Conference Agenda

Wheelchair users, especially those with spinal cord injuries, are at high risk of pressure injuries (PrIs). Prolonged pressure on vulnerable areas, like the ischial tuberosities, is a key cause, and while pressure relief maneuvers are effective, consistent implementation is challenging. Assistive health technologies that promote health prevention by tracking user behaviour show promise in enabling self-monitoring and real-time feedback to improve PrI prevention. However, their success depends on acceptability, including ease of use, psychological comfort, and integration into daily routines. This study aimed to investigate acceptability by gathering insights from wheelchair users and clinicians through interviews and focus groups. Users valued autonomy and preventative strategies such as repositioning and skin care but noted limitations. They saw the technology as beneficial for higher-risk users but emphasised the need for personalisation, discreet alerts, and privacy. Clinicians highlighted its potential to monitor behaviour, provide feedback, and support PrIs prevention but raised concerns about intrusiveness, usability. Both groups emphasised personalisation, simplicity, and affordability. The findings highlight the need for a collaborative, team-based approach, where users and clinicians work together with developers to ensure acceptability and effective implementation. Designing user-centered, clinician-endorsed technologies that adapt to diverse needs is crucial for fostering trust and widespread adoption.

Quality of service delivery is critical for the uptake of assistive technology, such as activity chairs, which are provided to support seated daily activities. This study investigates the scope and quality of instruction and training provided to users of activity chairs, aiming to identify gaps and inform provision practice.
A cross-sectional survey was conducted with N= 141 adult activity chair users, from 16 Danish municipalities. Data was collected by telephone interviews using a study-specific questionnaire. Descriptive statistics summarized the quantitative data, while thematic text analysis was applied to open-ended responses.
Results revealed varying levels of instruction and training: 32% of respondents received "curbside delivery," with no guidance on setup or use; 5% had the activity chair pre-adjusted but without further instruction. Approximately 33% received oral and/or written instructions, while 14% received a combination of pre-adjustment and oral/written instructions. Notably, 16% underwent activity-based training in their home environment.
Unfortunately, these devastating findings add to the existing body of literature demonstrating poor and substantial variability regarding the quality of the service delivery process. This emphasizes the need for improvement, potentially by means of sensor technology, allowing provision practice to follow the use over a certain time and providing instructions and training when needed.

Activity chairs are rehabilitation-grade ergonomic chairs for individuals with limited standing tolerance or balance. Our study used a mixed-methods, single-subject, quasi-experimental design to investigate the perceived impact of activity chairs on activity engagement among adults with standing difficulties. Performance measures (i.e. activity duration, fatigue, pain) were reported by participants in daily activity logs for five days prior and five days after receipt of the chair. Two semi-structured interviews were conducted. Quantitative data included satisfaction rating with Wheelchair Outcome Measure (WhOM) and task demand rating with NASA Task Load Index (TLX). Activity chairs were used for dishwashing, cooking, and studying. Compared to baseline, three participants had increased satisfaction and reduced pain and/or fatigue. One participant had equal satisfaction and fatigue; another participant had decreased satisfaction and worsened pain. Four participants had decreased total NASA-TLX score, indicating reduced task demand. Qualitatively, most participants were satisfied with seat elevation features but dissatisfied with ease of mobility and navigation. Activity chairs may facilitate engagement in seated activities when limitations relate to physical fatigue and pain. Prescribers must ensure the suitability of activity chairs in individual contexts.

Evidence for assistive technology (AT) efficacy remains limited. The activity chair is an AT designed to support individuals with physical limitations in performing seated activities. It features electrically adjustable elevation, seat tilt, and a central brake to enhance safety and stability. While randomised controlled trials are the gold standard for evaluating interventions, their focus on standardisation limits their relevance for evaluating AT efficacy, which is shaped by individual and contextual factors. Single-case experimental designs (SCEDs) provide a flexible, valid alternative by capturing real-world AT use in activity performance.

This study examined the efficacy of activity chairs through observed and self-reported activity performance. Using a SCED, activity performance with and without an activity chair was compared among five participants receiving training, housing adaptations, and follow-up. Data were collected at baseline and at five follow-up sessions using the Assessment of Motor and Process Skills and self-reported ratings of efficiency, effort, satisfaction, and safety in combination with sensor technology to monitor activity chair use. Preliminary findings suggest diverse outcomes. Results will be presented graphically, with clinical implications and methodological discussions concerning SCED in AT research. This study provides in-depth insights into activity chair efficacy and contributes to the development of user-centred AT solutions.

In this extended abstract, we present our explorative case study of how integration of automatic data collection from sensors build into an activity chair and visualizations of the collected sensor data can be employed as a means of methodological triangulation to identify patterns of use and non-use. By eliciting easily overlooked and often tacit knowledge about user behavior, sensor data holds the promise of flagging obstacles and inconveniences of assistive technology in the home setting, stimulating conversation between users and their surrounding carers about how these inconveniences can be mitigated, and, furthermore, informing assistive technology manufacturers' product development and bettering existing practices. Eventually, in the capacity of providing an additional measurement point for obtaining situational insights, methodologies that integrate automatic data collection from sensors into assistive technologies have an important equality in health potential of improving insight accuracy and lifting the burden from user, next of kins, as well as care personnel of identifying and communicating obstacles and inconveniences of assistive technologies.

In recent years, various industries, including logistics, e-commerce, and energy, have been revolutionized by data sharing, analysis, and AI, leading to innovative value chains. This transformation is especially visible in the fintech sector, where banks now provide easy data access through third-party apps. A similar shift is possible in home healthcare, where remote patient monitoring is being supplemented by personal activity trackers and apps.

At the same time demographic changes are placing pressure on healthcare systems due to an aging population, making traditional, labor-intensive care models unsustainable. This has increased the demand for home-based treatment and care, driving the development of data-based ecosystems for health and care at home. In this context the authors look at how the assistive technology (AT) field, traditionally focused on physical devices, may begin to integrate sensors and automated data-collection to contribute to these emerging data-based eco-systems for health and care at home, potentially transforming home care and independent living in the future.

The study targets a shared ambition across users, clinical assistive technology practice, industry and research aiming to improve the design of assistive technology and the provision practice, to support the user to the greatest extent. The key idea was to supplement observed and self-reported data on the quality of activity performance with sensor data tracking the actual use of assistive technology, in this case exemplified by means of the electric powered activity chair. To collect and analyze sensor data we developed a new type of toolbox with:
• Sensors to be integrated in the activity chair and the environment
• Data communication and collection
• Visualization tools
Collaboration between industry and software/hardware engineers played a crucial role during development of the sensor-components. As to the development of the visualization tools, clinical and research occupational therapists closely collaborated with visualization specialists and interaction designers to generate series of visualizations that allowed us to analyze and test different hypothesis about use.