Accessible exercise for wheelchair users: comparing the usability of two adapted exercise machines

Abstract

Introduction

Exercise is an important occupation for wheelchair users. Limited access to adapted aerobic exercise equipment in the community and lack of knowledge on how to exercise are barriers to exercise participation among wheelchair users. To address these barriers, the adapted rower (aROW) and adapted skier (aSKI) exercise machines and educational materials were created.

Purpose

1) To compare wheelchair users’ perspectives of the effectiveness and usability of the aROW and aSKI. 2) To explore perceptions of educational materials to support use of the machines.

Materials and Methods

A sequential, mixed-methods study design was used. Six wheelchair users trialled the machines, and completed an interview and two usability questionnaires. Qualitative data were analysed using thematic and conventional content analysis. Usability scores of both machines were compared using the Wilcoxon Signed Ranks Test.

Results

Data show high usability of the aROW and aSKI. More set up challenges were reported for the aROW than the aSKI. Participants perceived both machines provided effective cardiovascular workouts, and each met their exercise goals differently. Participants preferred the instructional videos over instructional sheets and provided suggestions for improving both. The Wilcoxon Signed Ranks Test showed no statistically significant difference in usability between the aROW and aSKI.

Conclusion

Implementing the aROW and aSKI in the community may address some equity issues that wheelchair users face by providing more aerobic exercise options. Results will inform educational material revisions to support use of the machines.

IMPLICATIONS FOR REHABILITATION

• The adapted rower (aROW) and adapted skier (aSKI) were perceived as highly usable, suggesting provision of more adapted aerobic exercise options, like the aROW and aSKI, may address some exercise-related equity issues wheelchair users experience.

• Wheelchair users may consider multiple factors when choosing adapted exercise equipment, highlighting the importance of providing multiple options for adapted aerobic exercise equipment to facilitate agency in choice of exercise.

Keywords:

• Aerobic exercise
• rowing
• skiing
• wheelchair user
• spinal cord injury
• participation
• adapted exercise

Disclosure statement

The researchers have no conflict of interests to report.

Additional information

Funding

This research was supported by the Craig H. Neilsen Foundation.

Notes on contributors

Elisabeth Anderson

Elisabeth Anderson, MOT, BA is a registered occupational therapist working in public practice. Passionate about supporting occupational participation for people with disabilities, she completed work in promoting inclusive health and human services education and promoting adaptive exercise for people with disabilities as a student researcher.

Abigail Baker

Abigail Baker, BSc, MOT, graduated from the University of British Columbia with a Masters of Occupational Therapy in 2022. She now works as an occupational therapist in the area of mental health and return to work.

Jaimie Borisoff

Jaimie Borisoff, BASc, PhD is Director of MAKE+ and the Rehabilitation Engineering Design Laboratory at the British Columbia Institute of Technology. Dr. Borisoff's research focuses on how technology development can improve accessibility and mobility for people with disabilities. His is work is intended to expand patients' ability to interact more fully with others, the environment, and their world. This includes dynamic wheeled mobility, the ability to change your position in a wheelchair to suit different daily activities.

Johanne Mattie

Johanne Mattie, BASc, MASc, is project lead at MAKE+ and the Rehabilitation Engineering Design Laboratory at the British Columbia Institute of Technology. She has over 30 years of experience related to research, development and design of health care related technology and assistive devices. Areas of expertise include needs assessment, device evaluation, and human factors engineering. Johanne use a variety of different methods to better understand the fit between the end users and technology, including focus groups, interviews, simulations, on-site observational analysis, and an array of biomechanical assessment techniques.

Bonita Sawatzky

Bonita Sawatzky, BP E, MP E, PhD. Her main research focus is mobility and quality of life for people with spinal cord injury/disease. Specifically, she has done considerable research on wheelchair propulsion in both powered and manual wheelchairs, looking at how to improve efficiency of the manual wheelchair. She is currently the Director of Equity, Diversity and Inclusion for the Department of Orthopaedics at the University of British Columbia.

Carolyn Sparrey

Carolyn Sparrey, BASc, MASc, PhD, is the Scientific Director of the ImageTech lab at Simon Fraser University. Her research focus is on applying mechanical engineering principles to understanding, diagnosing, preventing and treating spinal cord injuries. Dr. Sparrey is passionate about using health technology research to improve patient care and quality of life.

W. Ben Mortenson

W. Ben Mortenson, BScOT, MSc, PhD, FCAOT, is a Professor in the Department of Occupational Science and Occupational Therapy at the University of British Columbia. His work is centered on three main populations: people with disabilities (e.g., individuals with spinal cord injury, and residents in long-term care), family caregiver and formal caregivers. His research focuses on four overlapping areas: technology mobility, accessibility and outcome measurement.