchair is fixed to the floor. This requires a maximum concentration and gestational speed. Refined techniques and fatigue tolerance are essential to achieve competitive results. AIM: The main objective of this study was to measure the speed and muscular participation of a direct attack gesture with and without fatigue in a sample of elite wheelchair fencers. METHODS: The maximal isometric force, gestural speed, and resistance to gestural velocity were estimated in 10 elite performed direct fencers. RESULTS: The results revealed that sitting height and wingspan were important factors in achieving the highest speed, especially in women (r = 0.9; p = 0.07). Other factors, such as the elbow angle where the closed position was better, affected muscle contraction in both categories of athletes (p = 0.01). The onset of fatigue was earlier in category B than in category A, with greater variation in direct attack movement. The results highlight the importance of analyzing direct attacks for the best application of quick force, speed, and muscle participation, as well as identifying the onset of technical deterioration to devise a competitive strategy. These parameters may allow for precise design of conditioning sessions for elite wheelchair shooters.

Should I stay or should I go? An exploratory study comparing wheelchair-adapted rowing at home vs. in community gyms.

PURPOSE: Wheelchair users experience many barriers to physical activity as affordable and accessible exercise equipment options are limited. Thus, the home-based adapted rower (aROW) and gym-based aROW were developed. The objectives were to determine: 1) wheelchair users' preferences, perspectives, facilitators, and barriers to using the home-based versus the gym-based aROW, 2) perceived usability of the home and gym aROWs, and 3) recommendations to adapt the aROW further for home and community use. MATERIALS AND METHODS: In this two-phase exploratory mixed-methods study, participants completed one month of using a home aROW, followed by one month of using a community gym aROW. After each phase, participants completed a semi-structured interview and the System Usability Scale (SUS) questionnaire. Interview data were analyzed using conventional content analysis and effect size comparing SUS data was calculated. RESULTS AND CONCLUSIONS: Four categories were identified: what worked well, barriers to using the aROWs, what could be improved and important considerations. There was a large effect size in perceived usability between the aROWs with participants preferring the home aROW. Overall, rowing was enjoyable, and participants achieved positive physical outcomes. As preferences are individual, the home aROW provides wheelchair users with a potential choice between home or gym exercise.

Rowing is an enjoyable and effective form of aerobic exercise for wheelchair usersWheelchair users experience social, environment and financial barriers to engaging in exerciseThe home aROW provides a low-cost and accessible option for wheelchair-adapted aerobic exercise.

The maintenance and interface of two wheelchairs used by children with cerebral palsy in Kenya: a cross-sectional study.

Current wheelchairs used in low-resource settings lack the adjustability required for children with cerebral palsy and are not well-suited for rough terrain environments. This study aimed to examine the durability and functional interface of two wheelchairs specifically designed for use in low-resource settings. This descriptive study assessed 14 wheelchairs used by children with cerebral palsy living in Kenya, Africa (Momentum Wheels for Humanity's Liberty II wheelchair n = 6, Beeline's Honey Bee wheelchair n = 8). Four physical and occupational therapists evaluated durability using the Wheelchair Components Questionnaire (WCQ) and functionality using the Wheelchair Interface Questionnaire (WIQ). Medians were used to compare differences in the chair types using the Wilcoxon-Mann-Whitney test in Statistical Analysis Software (SAS) 9.4 with an alpha = 0.05. Median scores on the WCQ were 8.3/10 for the Liberty II and 7.8/10 for Beeline's Honey Bee wheelchair; however, the durability of the wheel locks was lower in the Beeline wheelchair (5.1/10 compared to the Liberty II 8.1/10 (p = 0.002). Median scores on the WIQ were lower and significantly different in the area of preventing distal lower extremity pain (Liberty II =3.7/10 and Beeline = 7.6/10, p = 0.045). Low scores occurred in both chairs in the areas of transfers and transporting the chairs in the community. The Beeline wheelchairs demonstrated higher average ratings for all areas of the WIQ, indicating the wheelchairs fit the children better and were more functional for use in the home and community environment.

Beeline Honey Bee and Clasp Liberty II wheelchairs demonstrate strengths supporting children in their communities, although no single type of wheelchair is perfect for children with cerebral palsy in low to middle-income countries with rough terrain.Rehabilitation professionals can use their physiological expertise to provide feedback on durability and functionality of wheelchairs in collaboration with wheelchair manufacturers to provide the most durable, cost-effective assistive technologies that support the user's physiological needs.The appropriate provision of wheelchairs can increase the quality of life for the child and their families, enabling them to participate in their local communities more fully.

