Developing a rigid frame wheelchair in Brazil.

Area of Science:

• Rehabilitation Engineering
• Assistive Technology Development
• User-Centered Design

Background:

• The World Health Organization (WHO) Wheelchair Guidelines advocate for user-centered and open innovation approaches in assistive device development.
• There is a need for affordable, high-quality manual wheelchairs within public healthcare systems, particularly in low- and middle-income countries.
• Previous development processes may not have adequately incorporated end-user feedback or interdisciplinary collaboration.

Purpose of the Study:

• To describe the development process of a rigid frame wheelchair utilizing user-centered and open innovation methodologies.
• To align the wheelchair design and development with the principles outlined in the WHO Wheelchair Guidelines.
• To create an acceptable and effective rigid frame wheelchair model for the Brazilian public healthcare system.

Main Methods:

• Initial product brief, design, and selection were informed by unstructured interviews and group discussions with active wheelchair users.
• Prototype development involved iterative adjustments based on ISO 7176 testing for safety and durability.
• Long-term follow-up included satisfaction, safety, mobility, and fitting assessments using QUEST 2.0 and WHO training package tools with 40 active wheelchair users.

Main Results:

• The iterative design process resulted in a prototype deemed appropriate by multiple stakeholders, with ISO testing confirming safety and durability.
• Follow-up trials with 40 active wheelchair users (80% male, average age 36.3 years, 92.5% with SCI) showed high satisfaction with products (4.4) and services (4.1).
• Users reported an average of 4.2 hours/day in their wheelchairs, with 7.5% experiencing pressure sores and 20% reporting falls.

Conclusions:

• A user-centered, open innovation approach successfully yielded a high-quality, affordable, and acceptable rigid frame wheelchair model.
• This development expanded the range of manual wheelchairs available through the Brazilian public healthcare system.
• Engaging users and rehabilitation professionals is crucial for effective assistive product development, ensuring devices meet user needs and are adequately serviced.