Skip to main content

Advertisement

Log in

An iterative design procedure for the development of assistive devices based on a participatory approach

  • Technical Paper
  • Published:
Journal of the Brazilian Society of Mechanical Sciences and Engineering Aims and scope Submit manuscript

Abstract

A large percentage of the world population is currently affected by functional impairments. In this context, the prescription of assistive technology products and services contributes to an individual’s quality of life. However, high abandonment rates of such devices have been reported and are commonly associated with the non-correspondence to users’ needs. The design of customized products requires a systematization level that is not well achieved by traditional methods, and customization-oriented approaches usually promote restricted user participation. This paper introduces an iterative participatory procedure focused on both early and conception stages of the design of assistive technology. It integrates data collection tools with field-specific assessment protocols, the house of quality technique for decision-making, and an effective participation of potential users. Due to the lack of functional adequacy observed in shower chairs for adults, such equipment was selected for a case study. The procedure comprises an iterative, spiral-shaped flowchart interspersed with interdisciplinary tasks, and the case study revealed complex and intricate interactions with the final user in both phase of design cross-domain establishment and different conceptual design presentations. The use of design techniques integrated with assistive technology assessment protocols provided greater fluidity in the communication between the interdisciplinary design team, represented by researchers in engineering design and occupational therapy. Three versions of the conceptual design were generated through the implementation of user feedback and technical improvements, showing a good correspondence with the initially gathered requirements and being satisfactorily evaluated by health professionals.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7
Fig. 8
Fig. 9

Similar content being viewed by others

References

  1. WHO (2022) Global report on health equity for persons with disabilities. World Health Organization, Geneva

    Google Scholar 

  2. Pelicioni PHS, Santos AD, Tako KV, Santos PCR (2021) COVID-19 and its impact on human motor control. Braz J Mot Behav 15:9–19. https://doi.org/10.20338/bjmb.v15i1.196

    Article  Google Scholar 

  3. Asano D, Kikuchi N, Yamakawa T, Morioka S (2021) Decline in motor function during the COVID-19 pandemic restrictions and its recovery in a child with cerebral palsy: a case report. Children 8:511–517. https://doi.org/10.3390/children8060511

    Article  PubMed  PubMed Central  Google Scholar 

  4. Brennan CS (2020) Disability rights during the pandemic: a global report on findings of the COVID-19 Disability Rights Monitor. COVID-19 Disability Rights Monitor, London

  5. Smith RO, Scherer MJ, Cooper R et al (2018) Assistive technology products: a position paper from the first global research, innovation, and education on assistive technology (GREAT) summit. Disabil Rehabil Assist Technol 13:473–485. https://doi.org/10.1080/17483107.2018.1473895

    Article  PubMed  Google Scholar 

  6. WHO (2022) Global report on assistive technology. World Health Organization, Geneva

    Google Scholar 

  7. De-Rosende-Celeiro I, Torres G, Seoane-Bouzas M, Ávila A (2019) Exploring the use of assistive products to promote functional independence in self-care activities in the bathroom. PLoS ONE 14:e0215002. https://doi.org/10.1371/journal.pone.0215002

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  8. Brim B, Fromhold S, Blaney S (2021) Older adults’ self-reported barriers to aging in place. J Appl Gerontol 40:1678–1686. https://doi.org/10.1177/0733464820988800

    Article  PubMed  Google Scholar 

  9. Fong JH (2019) Disability incidence and functional decline among older adults with major chronic diseases. BMC Geriatr 19:1–9. https://doi.org/10.1186/s12877-019-1348-z

    Article  Google Scholar 

  10. Gill TM, Allore HG, Han L (2006) Bathing disability and the risk of long-term admission to a nursing home. J Gerontol A Biol Sci Med Sci 61:821–825. https://doi.org/10.1093/gerona/61.8.821

    Article  PubMed  Google Scholar 

  11. LaPlante MP, Harrington C, Kang T (2002) Estimating paid and unpaid hours of personal assistance services in activities of daily living provided to adults living at home. Health Serv Res 37:397–415. https://doi.org/10.1111/1475-6773.029

