PURPOSE:Communication practices based on spoken instructions and auditory alerts can limit the participation of deaf and hard-of-hearing employees in fast-paced restaurant environments. This study developed a low-cost wearable multimodal framework to support operational communication through visual and haptic notifications. METHODS:The framework integrates a smartwatch-style wearable device, Message Queuing Telemetry Transport (MQTT) messaging, a web-based ordering platform, and a kitchen-management interface within a local Wi-Fi network. The system enables assigned employees to receive, acknowledge, perform, and complete delivery tasks through accessible notification channels. Technical evaluation included task synchronization, communication range and latency, battery performance, thermal safety, and server performance. RESULTS:The system demonstrated reliable task synchronization across three wearable devices and maintained communication over distances of up to 30 m. Average battery runtimes were 162-168 min, while rear-surface temperatures remained between 30.1 and 30.5 °C. The server also maintained stable performance under simulated workloads. The prototype hardware cost approximately IDR 291,500, indicating the potential for relatively low-cost implementation. CONCLUSIONS:The proposed framework demonstrates the technical feasibility of using visual and haptic wearable notifications for restaurant task coordination without relying exclusively on spoken instructions or auditory alerts. However, because deaf and hard-of-hearing restaurant employees were not included in the evaluation, the findings do not establish accessibility effectiveness or workplace benefits. Participatory co-design and field testing with intended users are required to evaluate its practical accessibility, usability, and workplace impact.
PURPOSE:This study presents a systematic framework for integrating domestic robots into home environments to support older adults (OAs) with instrumental activities of daily living (IADLs). As many OAs strive to find ways to maintain independence despite health-related challenges, existing assistive robots often struggle in unstructured, everyday home settings. To address this issue, this study proposes an integrated, environment-centred approach that enables more effective robot assistance through universal design principles. MATERIALS AND METHODS:Surveys with OAs and allied healthcare professionals identified the IADLs and movement patterns that are most challenging for OAs, as well as preferred features in assistive robots. These insights informed the concurrent design and development of demonstrative physical prototypes of a modified home environment and of a compatible assistive robot. Environmental adaptations, such as mounted dispensers, custom utensil handles, and redesigned drawers, were implemented to reduce robot complexity while enabling essential tasks.Results: The co-design approach demonstrated that environmental modifications can significantly simplify robot requirements without compromising functionality. The new, low-dexterity robot successfully performed critical tasks such as carrying items, pouring liquids, and opening containers. The findings highlight that strategically designed environments enhance robot performance, usability, and reliability in daily living activities. CONCLUSION:An integrated, environment-centred design framework can make assistive robots more practical, effective, and scalable for OAs. By aligning home modifications with robotic capabilities, this approach promotes greater independence and improves quality of life, providing a foundation for more functional and accessible robot-assisted living solutions.
BACKGROUND:Reliable identification of wheelchair users in public environments is an important enabling technology for assistive systems that aids independent mobility, accessibility monitoring, and inclusive public infrastructure. Accurate automated recognition could assist rehabilitation professionals, facility managers, and smart accessibility systems in assessing mobility support and enhancing access for individuals with disabilities. OBJECTIVE:This manuscript introduces an Explainable Multi-backbone Deep Feature Fusion based Wheelchair Detection and Disability-Aware Accessibility Monitoring (XMDF-WDDAM) approach. The major goal of the proposed model is to design an efficient wheelchair detection system for smart urban environments, classifying individuals into three categories: person, wheelchair, and not wheelchair. METHODS:Towards this objective, the proposed model initially undergoes a preprocessing stage to enhance image quality. Subsequently, a YOLOv9-based object detection approach is employed to detect wheelchair users in real-time environments. For feature extraction, the proposed model employs ResNet 18, EfficientNetV2-S, and Vision Transformer, which capture diverse informative features from the input images. Then, the extracted features are fused to form a unified representation. Besides, an attention-based fully connected neural network is applied to learn important patterns from the fused representations. The AdamW optimiser is further applied to enhance training efficiency and accelerate convergence speed. Eventually, the Grad-CAM++ is leveraged for visualising the important regions in the input images. RESULTS:The experimental result analysis of the XMDF-WDDAM methodology is performed utilising the benchmark Wheel Chair Dataset. The simulation results reported the superior outcomes of the XMDF-WDDAM technique with a precision of 99.43% over state-of-the-art models. Conclusion: The proposed XMDF-WDDAM framework provides an accurate and explainable solution for automated wheelchair detection and accessibility-aware monitoring in public environments.
