Facilitating fitness for wheelchair users: exploring safety and usability of a standing active arm passive leg exercise device.

Abstract

Introduction: Exercising upright can promote rehabilitation and reduce the risk of cardiorespiratory and musculoskeletal complications from prolonged sitting. Seated Active Arm Passive Leg Exercise (AAPLE) offers cardiovascular benefits; however, no commercially available device currently enables fully supported, upright AAPLE. The AAPLEwalk device transitions wheelchair users from sitting to standing, facilitating gait-like movements at varying intensities. An iterative development process incorporating user feedback refined the design from version 1 (v1) to version 2 (v2), which had yet to be formally evaluated.

Purpose: (1) To assess the perceptions of non-disabled users and wheelchair users regarding the safety, usability, and functionality of AAPLEwalk^™ v2. (2) To compare user experiences between v1 and v2 among a sub-sample who tested both.

Materials and methods: Participants were fitted to the AAPLEwalk. Before wheelchair users, non-disabled users initially tested the device to ensure skin and pressure safety. We explored comfort, usability, and design modifications through informal discussions, formal semi-structured interviews, and measured System Usability Scale (SUS) scores. RESULTS: Fourteen non-disabled and six wheelchair users participated. Respectively, average SUS scores were 70 (non-disabled) and 72 (wheelchair), ranking in the 50th and 80th percentiles. Three themes emerged: (1) A good workout, (2) Feeling secure, (3) Maximizing independence. Users reported physical, mental, and emotional benefits, finding AAPLEwalk v2 safe, comfortable, and feasible for independent use with practice.

Conclusion: The AAPLEwalk appears to be a promising device for enabling upright APPLE for wheelchair users. Future research should assess the device's physiological impact and long-term fitness benefits.