    Article  PubMed  PubMed Central  Google Scholar 

  12. Gell NM, Brown H, Karlsson L et al (2020) Bathroom modifications, clutter, and tripping hazards: prevalence and changes after incident falls in community-dwelling older adults. J Aging Health 32:1636–1644. https://doi.org/10.1177/0898264320949773

    Article  PubMed  Google Scholar 

  13. Koppelaar E, Knibbe HJJ, Miedema HS, Burdorf A (2012) The influence of ergonomic devices on mechanical load during patient handling activities in nursing homes. Ann Occup Hyg 56:708–718. https://doi.org/10.1093/annhyg/mes009

    Article  PubMed  Google Scholar 

  14. WHO (2016) Priority Assistive Products List: Improving access to assistive technology for everyone, everywhere. World Health Organization, Geneva

    Google Scholar 

  15. Friesen EL, Theodoros DG, Russell TG (2017) Usability of mobile shower commodes for adults with spinal cord injury. Br J Occup Ther 80:63–72. https://doi.org/10.1177/0308022616676817

    Article  Google Scholar 

  16. Curimbaba RG (2016) Design ergonômico de cadeiras de banho: diretrizes de projeto fundamentadas em experiência de usuários [Bath chairs ergonomic design: design guidelines based on user experience]. Master Thesis, School of Architecture, Arts, and Communication, São Paulo State University

  17. Comélio ME, Alexandre NMC (2005) Avaliação de uma cadeira de banho utilizada em ambiente hospitalar: uma abordagem ergonômica [Assessment of a hospital bath chair: an ergonomic approach]. Rev Bras Enferm 58:405–410. https://doi.org/10.1590/S0034-71672005000400005

    Article  PubMed  Google Scholar 

  18. Rodrigues A de SL (2022) Refinamento de uma metodologia de projeto direcionada para Tecnologia Assistiva, com abordagem participativa dos usuários [Refinement of a design methodology directed to assistive technology, with users' participatory approach]. Master Thesis, University of São Paulo

  19. Friesen EL, Theodoros DG, Russell TG (2013) Clinical assessment, design and performance testing of mobile shower commodes for adults with spinal cord injury: an exploratory review. Disabil Rehabil Assist Technol 8:267–274. https://doi.org/10.3109/17483107.2012.704656

    Article  PubMed  Google Scholar 

  20. Malassigné P, Nelson AL, Cors MW, Amerson TL (2000) Design of the advanced commode-shower chair for spinal cord-injured individuals. J Rehabil Res Dev 37:373–382

    PubMed  Google Scholar 

  21. Dutra FCM (2008) Desenvolvimento de protótipo de cadeira de banho para indivíduos com paralisia cerebral tetraparética espástica [Development of a shower chair prototype for people with spastic tetraplegia due to cerebral palsy]. Master Thesis, Center of Technology, Federal University of Rio Grande do Norte

  22. Yang S, Chen D, Que J, Wang M (2017) Design and analysis of a multifunctional electric bath chair. In: IEEE International Conference on Real-time Computing and Robotics (RCAR). IEEE, Okinawa, pp 223–228

  23. Howard J, Fisher Z, Kemp AH et al (2022) Exploring the barriers to using assistive technology for individuals with chronic conditions: a meta-synthesis review. Disabil Rehabil Assist Technol 17:390–408. https://doi.org/10.1080/17483107.2020.1788181

    Article  PubMed  Google Scholar 

  24. Sugawara AT, Ramos VD, Alfieri FM, Battistella LR (2018) Abandonment of assistive products: assessing abandonment levels and factors that impact on it. Disabil Rehabil Assist Technol 13:716–723. https://doi.org/10.1080/17483107.2018.1425748

    Article  PubMed  Google Scholar 

  25. de Santos AV, F, Silveira Z de C, (2021) Design for assistive technology oriented to design methodology: a systematic review on user-centered design and 3D printing approaches. J Braz Soc Mech Sci Eng 43:483–497. https://doi.org/10.1007/s40430-021-03184-1

