Disability and Rehabilitation, 2008; 30(7): 551 – 558

RESEARCH PAPER

User satisfaction with mobility assistive devices: An important element

in the rehabilitation process

KERSTI SAMUELSSON1 & EWA WRESSLE2

1
Department of Rehabilitation Medicine, and 2Department of Geriatrics, University Hospital, Linköping, Sweden
Disabil Rehabil Downloaded from informahealthcare.com by University of California Irvine on 11/02/14

Accepted March 2007

Abstract
Background. An assistive device often means an evident change in a person’s ability, more easy to notice than the effects of
most of other types of physiotherapy or occupational therapy intervention. In spite of this, there is very little evidence in this
area.
Purpose. The objective was to follow-up user satisfaction with and the use and usefulness of rollators and manual wheel-
chairs. The objective was also to determine any difference in satisfaction between users of the two different types of mobility
assistive products.
For personal use only.

Methods. A random sample of 262 users participated in the study, 175 rollator users and 87 wheelchair users. The Quebec
User Evaluation of Satisfaction with Assistive Technology—QUEST 2.0 and an additional questionnaire were used for data
collection.
Results. Overall satisfaction with both types of device was high and most clients reported use of their device on a daily basis.
There was a difference in how the users estimated the usefulness and other characteristics as well as some service aspects
related to prescription and use of the two types of device. Most users reported not having had any follow-up; however, most
users had not experienced any need for one.
Conclusions. A standardized follow-up will give rehabilitation professionals continuous and valuable information about the
effect of and satisfaction with assistive devices.

Keywords: QUEST 2.0, evaluation, rollator, manual wheelchair

many clients they are a prerequisite for maximum

Introduction
Historically, the biomedical model has significantly
influenced the view of the rehabilitation process,
client role and outcome measurement. Rehabilita-
tion including the outcome has most often been
described as a concept of interventions aimed to
improve function and activity, with the focus on
function. The definition and content of rehabilitation
has changed and the definition of factors that make a
change in each individual includes the role of
assistive devices, which plays a natural and important
part of a rehabilitation programme. In Sweden,
occupational- and physiotherapists are responsible
for most prescribing of assistive devices where
mobility assistive devices are the most common.
Assistive devices such as wheelchairs and rollators
are used both for training and compensation and for
independence.
Prescribing assistive devices of different kinds is a
therapeutic process, which is dependent on the
competence of the therapist [1]. As a prescriber,
one needs to have good knowledge about available
products but also a knowledge and understanding of
the physical, psychological, environmental presup-
positions, needs and priorities of each client [2,3]. In
addition to therapeutic knowledge and understand-
ing, client participation in the prescribing process is
probably just as essential to the outcome.
Mobility assistive devices in the Nordic countries
comprise the number one group of assistive devices
most frequently prescribed by occupational thera-
pists and physiotherapists. In Sweden rollators are
the most common assistive products and wheelchairs
the most costly. The Health and Medical Services