This study introduces an Attention-Guided Deep Learning Framework for Real-Time Text Emotion Recognition for Individuals with Disabilities (AGDL-TERID) model. The AGDL-TERID model aims to enhance assistive human-computer interaction by accurately identifying emotions from textual inputs generated by users with disabilities. In the initial stage, text pre-processing includes symbol removal and the removal of punctuation, stop word removal, tokenisation, stemming, and removal of HTML Tags or URLs, which are applied to standardise and clean the data. Following text pre-processing, features are extracted using term frequency-inverse document frequency (TF-IDF) word embeddings, which capture the importance of relevant terms. Finally, classification is performed utilising an attention-based convolutional recurrent neural network (A-CRNN) approach to capture both local patterns and long-range dependencies from text. The experimental result investigation of the AGDL-TERID model are investigated using a benchmark dataset. The experimental analysis of the AGDL-TERID approach portrayed a superior accuracy values of 97.47% and 98.76% over existing models under the dual datasets. The comparative results confirmed the improved performance of the proposed model compared to existing approaches in terms of diverse metrics, confirming its reliability and suitability for real-time assistive emotion recognition applications. This model can be used in real-world systems like social media, mental-health observation systems and chatbots for identifying user emotions from text. It provides good and highly personalised replies that are based on the emotions detected. It also supports assistive systems to understand their emotions efficiently. In general, it enhances human computer communications using different emotions of users.Implications for RehabilitationThe proposed AGDL-TERID framework can help assistive systems recognise emotional states from users' textual inputs, supporting more responsive and personalised human-computer interaction.Emotion recognition can enable assistive applications and chatbots to provide responses that are better aligned with the user's detected emotional state, potentially improving communication experiences for people with disabilities.The reported classification performance suggests potential for integration into emotion-aware assistive systems, including communication and monitoring applications.Future work should develop user-specific assistive datasets and improve interpretability through attention visualisation and personalisation, which may strengthen the adaptability of real-time assistive communication systems.
BACKGROUND:Effective leadership and coordination are essential for improving access to assistive technology (AT), particularly in low- and middle-income countries where efforts are often fragmented and resources limited, posing significant challenges. This study examines best practices, and lessons learned from efforts to strengthen AT leadership and coordination across six Sub-Saharan African countries. METHODS:A qualitative descriptive thematic analysis was conducted, drawing on document reviews and semi-structured interviews with eight subject matter experts (SMEs) involved in AT policy and implementation. The study focused on the structures, processes and stakeholder engagement strategies underpinning AT coordination frameworks. RESULTS:Findings reveal that strong government ownership, inclusive and structured coordination mechanisms such as technical working groups (TWGs), diverse stakeholder engagement and clear governance structures are critical for effective AT leadership and coordination. Successful initiatives emphasised transparent decision-making, sustainable funding and regular knowledge sharing. Key challenges include funding constraints, inter-ministerial coordination and limited capacity. CONCLUSIONS:Establishing inclusive, well-governed coordination mechanisms enhances AT access and aligns national efforts with international frameworks. The experiences of the studied countries offer actionable recommendations for policymakers and practitioners seeking to strengthen AT leadership and coordination. Ongoing capacity building, stakeholder engagement, awareness raising and global knowledge exchange are vital for sustainable progress.