    Article  Google Scholar 

  26. Pahl G, Beitz W, Feldhusen J, Grote K-H (2007) Engineering design: a systematic approach, 3rd edn. Springer-Verlag, London

    Book  Google Scholar 

  27. Ullman DG (2010) The mechanical design process, 4th edn. McGraw-Hill Education, New York

    Google Scholar 

  28. Ulrich K, Eppinger S (2015) Product design and development. McGraw-Hill Higher Education, New York

    Google Scholar 

  29. De Couvreur L, Goossens R (2011) Design for (every)one: co-creation as a bridge between universal design and rehabilitation engineering. CoDesign - Int J CoCreation Des Arts 7:107–121. https://doi.org/10.1080/15710882.2011.609890

    Article  Google Scholar 

  30. Trischler J, Pervan SJ, Kelly SJ, Scott DR (2018) The value of codesign: the effect of customer involvement in service design teams. J Serv Res 21:75–100. https://doi.org/10.1177/1094670517714060

    Article  Google Scholar 

  31. Burleson G, Herrera SVS, Toyama K, Sienko KH (2023) Incorporating contextual factors into engineering design processes: an analysis of novice practice. J Mech Des 145:21401. https://doi.org/10.1115/1.4055780

    Article  Google Scholar 

  32. Schwartz JK, Fermin A, Fine K et al (2019) Methodology and feasibility of a 3D printed assistive technology intervention. Disabil Rehabil Assist Technol 15:141–147. https://doi.org/10.1080/17483107.2018.1539877

    Article  PubMed  Google Scholar 

  33. Gherardini F, Mascia MT, Bettelli V, Leali F (2018) A co-design method for the additive manufacturing of customised assistive devices for hand pathologies. J Integr Des Process Sci 22:21–37. https://doi.org/10.3233/jid-2018-0002

    Article  Google Scholar 

  34. Aflatoony L, Lee SJ (2020) CODEA: A framework for co-designing assistive technologies with occupational therapists, industrial designers, and end-users with mobility impairments. In: Proceedings of the Design Society: DESIGN Conference. Cambridge University Press, Cambridge, pp 1843–1852

  35. García TP, Garabal-Barbeira J, Trillo PP et al (2021) A framework for a new approach to empower users through low-cost and do-it-yourself assistive technology. Int J Environ Res Public Health 18:3039. https://doi.org/10.3390/ijerph18063039

    Article  Google Scholar 

  36. Hobbs D, Walker S, Layton N, Hobbs D (2019) Appropriate assistive technology co-design: From problem identification through to device commercialisation. Global perspectives on assistive technology. World Health Organization, Geneva, pp 342–358

    Google Scholar 

  37. Varnier T, Pichler RF, Forcelini F, et al (2018) Os princípios do design universal no desenvolvimento de produtos para Atividades da Vida Diária: caso descascador manual de legumes [The universal design principles in the development of products for Activities of Daily Living: case of a manual vegetable peeler]. In: Tecnologia Assistiva: Pesquisa e Conhecimento I. Canal 6, Bauru, pp 225–234

  38. Faccio CA, Takayama L, Cunha JM, et al (2018) A impressão 3D no desenvolvimento de TA: adaptador de talheres para pessoas com dificuldade motora nas mãos [3D printing in AT development: cutlery adapter for people with physical impairments in their hands]. In: Tecnologia Assistiva: Pesquisa e Conhecimento I. Canal 6, Bauru, pp 235–243

  39. Bausch ME, Hasselbring TS (2004) Assistive technology: Are the necessary skills and knowledge being developed at the preservice and inservice levels? Teach Educ Spec Educ 27:97–104. https://doi.org/10.1177/088840640402700202