Correspondence: Kersti Samuelsson, PhD, Department of Rehabilitation Medicine, University Hospital, SE 581 85 Linköping, Sweden. Tel: þ46 13 2221560.
Fax: þ46 13 221564. E-mail: kersti.samuelsson@lio.se
ISSN 0963-8288 print/ISSN 1464-5165 online ª 2008 Informa UK Ltd.
DOI: 10.1080/09638280701355777
 552 K. Samuelsson & E. Wressle
Act states that both county councils and municipa-
lities have the responsibility to provide people who
have a need for assistive devices with suitable
products. The caregiver has the responsibility to
ensure that prescribers of assistive devices have
sufficient knowledge. What kind of knowledge does
a prescriber need, and what kind of support in the
prescribing process is recommended, to secure a
good quality and evidence based supply of assistive
devices? The health care provider must provide care
(including assistive devices) that enhances the
patient’s self-reliance, while maintaining quality in a
cost-effective way [4]. An assistive device often means
a very evident change in a person’s ability, far more
Disabil Rehabil Downloaded from informahealthcare.com by University of California Irvine on 11/02/14
easy to describe than most effects of other kinds of
physiotherapy or occupational therapy interventions.
Despite this, there is very little evidence in this area
[5]. An assistive device should compensate for a
decreased or lost function and ability to manage daily
life, increase or maintain function and ability and
prevent future loss of function and ability. The main
prescribing process has been illustrated and described
by the Swedish Handicap Institute [6].
Evidence-based practice should form the basis of all
rehabilitation including assistive devices. This is a
For personal use only.
challenge, as few measures are available which target
the measurement of assistive device outcomes.
Therapists are under increasing pressure to base their
practices more firmly on ‘evidence’ and to verify the
effects of certain interventions. An empirical and
useful ‘evidence base’ for the outcome of assistive
devices requires more research based on relevant and
valid evaluation tools as well as a client-centred
working model. The selection and clinical evaluation
of each device should, as far as possible, involve the
client.
Purpose
The objective of this study was to follow up client
satisfaction concerning products, service and the
prescribing process related to manual wheelchairs
and rollators. The objective was also to determine
whether there was any difference in satisfaction
between users of the two different types of mobility
assistive products.
Method
Design
A cross-sectional follow-up study design was used.
Three assistive device centres in three county
councils in Sweden participated.
In Sweden, each county council decides the
available selection of assistive devices possible to
prescribe for occupational- and physiotherapists
working in that county council. Each device is
distributed through the device centre, which means
that each device centre has a register of all prescribed
assistive devices in that county council. Manual
wheelchair users and rollator users 20 – 84 years of
age, who had received their device during a
12-month period, were identified from each register.
The size of each sub-group was proportional to the
total number of prescriptions.
Procedure
A postal package comprising two questionnaires was
sent to a random sample of 510 users of rollators
(n ¼ 340) and manual wheelchairs (n ¼ 170) during
summer 2004. One questionnaire included items
concerning demographic data, questions about usage
as well as user’s opinion of how the device had
influenced activity and participation and the pre-
scription process (Appendix). The other question-
naire was the QUEST 2.0 form (described below).
Sampling was done using the county councils’
registers containing all prescriptions for rollators
and manual wheelchairs over a 12-month period.
The sizes of the sub-groups were proportional to the
total number of prescriptions.
An addressed reply envelope and a letter explaining
the objective of the study were enclosed. The letter
also gave the user the option to not take part in the
study by returning the letter with a mark saying that
he/she did not want to participate. Type of device and
product were already filled in in the questionnaire in
order to clarify which assistive device was being
referred to (if the user had more than one).
Outcome measures
QUEST 2.0. The Swedish version of QUEST 2.0
was used [7]. This paper and pencil format instru-
ment was developed by an occupational therapist in
Canada during the 1980s and can be either
self-administered or completed with the help of an
evaluator [8]. It is designed to evaluate a person’s
satisfaction with his or her assistive device and can be
used with adolescents, adults and elderly people who
have acquired an assistive device as a result of phy-
sical or sensory impairment. QUEST 2.0 focuses on
satisfaction with specific features of the assistive
device as well as certain characteristics of the services
related to the device [8]. The QUEST 2.0 form
displays the scoring of the 12 satisfaction items in
two parts; device (eight items) and services
(four items). The satisfaction items related to the
characteristics of the device are dimensions, weight,
adjustment, safety, durability, simplicity of use,
comfort and effectiveness. Each item is scored using
a 5-point satisfaction scale, where 1 denotes

