"But, I Don't Want/Need a Power Wheelchair": Toward Accessible Power Assistance for Manual Wheelchairs
Dafne Zuleima Morgado Ramirez, Catherine Holloway · 2017 · Proceedings of the 19th International ACM SIGACCESS Conference on Computers and Accessibility (ASSETS '17) · doi:10.1145/3132525.3132529
Summary
This paper explores the needs, expectations, and experiences of manual wheelchair users regarding power assist devices — motorized attachments that augment a manual wheelchair's propulsion without converting it into a full power wheelchair. Manual wheelchair users face significant upper limb injury risks, with shoulder pain prevalence reported between 42% and 66%, and bilateral carpal tunnel syndrome as a common side effect of handrim propulsion. Power assist devices can reduce metabolic demand, increase mechanical efficiency, and help prevent repetitive strain injuries. However, it remains unclear whether existing devices actually match what users need and expect. The authors interviewed 12 UK-based manual wheelchair users with varying disabilities (including spinal cord injuries at various levels, spina bifida, cerebral palsy, multiple sclerosis, and post-poliomyelitis syndrome) and different levels of experience with power assist devices. They reviewed six commercially available devices in the UK market (SmartDrive, Twion, e-motion, WheelDrive, Xtender, and Batec hybrid handbikes), ranging from 6.1 to 29 kg in weight, all priced over £4,000. The study used semi-structured interviews analyzed through thematic analysis to identify barriers, needs, and ideal form factors for power assistance technology.
Key findings
Users identified both physical barriers (inaccessible built environments including curbs, rough surfaces, steep inclines, and door thresholds) and non-physical barriers (lack of awareness about available devices, incorrect understanding of their capabilities, emotional impacts of pain and anxiety, and high cost). Key situations requiring power assistance included ascending and descending inclines, travelling long distances, negotiating rough terrain, and emergency stops with reduced arm strength. Users strongly valued social accessibility — they preferred devices that concealed themselves within the wheelchair hub to maintain the accepted appearance of a manual wheelchair, rather than visibly altering it. Functionally, users wanted devices that attached to their existing favorite wheelchair without changing its width or weight significantly, with concealed batteries that could be detached for air travel. For interaction, users envisioned both mobile app and non-mobile control options, including tactile buttons below the seat, handrim tapping gestures, and voice control. The study introduced the concept of "chairable" devices — input and output technologies integrated into the wheelchair frame itself, independent from but not excluding wearable devices and smartphones. Users also expressed interest in monitoring the correlation between wheelchair pushes and shoulder pain, and in journey planning based on battery status. The authors identified the need for open-source, DIY wheelchair propulsion assistance devices that would be affordable in both developed and developing countries.
Relevance
This research highlights critical gaps in assistive technology design when user needs are not centered in the development process. For accessibility practitioners, it reinforces that functional accessibility alone is insufficient — social accessibility (how the technology affects the user's identity and social perception) is equally important. The concept of "chairable" devices is a valuable design paradigm: rather than assuming users will interact through smartphones or wearables, designers should consider embedding interaction capabilities directly into the assistive device itself. The finding that emotions and mental health directly impact wheelchair propulsion ability points to an underexplored dimension of assistive technology design. The call for open-source, DIY solutions reflects a broader accessibility equity concern — when commercial devices cost over £4,000 and may not meet user needs, community-driven alternatives become essential. This study's methodology of combining market analysis with participatory interviews provides a model for evaluating any category of assistive technology against actual user expectations.
Tags: wheelchair accessibility · assistive technology · participatory design · physical disability · spinal cord injury · wearable technology · interaction design · DIY assistive technology · social accessibility