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Purpose: This study aimed to evaluate the clinical applicability of a customised power wheelchair joystick using rapid prototyping with 3D modeling and printing technology within a rehabilitation centre for patients with cervical spinal cord injury. Materials and Methods: Two male participants with tetraplegia following cervical-level spinal cord injury who had difficulty operating a powered wheelchair were recruited. The procedure of the joystick-making and training service consists of four steps: (1) driving evaluation; (2) digital fabrication; (3) functional test; and (4) driving training. K-QUEST 2.0 (Korean-Quebec User Evaluation of Satisfaction version 2.0) was used to measure the usability of the off-the-shelf and customised joystick. Results: During the application process, several redesign stages were required to obtain the final customised joystick. After participants attended a 30-min driving training five times per week for 8 weeks, the usability of the customised joystick was higher than that of the off-the-shelf one. Conclusion: Providing the customised joystick-making and training service can be used in hospitalised rehabilitation centre before the hospital discharge of patients and returns to their everyday lives. IMPLICATIONS FOR REHABILITATION: 3D printing technology in rehabilitation clinics can provide new benefits, including cost-effectiveness, customisation of assistive devices, higher productivity, and enhanced collaboration with clients. More specifically, the entire intervention process, from medical evaluation, designing and manufacturing the devices, and training the client, can be performed efficiently and quickly by rehabilitation practitioners who best understand the client's characteristics. This study aimed to confirm the clinical applicability of a quick and efficient service for a customised power wheelchair joystick using 3D modelling and printing technology in rehabilitation centres for patients with cervical spinal cord injury. This study is expected to provide clinical support for connecting potential users and practitioners with technological advancements. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of the review was to explore current factors affecting the use of a powered wheelchair for an adult person a with a disability. Materials and Methods: This review followed the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) statement. Information about the characteristics of the studies (type, setting) and perceived barriers and facilitators to powered wheelchair use were extracted using a data extraction sheet. Data synthesis was achieved using narrative synthesis. The quality of the included studies was assessed using the Standard Quality Assessment Criteria for Evaluating Primary Research Papers from a Variety of Fields (SQAC) and the CASP checklist (Critical Appraisal Skills Programme), Centre for Evidence-Based Medicine, SIGN (Scottish Intercollegiate Guidelines Network). Results: Fifteen studies qualified for inclusion in the review. The narrative synthesis produced a conceptual map of reported factors affecting the usability of a powered wheelchair. Conclusions: This review demonstrates that powered wheelchair use is a multifaceted and multidisciplinary phenomenon that is dependent on numerous interconnected factors including individual adjustment, stakeholder cooperation, societal attitudes, functional performance, and environmental features. Based on the review findings, there are several applied learning outcomes and practical applications to the powered wheelchair prescription and provision. IMPLICATIONS FOR REHABILITATION: The rejection, misuse or damage of a powered wheelchair can result in condition deterioration and loss of independence for the user. Adult powered wheelchair prescription, maintenance, and use is a multi-faceted process spanning social, individual, environmental, technical and functional, and organisational factors. Individuals in this stakeholder network should aim to account for these interdisciplinary factors when engaging with people who use powered wheelchairs. [ABSTRACT FROM AUTHOR]