‘not satisfied at all’ and 5 ‘very satisfied’. The
satisfaction items associated with the related services
are service delivery, repairs and servicing, profes-
sional services and follow-up. The same 5-point
satisfaction scale is used to rate these items. A
checklist with the 12 satisfaction items is subse-
quently presented on the QUEST 2.0 form and the
user is asked to select the three most important
items. The psychometric properties of QUEST 2.0
have been tested in several studies [9 – 13].
The means for the sub-scale scores could provide
useful summary statistics about the relative satisfac-
tion or dissatisfaction of the Device and Services
dimensions as suggested in the QUEST 2.0 manual
Disabil Rehabil Downloaded from informahealthcare.com by University of California Irvine on 11/02/14
[12]. Another method, also described in the manual,
for interpreting the results is to perform an item-by-
item analysis, which then gives the evaluator the
opportunity to identify those areas where improve-
ments should be made. The users who report that
they are ‘more or less satisfied’ or less (scores 1, 2 or
3) could be treated as one group and those who are
‘quite satisfied’ or ‘very satisfied’ (scores 4 and 5) as
one group. The groups could then be compared
according to percentage [12].
For personal use only.
Additional questions. Ten additional questions
(Appendix) were used to illustrate the demography
of the group (questions 1 and 2) and to examine and
analyse the use of the devices, participation in the
prescribing process (questions 4 and 7), effect on
activity and participation (questions 5 and 6) and
finally satisfaction and need for follow-up (questions
8 – 10). The answers are categorised in predeter-
mined answer alternatives. Those questions selected
from an earlier questionnaire were the questions
validated through seven pilot interviews with users of
mobility devices. Participants were asked whether
questions were understandable, if they covered
important areas and if the answer alternatives were
clear [14].
Data analysis
Student t-test and the Chi squared test were used in
the data analyses of QUEST 2.0 as well as the addi-
tional questions. The 5-point satisfaction level scale
in QUEST 2.0 was split into two categories accord-
ing to the manual [12]: Scores 1, 2 & 3 and 4 & 5,
respectively. The additional questions were also cate-
gorised in a similar way, as described in connection
to each results. Significance level was p  0.05 in all
analyses.
Results
A total of 368 (72%) users out of the original 510
returned the questionnaires. Of these, 106 (21%)
User satisfaction with mobility assistive devices 553
declined participation. Included in the data analysis
are 262 users of mobility assistive devices, i.e.,
rollators (n ¼ 175) and manual wheelchairs (n ¼ 87).
In all, 165 women and 95 men participated. There
was a significant difference in gender frequency
(p ¼ 0.002) as well as age (p ¼ 0.000) between the
user groups (Table I).
Respondents in both groups still used their pres-
cribed assistive device to a very high degree (rollators
96% and manual wheelchairs 99%, respectively). An
absolute majority reported that they used their device
on a ‘daily basis’ or ‘several times/week’ (rollators
91% and manual wheelchairs 84%, respectively).
The users were asked to rate in what way the
assistive device had affected their activity and parti-
cipation possibilities (Table II). In the analysis, the
answer alternatives ‘No influence’ and ‘Negative’
were summarized and compared with the ‘Positive’
alternative. There was a difference in how the users
estimated the influence of the device insofar as the
rollators seemed to have a significantly more
positive influence on users’ feeling of ‘mobility’,
‘independence’, ‘self-esteem’ and ‘security’ than
manual wheelchairs. However, the wheelchair
seemed to have a more positive effect on ‘possibility
to work’ and ‘leisure’.
One question in the additional questionnaire
concerned the impact of the assistive device in daily
life. The users considered both rollator and manual
wheelchair to have a ‘significant’ or ‘very significant’
impact on their daily life, 72% and 65%, respectively.
The next question was; In what way do you feel
that the prescriber has shown consideration for your
needs, wishes and demands during the prescribing
process? This question had three answer alternatives:
‘no consideration’, ‘some consideration’, ‘much
consideration’. There was a difference between the
rollator users, where 73% answered ‘much consid-
eration’ compared to 57% of manual wheelchair
users ( p ¼ 0.01).
Some of the questions in the additional question-
naire were about follow-up and expectations. One
question concerned perceived need for follow-up.
Table I. Demographic data of the participants in both user groups,
n ¼ 262. There was a difference in gender frequency between the
user groups ( p  0.01) as well as age ( p  0.001).
Manual
Rollator wheelchair All
Gender
Female 121 44 165
Male 52 43 95
Age
Mean + SD (range), 74.2 + 9.6 61.1 + 8.1 69.8 + 13.7
(44 – 84) (26 – 84) (26 – 84)
 554 K. Samuelsson & E. Wressle

Table II. User perception of device influence on activity and participation, illustrated as percentage of those users who answered each item,
respectively. In the analysis are the answer alternatives ‘No influence’ and ‘Negative’ summarized.