    Article  Google Scholar 

  40. Souza AC de A e (2016) Avaliação dos dispositivos destinados ao uso de sustentação e movimentação de membros superiores e proposta da melhoria do projeto baseada na integração QFD e Análise Funcional [Evaluation of devices for the support and movement of the upper limbs and proposal of design improvements based on the integration between QFD and Functional Analysis]. PhD Dissertation, University of São Paulo

  41. Barbosa IM (2016) Equipamentos de autoajuda: projeto e validação de um protótipo funcional para sustentação e movimentação de membros superiores [Sling: design and functional prototype development applied to the apparatus for supporting and movement of the upper limbs]. Master Thesis, University of São Paulo

  42. Barbosa I (2020) Projeto e avaliação da efetividade de um dispositivo para reabilitação de membros superiores [Design and effectiveness assessment of a device for rehabilitation of the upper limbs]. PhD Dissertation, University of São Paulo

  43. Silveira Z de C, Souza AC de A e, Barbosa IM, Elui VMC (2017) Dispositivo para sustentação e movimentação de membros superiores [Device to provide support and movement for the upper limbs] [Unpublished patent] (Patent No. BR 102017002305–2 A2). Brazilian National Institute of Industrial Property

  44. Kaneko PM (2018) Desenvolvimento da solução construtiva e protótipo funcional de uma órtese infantil de mão e punho para auxílio em atividades diárias [Development of the constructive solution and functional prototype of a wrist and hand orthosis to assist children in daily activities]. Master Thesis, University of São Paulo

  45. Silveira ZC, Kaneko PM, Mattazzio RR, Cavalcanti A (2018) Dispositivo para estabilização e posicionamento de punho [Device for wrist stabilization and positioning] (Patent No. BR 202018013584-3). Brazilian National Institute of Industrial Property

  46. Santos AVF, Licursi LA, Amaral MF et al (2019) User-centered design of a customized assistive device to support feeding. Procedia CIRP 84:743–748. https://doi.org/10.1016/j.procir.2019.04.318

    Article  Google Scholar 

  47. Souza AC de A e, Santos AV de F, Silveira Z de C (2022) Dispositivo para auxílio de tarefas manuais [Device to assist manual tasks] (Patent No. BR 202016024314-4). Brazilian National Institute of Industrial Property

  48. Loureiro IM (2019) Projeto e desenvolvimento do protótipo funcional de um prato de alimentação adaptado para pessoas com distúrbios neuromotores e tremor essencial [Design and development of the functional prototype of an adapted dish for people with neuromotor disorders and essential tremor]. Bachelor Thesis, University of São Paulo

  49. Silveira ZC, Loureiro IM, Martinez LBA (2022) Prato adaptado para auxílio de várias tarefas e etapas envolvidas na alimentação [Adapted dish to assist with various tasks and steps involved in eating] [Unpublished patent] (Patent No. BR102022017555-1). Brazilian National Institute of Industrial Property

  50. Martinez LBA, dos Santos MA, de Silveira Z, C, (2021) Desenvolvimento de dispositivo assistivo para higiene oral baseado em metodologia de projeto participativo [Development of assistive device for oral hygiene based on participatory design methodology]. Rev Educ Espec. 34:1–28. https://doi.org/10.5902/1984686X64660

    Article  Google Scholar 

  51. de Santos AV, F, Silveira Z de C, (2020) AT-d8sign: methodology to support development of assistive devices focused on user-centered design and 3D technologies. J Braz Soc Mech Sci Eng 42:1–15. https://doi.org/10.1007/s40430-020-02347-w

    Article  Google Scholar 

  52. Sanders EB-N (2006) Design research in 2006. Design research quarterly. Design Research Society, London, pp 1–8

    Google Scholar 

  53. Sanders EB-N, Stappers PJ (2008) Co-creation and the new landscapes of design. Co-design 4:5–18. https://doi.org/10.1080/15710880701875068

    Article  Google Scholar 

  54. Robertson T, Simonsen J (2012) Participatory Design: an introduction. In: Simonsen J, Robertson T (eds) Routledge international handbook of participatory design. Routledge, New York, pp 1–17