To evaluate children's characteristics and impact of a powered wheelchair lending program including comparisons of diagnostic sub-groups, and validation of a predictive model of powered mobility proficiency. This retrospective study included 172 children who participated in the ALYN powered mobility lending program from 3/2009-7/2022. Demographics and functional levels were measured via questionnaires; driving proficiency was evaluated when the wheelchair was returned, and parents and children were interviewed following their participation in the program. Two diagnostic groups were identified: cerebral palsy (CP) (n = 136, median = 9.75 yrs) and other neuromuscular diseases (NMD) (n = 30, median = 5.83 yrs). They differed significantly in the age they commenced PM training, the male/female ratio, walking ability and access mode. Fifty-seven percent of the participants with CP achieved powered mobility proficiency, a rate that was significantly lower than the 73% proficiency found for the NMD group. Four significant predictors were identified: communication, manual wheelchair operation, access mode and go-stop upon request. They predicted proficiency in approximately 80% of cases. Overall feedback from the parents and children indicated that their personal and family's quality of life improved as a result of their child's ability to use a powered wheelchair. A lending program provides children with opportunities to improve mobility skills in an appropriate powered wheelchair. Children who can communicate verbally, propel a manual wheelchair, use a joystick and go-stop upon request are significantly more likely to become proficient drivers; however, many who were unable to complete these tasks also improved and even became proficient drivers. Children who are able to engage in verbal communication, propel a manual wheelchair for short distances, use a joystick and go-stop upon request are significantly likely to become a proficient powered wheelchair drivers. Children with cerebral palsy who have greater physical challenges (e.g., cannot walk at all or propel a manual wheelchair) can reach powered mobility proficiency following practice with a powered wheelchair borrowed from a lending program, although at a lower rate than those with other neuromuscular diseases; additional training strategies should be developed to increase the percent success for children with cerebral palsy. A multivariate logistic regression was able to correctly predict whether a child will become proficient driver in 80% of case. Training with a powered wheelchair from the lending program enabled parents to observe their children's independent mobility in their home environment; they reported improvement in the family's quality of life. [ABSTRACT FROM AUTHOR]

To develop a tool to assess the progression of powered mobility skills for children and determine its psychometric properties. A three-phase, the mixed-method design included: I) conceptualisation based on international specialists' input through a focus group or interview to generate initial items; II) tool development using a two-round Delphi survey and III) evaluation of psychometric properties from eight video recordings of children. The Progression of Paediatric Powered Mobility (3PM) was validated via Intraclass correlation coefficients (ICC) calculated from conventionally powered mobility assessments: the Powered Mobility Program, the Assessment of Learning Powered Mobility tool, and the Powered Mobility Proficiency test. Content derived from 20 clinical experts led to the development of the first version consisting of 19 demographic and 61 driving skill items. Following two Delphi rounds, the final tool included 14 demographic and 41 driving skill items. Internal consistency was excellent (Cronbach alpha = 0.96) as was the inter-rater reliability (ICC = 0.96, 95% confidence interval = 0.95–0.96). Pearson correlation coefficients between the 3PM and other PM assessments demonstrated good convergent validity. The 3PM, created through international collaboration with experts in PM, has excellent psychometric values as a valid measure that can be used reliably to assess children's powered mobility skills. The 3PM reflects the three stages of powered mobility development: exploratory, operational, and functional stages. Input from clinical experts in PM mobility contributed to the identification of the key driving skills important to include in the 3PM. A reliable and valid tool can facilitate assessment and tailored intervention in paediatric powered mobility. [ABSTRACT FROM AUTHOR]

Powered wheelchair use promotes participation in individuals with limited mobility, however training is required for safe and effective use. There is limited evidence on the task demands of powered wheelchair use to inform an evidence-based skills training programme. To conduct a systematic exploration of the task demands of indoor powered wheelchair use to identify frequently used skills, abilities, and knowledge. We used a two-phased think aloud process to conduct a task analysis of powered wheelchair use with experienced powered wheelchair users (n = 5) and expert clinicians (n = 5). Participants completed seven indoor driving tasks while speaking aloud (concurrent think aloud) and subsequently engaged in a structured qualitative interview to discuss skills, abilities, and knowledge used across each of the seven tasks (retrospective think aloud). We used directed content analysis to map the skills and abilities to the ICF framework and conventional content analysis to develop thematic areas of knowledge used while operating a powered wheelchair. One-hundred and ten (110) distinct skills and abilities were identified and mapped to the ICF; 80 in the Body Structures and Functions domain, and 30 in the Activities and Participation domain. Approximately 50% of skills and abilities were mental functions. Four thematic knowledge domains were identified: knowledge of self, environment, wheelchair, and task. Powered wheelchair use is complex and requires a variety of skills and abilities from all areas of human functioning, in addition to a wide range of knowledge. Training programmes should address a range of areas of skill development. Powered wheelchair use is a complex skill; training should develop skills from all. Domains of the ICF, including mental and physical functions. A range of knowledge is used while operating a powered wheelchair; training programs. Should include the development and application of necessary knowledge. Clinicians may consider a range of factors when assessing suitability for powered. Wheelchair user, however should acknowledge that while the range of skills idenotified. May be useful, they may not be critical for success in powered wheelchair use. [ABSTRACT FROM AUTHOR]