Rollator % n Manual wheelchair % n p

Possibility to work 46 26 *
Positive 48 73
No influence 46 27
Negative 6
Possibility to lead an active leisure life 100
Positive 66 77 64 **
No influence 20 13
Negative 14 11
Possibility to socialize 121 74 ns
Positive 80 78
No influence 14 14
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Negative 6 8
Possibility to go shopping or similar 124 64 ns
Positive 82 77
No influence 15 14
Negative 3 9
Possibility to be mobile 140 76 *
Positive 87 76
No influence 7 12
Negative 6 12
Feeling of safety/security 150 75 ***
Positive 94 80
No influence 3 12
For personal use only.

Negative 3 8
Feeling of independence 130 71 ***
Positive 83 61
No influence 12 25
Negative 5 14
Self-esteem 137 73 *
Positive 82 68
No influence 9 19
Negative 9 12

*p  0.05, **p  0.01, ***p  0.001, ns ¼ not significant.

A majority of both manual wheelchair (75%) and
rollator users (83%) answered ‘No’ here. Only 28%
of the wheelchair users and 21% of the rollator users
answered that there had been a follow-up.
The last question in the additional questionnaire
was about fulfilment of expectations. The answer
alternatives were ‘Not at all’, ‘To a little extent’, ‘To
some extent’, ‘To a great extent’ and ‘To a very great
extent’. Wheelchair users answered ‘To a great
extent’ or ‘To a very great extent’ in 61% of cases
and rollator users had the same answers in 81% of
cases ( p ¼ 0.001).
The five alternatives in QUEST 2.0 were grouped
into two categories; Satisfied (4 & 5), Not quite
satisfied (3, 2 & 1). User satisfaction with the assis-
tive device and with service was high for both groups,
as illustrated in Table III. A majority of all users
rated most items 4 ¼ ‘quite satisfied’ or 5 ¼ ‘very
satisfied’. There was a difference in satisfaction
between users of the two device groups for most
items. However, rollator users seemed more satisfied
in all significant parts.
A separate analysis was performed to look for
differences in estimated satisfaction with the char-
acteristics of the assistive device as opposed to
satisfaction with service and follow-up. The esti-
mated satisfaction from the first eight questions,
about assistive product qualities, was compared with
the estimated satisfaction from the last four items on
service and follow-up. The 5-point scale was divided
into two categories as in the previous analysis. There
was a difference in users estimated satisfaction with
device characteristics compared to satisfaction with
service. Both rollator and wheelchair users scored
higher satisfaction with characteristics of the device
than with service aspects (Table IV).
The two most important items identified were the
same for both rollators and manual wheelchairs, viz.
‘Ease of use’ (88% and 69%, respectively) and
‘Safety’ (81% and 57%, respectively). The third most
 User satisfaction with mobility assistive devices 555

Table III. Item-by-item analysis for rollator and manual wheelchair users.

Rollator Manual wheelchair

% subjects % subjects % subjects % subjects

‘quite satisfied’ or ‘somewhat satisfied’ ‘quite satisfied’ or ‘somewhat satisfied’
‘very satisfied’ or less ‘very satisfied’ or less
Items (scores 4 & 5) (scores 1,2 & 3) n (scores 4 & 5) (scores 1,2 & 3) n p

1. Dimensions 92 8 139 83 17 75 *
2. Weight 80 20 117 67 33 72 *
3. Adjustment 87 13 130 64 36 73 ***
4. Safety 92 8 139 78 22 74 **
5. Durability 90 10 133 82 18 73 ns
6. Ease of use 94 6 140 72 28 74 ***
7. Comfort 90 10 137 74 26 74 **
8. Effectiveness 95 5 139 81 19 73 ***
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9. Service delivery 80 20 107 57 43 68 ***

10. Repairs & services 71 29 78 68 32 59 ns
11. Prof. Service 76 24 99 63 37 68 ns
12. Follow-up 63 37 86 42 58 60 **

*p 5 0.05, **p 5 0.01, ***p 5 0.001, ns ¼ not significant.

