A Participatory Risk-Matrix Framework for User-Centered Validation of a Manual Standing Wheelchair
Abstract
This study presents a participatory, risk-based validation framework for a manually actuated standing wheelchair. The standing function offers both physical and psychosocial benefits, including greater independence, improved social interaction, and better access to vertical space. However, adoption of such devices remains limited, especially in low-resource settings, due to concerns about usability, comfort, and safety. Rather than emphasizing technical novelty, the contribution of this study lies in applying a user-centered risk-matrix approach to systematically translate stakeholder concerns into design priorities. Through engagement with eight stakeholders, including direct users and institutional representatives, the study collected qualitative feedback on user experience. This feedback was organized into eight thematic risk categories. Among them, stability during transitions and the level of physical effort required were identified as the most pressing concerns. Each risk type was then evaluated using a qualitative 5×5 matrix to assess its likelihood and potential impact. This structured process enabled the design team to prioritize and implement targeted improvements, effectively reducing the likelihood of tipping-related risks. However, physical accessibility, particularly for users with limited upper-body strength, remained a high, unmitigated risk due to inherent limitations of manual operation. The study highlights the importance of integrating structured risk analysis with real user input to inform assistive technology development that is not only functional, but also contextually responsive.
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A. Liampas, P. Neophytou, M. Sokratous, G. Varrassi,
C. Ioannou, G. M. Hadjigeorgiou, and P. Zis, “Mus
culoskeletal pain due to wheelchair use: A system
atic review and meta-analysis.,” Pain and Therapy,
vol. 10, pp. 973–984, Dec 2021.
I. Garate, J. Yanci, J. Ascondo, A. Iturricastillo,
and C. Granados, “Reliability and validity of lab
oratory and field cardiorespiratory exercise tests for
wheelchair users: A systematic review,” International
Journal of Environmental Research and Public Health,
vol. 22, no. 3, p. 384, 2025.
C. Paquin, F. Nindorera, M. Gagnon, M.-È. Lamon
tagne, and F. Routhier, “Personal risk factors for
pressure injuries among wheelchair users: an um
brella review of new insights in 2024,” Disability and
Rehabilitation. Assistive Technology, vol. 20, pp. 1–16,
Jan 2025.
M. Rasoulivalajoozi, C. Cucuzzella, and M. Farhoudi,
“Domains of wheelchair users’ socio-emotional expe
riences: Design insights from a scoping review,” Dis
ability and Health Journal, vol. 18, no. 3, p. 101829,
C. L. Flemmer, “Improving the built environment for
manual wheelchair users: A review,” IOP Conference
Series: Earth and Environmental Science, vol. 1101,
p. 032031, nov 2022.
N. S. Poulsen, L. R. Kraglund, and J. Vissing, “Physi
cal training of wheelchair users with neuromuscular
disorders: A systematic review.,” Journal of Neuro
muscular Diseases, vol. 12, pp. 330–341, May 2025.
S. Selph, A. Skelly, N. Wasson, J. Dettori, E. Brodt,
E. Ensrud, D. Elliot, K. Dissinger, and M. McDon
agh, “Physical activity and the health of wheelchair
users: A systematic review in multiple sclerosis, cere
bral palsy, and spinal cord injury,” Archives of Physi
cal Medicine and Rehabilitation, vol. 102, pp. 2464
, 10 2021.
R. E. Cowan, S. L. Silveira, T. Helle, U. Læssøe,
K. R. Gøeg, J. Bangshaab, and R. W. Motl, “Lifestyle
physical activity in manual wheelchair users
an overlooked public health opportunity.,” Spinal
Cord, vol. 60, pp. 190–192, Feb 2022. Grant
F32HD101214/U.S. Department of Health & Human
Services | NIH | Eunice Kennedy Shriver National
Institute of Child Health and Human Development
(NICHD)/.
K. Charlton, C. Murray, N. Layton, E. Ong, L. Farrar,
T. Serocki, and S. Attrill, “Manual wheelchair train
ing approaches and intended training outcomes for
adults who are new to wheelchair use: A scoping
review.,” Australian Occupational Therapy Journal,
vol. 72, p. e12992, Feb 2025.
G. Fasipe, M. Goršiˇ c, M. H. Rahman, and J. R. Ram
mer, “Community mobility and participation assess
ment of manual wheelchair users: a review of cur
rent techniques and challenges,” Frontiers in Human
Neuroscience, vol. 17, p. 1331395, 2024.
J. Duvall, S. Satpute, R. Cooper, and R. A. Cooper,
“A review of adaptive sport opportunities for power
wheelchair users.,” Disability and Rehabilitation. As
sistive Technology, vol. 16, pp. 407–413, May 2021.
K. E. Griggs, “Wheelchair satisfaction and recom
mended improvements of manual wheelchairs in the
uk.,” Disability and Rehabilitation. Assistive Technol
ogy, vol. 20, pp. 163–170, Jan 2025.
R. Togni, A. Kilchenmann, A. Proffe, J. Mullarkey,
L. Demkó, W. R. Taylor, and R. Zemp, “Turning in
circles: Understanding manual wheelchair use to
wards developing user-friendly steering systems,”
Frontiers in Bioengineering and Biotechnology, vol. 10,
p. 831528, 2022.