Purpose: The objective of this research is to identify stakeholder views with regard to the development of effective powered wheelchair assistive technologies more suited to the user and carer needs, whilst also meeting the requirements for other stakeholders, such that developers can be better guided towards producing solutions which have a better chance of getting to the market place and hence to the end user. Method: A questionnaire was designed to collect the views of all stakeholders and circulated to a statistically representative number of them. The question rating data were then checked for correlation between groups, and within groups, to establish validity. Results: The 74 stakeholders across the eight classes who responded had a good correlation between each other, with a cross class "Pearson's correlation" ranging between 0.7 and 0.95, and the "Fleiss's Kappa reliability of agreement" within each class ranging between 0.07 and 0.36. Conclusions: This research has identified that all stakeholders should be involved in the development of the technology and that some may benefit in 'role-reversal' to help understand user problems and stakeholder concerns more clearly. Cost was a significant barrier to the uptake of appropriate technology, and training of users and carers was a major issue. Furthermore, development should not increase user isolation and the impact on the user must be monitored for 'quality of life'. Technical support and training should be given to the user and their carers, and equipment must be adaptive to meet the changing needs of the user. Improved acceptance and use of technology by the user and their carers. Reduced rejection of appropriate provision. Improved mobility and interaction with others. Improved quality of life for users and carers. [ABSTRACT FROM AUTHOR]

Objective: To describe how men and women experience their use of powered wheelchairs (PW) and powered scooters (PS) in everyday occupations, in the home and in society at large. Methods: A qualitative research approach with focus-group methodology was used. Four focus groups were created, with men and women as well as PW and PS users in different groups. Applying a descriptive approach, data were analysed according to the principles described by Krueger. Findings: Three categories emerged and revealed that even though use of PW and PS increased independence and enabled everyday occupations, participants struggled to be independent powered mobility device (PMD) users. They experienced many accessibility problems in dwellings and in society, described similarly by users of PW and PS. Men and women experienced their use of (PMD) differently, especially in relation to the service delivery process. Conclusions: The study contributes with new knowledge on accessibility for PW and PS users and related service delivery processes, stating that gender differences regarding provision and training must be taken into account. Occupational therapists can contribute to an enhanced understanding of PMD users' challenges in person-environment-occupation transactions in the home and society, and thereby promote occupational justice for PMD users. [ABSTRACT FROM AUTHOR]

Purpose: Personal mobility vehicles (PMVs) are under active development. Most PMVs are wheel-driven, a mode of transport notable for its efficiency. However, wheeled PMVs tend to have poor mobility against negotiating obstacles. The four-wheeled vehicle RT-Mover PType 3 has been developed featuring wheeled legs capable of leg motion. This allows the PMV to overcome uneven terrains, including a step approached at an angle, which ordinary wheelchairs cannot negotiate. Method: This article discusses a gait algorithm in which a leg executes the necessary leg motion when optionally presented with obstacles on a road. In order to lift a wheel off the ground and perform a leg motion, the support wheels must be moved to support points to ensure that the vehicle remains stable on three wheels. When moving towards the target support point, a wheel may encounter another obstacle, and a response method for this case is also described. Results: To assess the gait algorithm, several configurations of obstacles were used for performance tests with a passenger. The capabilities of the PMV were demonstrated through experiments. Conclusion: We proposed a novel gait algorithm for our PMV and realised the proposed motion pattern for PMV-based negotiating obstacles. [ABSTRACT FROM AUTHOR]