Table IV. Percentage of all answers comprised into two answer were less satisfied compared to rollator users.
categories: satisfied (scores 4 & 5) and not very satisfied (scores 1,
Overall, wheelchair users had a lower satisfaction
2 & 3). The p-value represents the difference between the
estimated satisfaction with assistive device characteristics (items score than rollator users. The difference could be an
1 – 8) compared to service and follow-up (items 9 – 12). expression of the different kind, function and com-
For personal use only.

plexity of the mobility assistive devices in question. It

% subjects % subjects might also be an expression of the fact that rollator
‘quite satisfied’ ‘somewhat satisfied’
or ‘very satisfied’ or less
users are generally less dependent on their devices
(scores 4 & 5) (scores 1,2 & 3) p than wheelchair users and that the rollator is more
supportive than the wheelchair, which aims to
Rollator compensate significant impairment or total loss of
Items 1 – 8 90 10
Items 9 – 12 73 27 ***
walking ability. The wheelchair is heavier and a more
complex and extensive device than the rollator and a
Manual wheelchair symbol for dependence. These aspects are important
Items 1 – 8 75 25
Items 9 – 12 58 42 *** to consider and relate to when introducing a new
assistive device to a client.
***p 5 0.001. For both devices, there was a significant difference
between estimated satisfaction with the characteris-
tics of the product compared to estimated satisfac-
important item was ‘Weight’ (27%) for rollator users tion with service and follow-up. This information is
and ‘Comfort’ for manual wheelchair users (47%). of great importance and interest in the development
of service delivery organization and the develop-
ment of a well functioning prescribing process,
Discussion
including the follow-up.
The results of this study show that QUEST 2.0 and The most important aspects perceived by users
additional questions could be an easy and useful were; ‘Ease of use’, ‘Safety’ and ‘Weight’ for rollator
method aiming to bring some light to the evaluation users and ‘Comfort’ for manual wheelchair users. In
of mobility assistive devices and ideas to support relation to that one could find a significant difference
future development of both assistive products and between groups of devices in all four items identified.
follow-up methods. The results from QUEST 2.0 Users of rollators seem to be more satisfied than
showed that the overall satisfaction with device wheelchair users in all aspects.
characteristics and service was high. However, there The item ‘Follow-up’ is the one question with
was a difference in satisfaction between wheel- the largest number of ‘not very satisfied’ users.
chair and rollator users in several items. The most Overall, the service part in QUEST 2.0 showed less
significant differences were found for the items: satisfaction than the assistive device characteristics in
‘adjustment’, ‘ease of use’, ‘effectiveness’ and both groups. These different aspects are not related
‘service delivery’. In all these items, wheelchair users and most often, in the Nordic countries, managed by
 556 K. Samuelsson & E. Wressle
different organizations. This might be useful in the
local perspectives of all aspects included in the
assistive device delivery system.
The additional questionnaire used in this study
brought up some useful information about the use
and usefulness of the devices. Those who answered
the questionnaire reported a very high level of use in
both user groups. This result is not in accordance
with other studies like the ones summarized by
Scherer [15], who reported prevalence of disuse of
devices between 30 – 50% in aggregation, ranged
from 8 – 75% for particular devices. Of course, aban-
donment is not the only indicator of user dissatisfac-
tion and probably there are users who continue to use
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assistive devices despite dissatisfaction due to a lack of
more suitable alternatives. An analysis of the external
drop-outs in this study might have resulted in another
interpretation. Those who answered the questions in
this study might be the most satisfied.
The difference in the answers between the wheel-
chair and rollator users was significant for several
items. When the users were asked to rate how the
present device influenced the opportunity for activity
and participation, the rollator users were more
