Participatory action design and engineering of a manual wheelchair virtual coach including in-home and community usage

The Journal of Spinal Cord Medicine, 2023 · DOI: 10.1080/10790268.2022.2107352 · Published: July 1, 2023

Spinal Cord Injury Assistive Technology Rehabilitation

Simple Explanation

This study focuses on developing a virtual coaching system for manual wheelchair users (MWU) to improve pressure redistribution (PR) and reduce the risk of pressure injuries (PI). The system includes a seat instrumented with force sensors, algorithms to detect PR, and a smartphone app for user interface. The development process involved focus groups with clinicians and MWUs, short in-home trials to identify and fix system failures, and longer in-home trials to gather feedback on usability and record PR behavior. The MW-VC is comprised of a mechanical assembly instrumented with load cells, an electronics package, a smartphone application, and an online database. The goal is to create a device that is effective for both MWUs and clinicians, promoting active sitting and regular PR to prevent PI. The prototype system was developed using a participatory action design and engineering (PADE) approach.

Study Duration

Focus Groups, Five-Day Assessment, Four-Week Investigation

Participants

Focus Groups: 10 clinicians and 10 MWU; Five-Day Assessment: 5 male MWU; Four-Week Investigation: 7 participants

Evidence Level

Not specified

Key Findings

1
Focus groups provided guidance on ergonomics, user interface, charging frequency, and key dimensions and mass of the device.
2
The 5-day study identified mechanical, electrical, and connectivity challenges that were addressed before the 4-week study.
3
The 4-week trial indicated that participants performed PR less frequently than clinically recommended and provided insights into the types of maneuvers performed.

Research Summary

This study describes the development of a manual wheelchair virtual coaching system using a participatory action design and engineering (PADE) approach. The system aims to improve pressure redistribution (PR) among manual wheelchair users (MWU) to reduce the risk of pressure injuries (PI). The development process included focus groups with clinicians and MWUs, short in-home trials to identify and fix system failures, and a longer 4-week in-home trial to assess usability and PR behavior. The study identified challenges and areas for improvement in the system's hardware, software, and user interface. The results suggest that the system has the potential to improve training and adherence to PR guidelines, but further development and testing are needed to address usability issues and ensure effective implementation.

Practical Implications

Improved PI Prevention

The MW-VC system aims to reduce the incidence of pressure injuries by promoting regular pressure redistribution among MWUs.

Enhanced Training and Adherence

The system can be used as a training tool to educate MWUs on proper PR techniques and encourage adherence to clinical guidelines.

Personalized Feedback

The smartphone app provides real-time feedback on CoP, detected PR techniques, and time remaining to complete a successful PR, enabling users to adjust their behavior accordingly.

Study Limitations

1
The most common usability issue was that the MW-VC application did not always reliably connect to the MW-VC hardware.
2
Data from the 4-week study indicate that participants did not do as many complete PR as rec-ommended by clinical guidelines.
3
The PR determination algorithm only considered left, right, and forward leans.

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