Feasibility, Usability, and Acceptability of a Novel Open-source Manual Standing Wheelchair in Low Resource Settings

Background: Standing wheelchairs are highly beneficiary for improving mobility and independence, but they tend to be expensive due to their advanced features and technology. We have recently developed an open-source high-quality, low-cost manual standing wheelchair to enhance independence and quality of life for individuals with paralysis. This study aimed to address the feasibility, usability and acceptability of the developed manual standing wheelchair among individuals with low socioeconomic settings. Methods: Thirty paraplegic wheelchair users were enrolled in this study from the Centre for the Rehabilitation of the Paralysed, Savar, Bangladesh using purposive sampling to evaluate the wheelchair's usability. The data was collected using a wheelchair usability questionnaire with the use of a Likert scale and qualitative feedback was obtained through a qualitative questionnaire to examine the acceptability of the wheelchair. Results: The locally developed standing wheelchair material cost was only US$166 which is much lower than the median income in Bangladesh, hence found feasible and mostly affordable for paraplegics. The usability and acceptability study involved 26 males and 4 females with age (Mean 30.8, SD 8.5 years), height (165.02, 6.8 cm) and weight (57.3, 8.3 kg) who sustained a complete motor injury (ASIA A/B) between Thoracic 4 to Lumber 2 spinal cord who sustained a complete motor injury within the past four years. Each study participant on average spent a total of 7.7 hours in the standing wheelchair per day. Our questionnaire data suggests that the study participants felt safe (mean score 8.4 out of 10) in our standing wheelchair and very little effort was needed to operate and propel (3.3 / 10) the wheelchair. Furthermore, being able to talk to people in a standing position using the standing wheelchair made them feel more confident (7.7 / 10) and they felt very happy (8.2 / 10). When standing, all subjects showed a lower level of nervousness (2.4 / 10). The users also anticipated that the standing wheelchair would enhance their involvement in household activities (7.3 /10). The overall user satisfaction of the standing wheelchair was high (7.1 / 10). Conclusions: The study found that the manual standing wheelchair is affordable, easy to operate, and well-accepted by conventional wheelchair users in rehab settings. However, further testing in community settings is warranted.