positive, in particular with regard to the feeling of
For personal use only.
safety/security and the feeling of independence.
Users of manual wheelchairs considered the wheel-
chair to have a positive influence on their possibility
to work and to have an active leisure life. Consider-
ing the purpose and field of application, there is a
difference in rollators and wheelchairs and the body
function of its users. A rollator user is able to walk
with the support of the device. A feeling of insecurity
and impaired balance might be the cause of
prescription. The user is probably a person who
expects a continuous active life in all areas of life. A
rollator might then be experienced as a barrier in
certain activities such as work and leisure. A manual
wheelchair user is probably a person with a sig-
nificantly decreased or total loss of walking ability.
The wheelchair then means the possibility to be at
work and enjoy certain leisure activities, which would
not be possible at all without the device.
The answer to the question concerning to what
extent the prescriber had shown consideration for
needs, wishes and demands of the user during the
prescribing process showed a difference between
groups. It may be that rollator users are more active
and resourceful than wheelchair users. This question
is an important one to develop and needs further
research.
An obvious and unexpected result was related to
the questions about follow-up. Very few respondents
in both groups answered that they had a need for
follow-up and less than 30% of respondents had
actually had a follow-up, according to what they
themselves say. Perhaps the time-span from pre-
scription to this survey was too short to get an idea of
users’ need for a follow-up. Or is the need for a
follow-up exaggerated? The authors do not think so,
they believe that the follow-up is of extraordinary
importance, both to the user and therapist. Without a
follow-up, it is not possible to correct unsatisfactory
solutions and extend the therapist’s knowledge and
experience.
User expectation is probably one of the most
important aspects in relation to satisfaction. In this
study rollator users considered their expectations
met to a greater extent than wheelchair users. This
difference might be due to the fact that a wheelchair
is a symbol of a handicap and not so easy to consider
as something positive, as opposed to the rollator,
which gives the user a greater opportunity to con-
tinue an active and social life to a greater extent.
Limitations and considerations
The objective of this study was to measure and
compare client satisfaction concerning product,
service and prescribing process for manual wheel-
chairs and rollators. These objectives are clearly
related to relevant clinical questions, which are to be
focused in today’s medical care, such as client
satisfaction, cost-effectiveness and usability.
In all, 368 persons responded (72%) and 106 of
these declined participation. Users of mobility
assistive devices are often elderly and disabled, which
might explain the high number of dropouts. No
reminder was sent out which might have increased
the number of participants. The responding groups
in this study are heterogeneous in several aspects but
representative of the user groups. There are several
different types of manual wheelchairs and rollators
used by the respondents and the experience,
expectations, environment and personal character-
istics of the users probably varies substantially. These
aspects are not considered in this study, which means
that the study has a limited explanatory value.
However, this was never the intention. Neither did
this study look at different age groups in relation to
results. This might be very interesting but needs an
increased number of included subjects.
QUEST 2.0 was chosen as a follow-up tool and an
outcome variable as this is one (if not the only)
standardized evaluation tool, especially developed to
measure user satisfaction with assistive devices [8]. It
has been used in several outcome studies and has
been translated and is used in several countries
[14,16,17]. QUEST 2.0 is suitable in studies with a
large sample since it is possible to collect data
through a postal survey. However, QUEST 2.0 does
not include any questions about user characteristics
such as age, living conditions, use of the device or the
effects on activity and participation. An additional