    Google Scholar 

  55. Kensing F, Greenbaum J (2012) Heritage: Having a say. In: Simonsen J, Robertson T (eds) Routledge International Handbook of Participatory Design. Routledge, New York, pp 21–36

    Google Scholar 

  56. Folstein MF, Folstein SE, McHugh PR (1975) “Mini-mental state”: a practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 12:189–198. https://doi.org/10.1016/0022-3956(75)90026-6

    Article  CAS  PubMed  Google Scholar 

  57. Brucki S, Nitrini R, Caramelli P et al (2003) Sugestões para o uso do mini-exame do estado mental no Brasil [Suggestions for utilization of the mini-mental state examination in Brazil]. Arq Neuropsiquiatr 61:777–781. https://doi.org/10.1590/S0004-282X2003000500014

    Article  PubMed  Google Scholar 

  58. Mackintosh S (2009) The Functional Independence Measure. Aust J Physiother 55:65. https://doi.org/10.1016/s0004-9514(09)70066-2

    Article  PubMed  Google Scholar 

  59. Cooper RA (2007) Introduction. In: Cooper RA, Ohnabe H, Hobson DA (eds) An introduction to rehabilitation engineering. Taylor & Francis, Boca Ranton, pp 1–18

    Google Scholar 

  60. Demers L, Weiss-Lambrou R, Ska B (2002) The Quebec User Evaluation of Satisfaction with Assistive Technology (QUEST 2.0): an overview and recent progress. Technol Disabil 14:101–105. https://doi.org/10.3233/TAD-2002-14304

    Article  Google Scholar 

  61. Law M, Baptiste S, McColl M et al (1990) The Canadian occupational performance measure: an outcome measure for occupational therapy. Can J Occup Ther 57:82–87. https://doi.org/10.1177/000841749005700207

    Article  CAS  PubMed  Google Scholar 

  62. Friesen EL, Theodoros DG, Russell TG (2016) An instrument to measure mobile shower commode usability: the eMAST 1.0. J Assist Technol 10:153–161. https://doi.org/10.1108/JAT-12-2015-0037

    Article  Google Scholar 

  63. Mizuno S, Akao Y (1994) QFD: Customer-driven approach to quality planning and deployment. Asian Productivity Organization, Tokyo

  64. Rianmora S, Werawatganon S (2021) Applying quality function deployment in open innovation engineering. J Open Innov Technol Mark Complex 7:26. https://doi.org/10.3390/joitmc7010026

    Article  Google Scholar 

  65. Franceschini F (2001) Advanced quality function deployment. CRC Press, Boca Ranton

    Book  Google Scholar 

  66. Dym C (2004) Principles of mathematical modeling. Elsevier, Burlington

    Google Scholar 

  67. Ritchey T (2011) General morphological analysis (GMA). In: Wicked Problems–Social Messes: Decision Support Modelling with Morphological Analysis. Springer, pp 7–18

  68. Laffranchi M, D’Angella S, Vassallo C et al (2021) User-centered design and development of the modular TWIN lower limb exoskeleton. Front Neurorobot 15:1–17. https://doi.org/10.3389/fnbot.2021.709731

    Article  Google Scholar 

  69. Haring E, Vaes K, Truijen S, et al (2019) The Development of an Adaptive Device for Children with a Hand Impairment. In: Proceedings of the 20th Congress of the International Ergonomics Association (IEA 2018). pp 612–621

  70. Tochetto J, Guimarães C, Maranho AL, Tartari AL (2016) Design with me: I have special needs! the case for cerebral palsy. In: International Conference on Universal Access in Human-Computer Interaction. Springer, pp 214–222

  71. Rodrigues ASL, Martinez LBA, Silveira ZC (2023) Guidelines for user requirements elicitation in design for assistive technology: a shower chair case study. Procedia CIRP 119:121–126. https://doi.org/10.1016/j.procir.2023.02.128

