Durability and usability evaluation of a tilt-in-space manual wheelchair for children in India

Around 8 million children with functional disabilities in India need postural support wheelchair designs. This study tests the durability and usability of a new tilt-in-space, postural support wheelchair design for children. The International Organization for Standardization (ISO) wheelchair durability testing was followed by a mixed-method observational field with a purposively selected, diverse sample of children aged 3-17 with varying diagnoses needing a tilt-in-space wheelchair in the rural and urban community settings in South India. Children were fitted with appropriate size wheelchairs. Demographic information was collected at baseline. Customized rapid surveys and interviews evaluated usability, use satisfaction, and willingness to buy and use the wheelchair device at the 2- and 12-month follow-up visits. The wheelchair passed ISO durability testing without part failures. Twelve participants (n = 7 boys, n = 5 girls), aged 10.25 +/- 2.67 years, reported high to moderate satisfaction of use. During follow-up, caregivers reported improvements in the child's physical function, social interaction, and time spent in the chair. No part failures were reported. Themes were found regarding the inappropriateness of previous wheelchair designs and the benefits for children's growth, function, and participation, as well as burden reduction for caregivers. The participants reported that they would buy the wheelchair for a price range of Rs. 15500-28751 ($186-346). The study results demonstrate the benefits of high-quality and usability of the postural support wheelchair design for children with functional disabilities. Such a design is necessary to promote growth, social skills, and reduced parental burden. Future studies should compare the design with wheelchairs currently prescribed in India.