questionnaire was used in this study to supplement
and focus on other aspects of the effects achieved
with assistive devices.
All subjects in the study had used their devices for
8 – 10 months, which should guarantee some experi-
ence and the possibility to answer most of the
questionnaires. The questions about durability and
service in QUEST 2.0 might be very difficult to
answer since the expected durability of a mobility
device should exceed the used time span. The
questions included in QUEST 2.0 are a mixture of
questions that require short, medium and long-term
experience on the part of the user. This is a weak
point and needs further discussion in the develop-
Disabil Rehabil Downloaded from informahealthcare.com by University of California Irvine on 11/02/14
ment of the instrument. Another weak point is the
lack of ‘not applicable’ as an answer alternative.
When analysing the answers from QUEST 2.0, it is
not possible to know if an internal dropout depends
on the fact that the subject has forgotten to answer or
if he/she has no opinion due to lack of experience.
The 5-point scale in QUEST 2.0 is not considered
optimal since the answer alternatives are quite hard
to differentiate, e.g., ‘not very satisfied’ and ‘more or
less satisfied’. For this reason, it was chosen to
dichotomise the scale and use the chi-square in the
For personal use only.
analysing process.
Assistive devices are used to compensate for
functional limitations and to enhance and increase
learning, independence, mobility, communication,
environmental control and choice. Even though
assistive devices have been used as obvious tools in
rehabilitation programmes all over the world for
many decades, the interest in outcomes of assistive
devices is a relatively recent phenomenon [5]. Prior
to 1996, there is little evidence to indicate any
interest in the collection and use of outcome data in
Assistive Devices [18].
Perhaps the new classification of Functioning,
Disability and Health—ICF [19] has been of help
to the professionals in thinking, describing and
evaluating the role of assistive devices in the
rehabilitation process [20]. Several authors state that
assistive devices can empower people with disabilities
in ways that go far beyond medicine and surgery
[20 – 22]. Previous research suggest that the con-
struct of Assistive Device outcome should be multi-
dimensional and include changes in performance/
function and participation, usage as well as user
satisfaction [23].
Since assistive device often are a frame in the
rehabilitation process, the need for a better under-
standing in the prescribing process, use and utility
of assistive devices is of utmost interest to the
profession. There are a lot of unanswered questions
in the field and one should benefit from more studies
dealing with both user experiences and underlying
factors making a difference in outcome.
User satisfaction with mobility assistive devices 557
Acknowledgements
We wish to express our gratitude to The Health
Research Council in the south-east of Sweden who
supported this project financially. We would also like
to thank all those who participated in this study and
the three representatives from the different county
councils.
References
1. Ward DE. Prescribing seating for wheeled mobility. Theory,
application, and terminology. Kansas City, KS: Health Wealth
International; 1994.
2. Aminzadeh F, Edwards N. Factors associated with cane use
among community dwelling older adults. Publ Health Nurs
2000;17:474 – 483.
3. Roelands M, Van Oos P, Buysse A, Depoorter AM. Aware-
ness among community-dwelling elderly of assistive devices of
mobility and self-care and attitudes towards their use. Soc Sci
Med 2002;54:1441 – 1451.
4. Yeomans SG. The clinical application of outcomes assess-
ment. Stamford, CT: Appleton & Lange; 2000.
5. Fuhrer M. Assistive technology outcomes research: Impres-
sions of an interested newcomer. Paper presented at the
International Conference on Outcome Assessment in Assistive
Technology, Oslo, Norway; 1999. Available online at: http://
www.utoronto.ca/atrc/reference/atoutcomes/newcomer/index.
html, accessed 19 July 2005.
6. Swedish Handicap Institute. Förskrivningsprocessen för hjälp-
medel till personer med funktionshinder. Vällingby, Sweden:
Hjälpmedelsinstitutet; 2000.
7. Swedish Handicap Institute. QUEST 2.0—ett utvärderingsin-
strument för hjälpmedel. Vällingby, Sweden: Hjälpmedelsin-
situtet; 2001. [In Swedish].
8. Demers L, Weiss-Lambrou R, Ska B. The Queec User
Evaluation of Satisfaction with assistive Technology: QUEST.
Assist Technol 1996;8:3 – 13.
9. Wessels RD, De Witte LP. Reliability and validity of the
Dutch version of QUEST 2.0 with users of various types of
assistive devices. Disabil Rehabil 2003;25:267 – 272.
10. Demers L, Monette M, Lapierre Y, Arnold DL, Wolfson C.
Reliability, validity and applicability of the Quebec User
Evaluation of Satisfaction with Assistive Technology (QUEST
2.0) for adults with Multiple Sclerosis. Disabil Rehabil
2002;24:21 – 30.
11. Demers L, Wessels R, Weiss-Lambrou R, Ska B,
De Witte LP. Key dimensions of client satisfaction with
assistive technology: a cross-validation of a Canadian measure
in the Netherlands. J Rehabil Med 2001;33:187 – 191.
12. Demers L, Weiss-Lambrou R, Ska B. Item analysis of the
Quebec User Evaluation of Satisfaction with Assistive
Technology (QUEST). Assist Technol 2000;12:96 – 105.
13. Demers L, Wessels RD, Weiss-Lambrou R, Ska B,
De Witte LP. An international content validation of the
Quebec User Evaluation of Satisfaction and Assistive
Technology (QUEST). Occup Ther Int 1999;6:159 – 175.
14. Wressle E, Samuelsson K. User satisfaction with mobility
assistive devices. Scand J Occup Ther 2004;11:143 – 150.
15. Scherer MJ. The impact of assistive technology on the lives
of people with disabilities. In Gray DG, Quatrano LA,
Lieberman ML, editors. Designing and using assistive techno-
logy: The human perspective. Balitmore: Paul H Brooks; 1998.
16. Benedict RE, Lee JP, Marrujo SK, Farel AM. Assistive
devices as an early childhood intervention: Evaluating out-
comes. Technol Disabil 1999;11:79 – 90.
 558 K. Samuelsson & E. Wressle

