Systematic Review of Usability Tests for Manual Wheelchairs: Enhancing Mobility and Reducing Shoulder Injuries in Individuals with Spinal Cord Injuries.

Manual wheelchairs (MWCs) are critical assistive devices for individuals with spinal cord injury (SCI) and other mobility impairments. However, inconsistencies exist in evaluating usability across different manual wheelchair designs. Usability evaluation methods are essential to ensure optimal design and function. A systematic review following PRISMA guidelines was conducted. Databases searched included PubMed, ScienceDirect, and DBpia. A comprehensive search was completed up to April 2024. Keywords combined concepts such as "spinal cord injury", "manual wheelchair", and "usability evaluation" using Boolean operators (AND, OR) and truncation strategies. From 2134 initial records, 30 studies met the inclusion criteria. Studies included individuals with SCI as the primary population, but also incorporated able-bodied participants when necessary to simulate conditions not feasible for SCI users. Evaluation methods included objective assessments (e.g., kinematics, kinetics, electromyography) and subjective measures (e.g., System Usability Scale, user interviews). This review highlights methodological trends in MWC usability testing and identifies key metrics to guide future research and design improvements. While the primary focus was on individuals with SCI, studies involving healthy participants were included where ethically or practically justified.