    Article  Google Scholar 

  72. Tao G, Charm G, Kabacińska K et al (2020) Evaluation tools for assistive technologies: a scoping review. Arch Phys Med Rehabil 101:1025–1040. https://doi.org/10.1016/j.apmr.2020.01.008

    Article  PubMed  Google Scholar 

  73. Scherer Marcia JLAC (2001) Measuring subjective quality of life following spinal cord injury: a validation study of the assistive technology device predisposition assessment. Disabil Rehabil 23:387–393. https://doi.org/10.1080/09638280010006665

    Article  Google Scholar 

  74. Brooke J (1996) SUS: A “quick and dirty” usability scale. In: Usability evaluation in industry. Taylor & Francis, London

  75. Ostuzzi F, Rognoli V, Saldien J, Levi M (2015) +TUO project: Low cost 3D printers as helpful tool for small communities with rheumatic diseases. Rapid Prototyp J 21:491–505. https://doi.org/10.1108/RPJ-09-2014-0111

    Article  Google Scholar 

  76. Cheng CYM, Lee CCY, Chen CK, Lou VWQ (2022) Multidisciplinary collaboration on exoskeleton development adopting user-centered design: a systematic integrative review. Disabil Rehabil Assist Technol. https://doi.org/10.1080/17483107.2022.2134470

    Article  PubMed  Google Scholar 

  77. de Maia FN, Freitas SF (2014) Proposta de um fluxograma para o processo de desenvolvimento de produtos de Tecnologia Assistiva [Proposal of a flowchart for the development process of assistive technology products]. Cad Ter Ocup da UFSCar 22:561–567. https://doi.org/10.4322/cto.2014.078

    Article  Google Scholar 

  78. Okumura MLM, Júnior OC (2015) Design for assistive technology: a preliminary study. In: Curran R, Wognum N, Borsato M et al (eds) Transdisciplinary engineering lifecycle analysis of systems. IOS Press, Amsterdam, pp 122–133

    Google Scholar 

  79. Madden RH, Bundy A (2019) The ICF has made a difference to functioning and disability measurement and statistics. Disabil Rehabil 41:1450–1462. https://doi.org/10.1080/09638288.2018.1431812

    Article  PubMed  Google Scholar 

  80. WHO (2001) ICF: International Classification of Functioning, Disability and Health. World Health Organization, Geneva

  81. Scherer M, Jutai J, Fuhrer M et al (2007) A framework for modelling the selection of assistive technology devices (ATDs). Disabil Rehabil Assist Technol 2:1–8. https://doi.org/10.1080/17483100600845414

    Article  PubMed  Google Scholar 

  82. Liew SK, Shim BJ, Gong HS (2020) Upper limb reconstruction in tetraplegic patients: a primer for spinal cord injury specialists. Korean J neurotrauma 16:126–137. https://doi.org/10.13004/kjnt.2020.16.e48

    Article  PubMed  PubMed Central  Google Scholar 

  83. Portney LG, Watkins MP (2020) Single-subject designs. In: Foundations of clinical research: applications to practice, 4th ed. McGraw Hill, Philadelphia

Download references

Acknowledgements

This research was partially financed by the Coordination for the Improvement of Higher Education Personnel – Brazil (CAPES) –Finance Code 001. The authors acknowledge Gabriella de Oliveira Pratti for the support during interviews and Angela Cristina Pregnolato Giampedro for the professional proofreading. They are also indebted to the institutions that assisted in spreading the call for participation and all shower chair users that contributed to the research.

Funding

This research was partially financed by the Coordination for the Improvement of Higher Education Personnel – Brazil (CAPES) –Finance Code 001.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Alina de Souza Leão Rodrigues.

Additional information

Technical Editor: Rogério Sales Gonçalves.

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Rodrigues, A.d.L., Martinez, L.B.A. & Silveira, Z.C. An iterative design procedure for the development of assistive devices based on a participatory approach. J Braz. Soc. Mech. Sci. Eng. 46, 127 (2024). https://doi.org/10.1007/s40430-024-04695-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1007/s40430-024-04695-3

Keywords

Navigation