Usage problems and social barriers faced by persons with a wheelchair and other aids. Qualitative study from the ergonomics perspective in persons disabled by rheumatoid arthritis and other conditions.

OBJECTIVE: The objective of this study was to identify the usage and accessibility problems faced by the disabled (whether in pain or not) users of assistive devices (conventional wheelchairs), identify physical barriers that limit their mobility, and recognize the socio-cultural practices excluding them from the design process of such devices. Another main purpose of this paper is to improve the ergonomic criteria that influence the design and manufacture of assistive devices.

STUDY POPULATION: 15 patients with any of the following diagnoses: ankylosing spondylitis, rheumatoid arthritis, or amputees using wheelchairs in Mexico and Colombia.

DESIGN: Qualitative study. Thematic analysis with a theoretical industrial design approach to employing usability testing for ergonomic analysis.

RESULTS: We identified 6 issues associated with usability problems from the patient's standpoint: barriers for use of wheelchairs (usability and acceptability), creative adaptations, potential use of technical devices, independence, body perception and assistive devices, and architectural barriers. The ergonomic and usability requirements and the resulting level of independence vary across wheelchair users with chronic pain and those whose disability does not involve pain. The latter are more independent in their movements and decisions.

CONCLUSIONS: User input is essential in the design of assistive devices. The proposal of "design from and for the user" must rely on both engineering and medical perspective on the ergonomy as well as the user interpretation of the environment and the experience of the disease. Thus we can arrive at a "user-centered design".