A study on the formative usability testing for modular powered wheelchair.

The increasing prevalence of mobility impairments underscores the urgent need for accessible and affordable mobility aids. To overcome the mobility limitations of people with disabilities, there is an increasing need for the development of lightweight and portable powered wheelchairs that can be easily loaded. This study aimed to perform an early health technology assessment and a formative usability evaluation on a modular (detachable) powered wheelchair. It aimed to gauge device satisfaction among users, pinpoint areas for improvement, and detect any unforeseen errors to inform future development. Engaging 16 participants, including powered wheelchair users, healthcare professionals, and caregivers, the research evaluated the wheelchair's functionality in various scenarios, emphasizing safety, effectiveness, and convenience. Statistical analyses of task performance and satisfaction surveys highlighted that, while powered wheelchair users successfully completed tasks focusing on driving and power control, healthcare professionals and caregivers encountered difficulties with the wheelchair's assembly and disassembly. Despite general positivity, the surveys indicated mixed satisfaction levels regarding safety, validity, and convenience, with specific issues related to frame durability, seat comfort, and control mechanisms. These findings suggest that refining the wheelchair's design and addressing user concerns could significantly enhance satisfaction and mobility services. Future efforts will include a thorough review of an advanced prototype and further satisfaction assessments.

We believe that our study makes a significant contribution to the literature by addressing a critical gap in the understanding of user-centric design and usability testing for powered wheelchairs.By emphasizing the importance of early assessments and incorporating user feedback into the development process, our research offers practical insights for creating more accessible and user-friendly mobility solutions.This contribution is particularly relevant in the context of advancing assistive technology and improving the quality of life for individuals with disabilities.

Inertial Measurement Unit and Heart Rate Monitoring to Assess Cardiovascular Fitness of Manual Wheelchair Users during the Six-Minute Push Test.

Manual wheelchair users (MWUs) are prone to a sedentary life that can negatively affect their physical and cardiovascular health, making regular assessment important to identify appropriate interventions and lifestyle modifications. One mean of assessing MWUs' physical health is the 6 min push test (6MPT), where the user propels themselves as far as they can in six minutes. However, reliance on observer input introduces subjectivity, while limited quantitative data inhibit comprehensive assessment. Incorporating sensors into the 6MPT can address these limitations. Here, ten MWUs performed the 6MPT with additional sensors: two inertial measurement units (IMUs)-one on the wheelchair and one on the wrist together with a heart rate wristwatch. The conventional measurements of distance and laps were recorded by the observer, and the IMU data were used to calculate laps, distance, speed, and cadence. The results demonstrated that the IMU can provide the metrics of the traditional 6MPT with strong significant correlations between calculated laps and observer lap counts (r = 0.947, p < 0.001) and distances (r = 0.970, p < 0.001). Moreover, heart rate during the final minute was significantly correlated with calculated distance (r = 0.762, p = 0.017). Enhanced 6MPT assessment can provide objective, quantitative, and comprehensive data for clinicians to effectively inform interventions in rehabilitation.

Sitting Pressure Measurements in Wheelchair Users-Can the Effects of Daily Relief Activities Be Depicted?

Seat pressure measurements in wheelchair users have been available for some time; however, repeated measurements from a commercially available pressure mat over 90 min did not differ in the pressure-loaded measurement area or the coordinates of the center of pressure, even in participants who were able to reposition themselves in the wheelchair. The question therefore arises: to what extent are there other parameters that reflect the activity of wheelchair users with the pressure mat? To investigate this, a commercial pressure mat (BodiTrak®) was used to perform the measurements of pressure of 33 adult wheelchair-dependent people with spinal cord injury after 30 and 90 min sitting on the cushion. In addition to the standard output of the pressure mat, graph-based surface analyses (calculation of the area of maximum pressure, calculation of the pressure-loaded measurement area, and pressure-area ratio) was performed retrospectively using Python 3.7. The analysis of the measurements after 30 and 90 min was performed by distinguishing the participants between those who could actively change their position (N = 24) and those who could not (N = 9). The parameters of the pressure mat and the graph-based analyses remained unchanged for active participants. In participants who were unable to actively change their position, the area of maximum pressure and the pressure-area ratio (ratio of maximum pressure area and total pressure-loaded area) increased. Significant differences between minutes 30 and 90 are only found for the pressure-area ratio. Thus, when measuring the seat pressure of wheelchair users, the pressure-area ratio should be taken into account as it reflects the daily relief activities of wheelchair users.