G. da Silva Bertolaccini, F. E. Sandnes, F. O. Medola,
and T. Gjøvaag, “Effect of manual wheelchair type on
mobility performance, cardiorespiratory responses,
and perceived exertion.,” Rehabilitation Research and
Practice, vol. 2022, p. 5554571, 2022.
S. J. Briley, R. J. K. Vegter, V. L. Goosey-Tolfrey, and
B. S. Mason, “The longitudinal relationship between
shoulder pain and altered wheelchair propulsion
biomechanics of manual wheelchair users.,” Journal
of Biomechanics, vol. 126, p. 110626, Sep 2021.
M. Khalili, A. Eugenio, A. Wood, M. Van der Loos,
W. B. Mortenson, and J. Borisoff, “Perceptions
of power-assist devices: interviews with manual
wheelchair users.,” Disability and Rehabilitation. As
sistive Technology, vol. 18, pp. 693–703, Jul 2023.
N. Krayn-Deckel, K. Presaizen, and A. Kalron, “Cog
nitive status is associated with performance of man
ual wheelchair skills in hospitalized older adults.,”
Disability and Rehabilitation. Assistive Technology,
vol. 19, pp. 24–29, Jan 2024.
L. K. Kenyon, K. L. Harrison, M. K. Huettner, S. B.
Johnson, and W. C. Miller, “Stakeholder perspectives
of pediatric powered wheelchair standing devices: a
qualitative study,” Developmental Medicine & Child
Neurology, vol. 63, no. 8, pp. 969–975, 2021.
C. Schofield, K. Evans, H. Young, S.-G. Paguinto,
K. Carroll, E. Townsend, M. Kiefer, M. McGuire,
J. Sodhi, P. Bray, K. Bayley, N. M. Vorster, and
J. Downs, “The development of a consensus state
ment for the prescription of powered wheelchair
standing devices in duchenne muscular dystrophy.,”
Disability and Rehabilitation, vol. 44, pp. 1889–1897,
May 2022.
S. Merai, D. Shah, B. Trivedi, P. Joshi, and S. Kush
wah, “A study and design of standing wheelchair,”
Materials Today: Proceedings, vol. 65, pp. 3787–3792,
J. Shaikh-Mohammed, S. S. Dash, V. Sarda, and
S. Sujatha, “Design journey of an affordable manual
standing wheelchair.,” Disability and Rehabilitation.
Assistive Technology, vol. 18, pp. 553–563, Jul 2023.
J. S. Ortiz, G. Palacios-Navarro, V. H. Andaluz,
and B. S. Guevara, “Virtual reality-based frame
work to simulate control algorithms for robotic as
sistance and rehabilitation tasks through a standing
wheelchair,” Sensors, vol. 21, no. 15, p. 5083, 2021.
V. Sarda, S. S. Dash, D. S. Mohan Varma, J. Shaikh
Mohammed, and S. Sujatha, “Design of a low-cost,
reconfigurable, standing wheelchair with easy and
stable sit-stand-sit transition capability.,” Disabil
ity and Rehabilitation. Assistive Technology, vol. 18,
pp. 1056–1065, Oct 2023.
S. Daniel, N. Rawat, R. Iyer, J. Shaikh-Mohammed,
S. S. Dash, V. Sarda, and S. Sujatha, “User experience
study of an affordable manual standing wheelchair.,”
Disability and Rehabilitation. Assistive Technology,
vol. 18, pp. 1536–1543, Nov 2023.
M. Z. U. Rahman, I. Ali, A. Ishfaque, M. T. Riaz,
N. Ahmad, M.M.S.AlMahmud,andR.Tanveer, “De
sign, analysis, and control of biomedical healthcare
modular wheelchair with posture transformation,”
Complexity, vol. 2023, p. 7310265, 2023.
F. Taoheed, S. Parvez, M. A. Rahman, M. Hossain,
M. A. Hossain, M. O. Haque, V. A. Taylor, M. S. Hos
sain, and M. Alam, “Feasibility, usability, and ac
ceptability of a novel open-source manual standing
wheelchair in low resource settings,” medRxiv, 2025.
M. Zeeshan, M. A. Aslam, A. Waleed, and M. Asif,
“Comprehensive featured based standing wheelchair
using voice and gesture control for enhancing mobil
ity and accessibility,” in 2024 International Confer
ence on IT and Industrial Technologies (ICIT), pp. 1–5,
S.Daniel Frederick, J. Shaikh Mohammed, G. Suresh,
and S. Sujatha, “Long-term community integration
study of an affordable manual standing wheelchair.,”
Disability and Rehabilitation. Assistive Technology,
vol. 19, pp. 2698–2707, Oct 2024.
M. A. Alapakkam Govindarajan, P. S. Archambault,
and Y. Laplante-El Haili, “Comparing the usability
of a virtual reality manual wheelchair simulator
in two display conditions.,” Journal of Rehabilita
tion and Assistive Technologies Engineering, vol. 9,
p. 20556683211067174, 2022.
R. K. Hansen, A. Samani, U. Laessoe, R. G. Larsen,
and R. E. Cowan, “Sociodemographic characteris
tics associated with physical activity barrier percep
tion among manual wheelchair users,” Disability and
Health Journal, vol. 14, no. 4, p. 101119, 2021.
DOI: http://dx.doi.org/10.12962%2Fj25807471.v9i2.23228
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