17. Brandt Å, Iwarsson S, Ståhl A. Satisfaction with rollators
among community-living users: A follow-up study. Disabil
Rehabil 2003;25:343 – 353.
18. Edyburn DL, Smith RO. Creating an assistive technology
outcomes measurement system: Validating the components.
Assist Technol Outcomes and Benefits 2004;1:8 – 15.
19. World Health Organization (WHO). International Classifica-
tion of Functioning, Disability and Health: ICF. Geneva.
Switzerland: WHO; 2001.
20. Lee KR. Where does assistive technology fit in ICIDH-2? Am
J Phys Med Rehabil 2002;81:636.
21. Stineman M. Assistive technology outcomes: Commodity or a
therapy? Am J Phys Med Rehabil 2002;81:636.
22. McMillen A-M, Söderberg S. Disabled persons’ experience
of dependence on assistive devices. Scand J Occup Ther
2002;9:176 – 183.
23. Edyburn DL. Measuring assistive technology outcomes: Key
concepts. J Special Educ Technol 2003;18:53 – 55.

Appendix: Additional questions

We kindly ask you to answer the following questions concerning your manual wheelchair/rollator.

1. Your age . . . . . . . . . . . . . . . . . . . . . . .
Disabil Rehabil Downloaded from informahealthcare.com by University of California Irvine on 11/02/14

2. Gender Male ¤
Female ¤
3. Use of the assistive device.
I still use the device ¤
I do not use the device any more ¤
4. How often do you use the device?
Every day ¤
Several times/week ¤
Several times/month ¤
More seldom ¤
5. How would you say that the device has influenced the following?
For personal use only.

Positively Not at all Negatively Not applicable

A. Your possibility to work ¤ ¤ ¤ ¤
B. Your possibility to lead an active leisure life ¤ ¤ ¤ ¤
C. Your possibility to socialize ¤ ¤ ¤ ¤
D. Your possibility to go shopping ¤ ¤ ¤ ¤
E. Your possibility to be mobile ¤ ¤ ¤ ¤
F. Your feeling of safety/security ¤ ¤ ¤ ¤
G. Your feeling of independence ¤ ¤ ¤ ¤
H. Your feeling of self-esteem ¤ ¤ ¤ ¤
6. What impact do you think the assistive device has had on your daily life?
(1) None at all ¤
(1) Little impact ¤
(1) Some impact ¤
(2) Great impact ¤
(2) Very great impact ¤
To what extent do you think the profession has considered your needs, wishes and
demands, during the prescribing process?
(1) No consideration ¤
(1) Some consideration ¤
(2) Great consideration ¤
7. Have you had a need for a follow-up?
Yes ¤
No ¤
8. Have you had any follow-ups regarding the device?
Yes ¤
No ¤
9. To what extent did the device fulfil your expectations?
(1) Not at all ¤
(1) To little extent ¤
(1) To some extent ¤
(2) To a great extent ¤
(2) To a very great extent ¤