PURPOSE:This study analyse the adoption trajectory of assistive technology (AT) and its impacts on mobility independence and social participation-well-being among persons with disabilities. MATERIALS AND METHODS:Following the PRISMA 2020 guideline, 80 empirical articles (2015-2025) from Scopus and Web of Science were synthesised using a three-dimensional scoring system: (1) the adoption trajectory, (2) mobility independence and (3) social participation-well-being. RESULTS:AT adoption correlates strongly with functional mobility (ρ = 0.70), but only moderately with well-being (ρ = 0.58). This gap indicates that technical efficacy requires contextual factors like inclusive policies and accessible infrastructure. CONCLUSION:This article presents the Inclusive Mobility Impact Framework, a model detailing how long-term use of assistive technology gradually boosts functional mobility and social participation. The framework highlights multi-level strategies to support sustainable adoption and inclusive well-being outcomes.
PURPOSE:We examined AI-related risk perceptions among people with disabilities by distinguishing personal risk from societal risk. We further asked whether people with disabilities perceived themselves as more exposed to AI-related risks than society, a pattern this study terms self-relative pessimism. MATERIALS AND METHODS:Data were obtained from the 2023 Digital Divide Survey in South Korea. The analytic sample included 2,200 respondents who self-identified as having disabilities. Linear regression models were used to examine personal risk perception, societal risk perception, and optimism, which was defined as the difference between societal and personal risk perceptions. Multinomial logistic regression was used to assess membership in the equal, optimistic, and pessimistic groups. RESULTS:Most respondents reported equal levels of personal and societal risk perception, whereas a smaller subgroup showed self-relative pessimism. Dread was not significantly associated with personal risk perception but was positively associated with membership in the pessimistic group. Involvement was negatively associated with personal and societal risk perceptions and membership in the pessimistic group. Perceived Controllability showed a dual pattern: it was negatively associated with personal and societal risk perception but positively associated with membership in the pessimistic group. Disability type showed no consistent association, and the degree of disability showed only limited associations. CONCLUSIONS:Among people with disabilities, AI-related risk perception was more clearly associated with selected sociotechnical conditions than with diagnostic disability categories. The findings point to considerations for AI-enabled assistive technology, including accessible risk communication, user control and safeguards, and reporting pathways within the service delivery.
PURPOSE:This review examines recent developments in AI-powered assistive technologies for individuals with visual impairment, focusing on object detection, obstacle avoidance, navigation, haptic feedback, and user-centered design. It aims to synthesize their capabilities, advantages, limitations, and gaps relevant to practical and rehabilitation-oriented applications. MATERIALS AND METHODS:A structured literature review was conducted using Scopus, Web of Science, IEEE Xplore, PubMed, and Google Scholar. Literature published between 2017 and 2025 was considered. Studies were screened using predefined inclusion and exclusion criteria, and information on device type, AI and sensing techniques, navigation approaches, feedback mechanisms, and user-centered considerations was extracted and thematically analyzed. A total of 110 studies were included in the review. RESULTS:The reviewed literature demonstrates substantial development of smart canes, wearable systems, smart glasses, smartphone-based applications, and other AI-enabled assistive devices. Vision-based and deep learning approaches support object recognition and environmental perception, while ultrasonic, LiDAR, and other sensing technologies contribute to obstacle detection and navigation. Haptic and auditory feedback provide alternative means of conveying environmental information. However, challenges remain in dynamic environments, including computational and energy requirements, false detections, environmental sensitivity, cognitive load, usability, affordability, and limited real-world validation. Emerging multimodal and edge-based approaches show potential for improving adaptability and accessibility. CONCLUSION:AI-powered assistive technologies have considerable potential to improve mobility, environmental awareness, independence, and quality of life. Future research should emphasize multimodal perception, advanced AI models, adaptive feedback, energy-efficient systems, and long-term user-centered evaluation, with greater attention to affordability, accessibility, and real-world validation.
PURPOSE:Wheelchair provisions are essential for independence among individuals with mobility impairment, yet geographic barriers limit access to specialist wheelchair services in rural Wales. This study applies demand-weighted p-median optimisation to identify configurations minimising travel burden and spatial inequity. METHODS:A cross-sectional analysis of 43,790 wheelchair users across 1,917 Welsh lower super output areas was conducted using mixed-integer p-median programming on a road-network travel time matrix. Ten scenarios were evaluated: baseline, unconstrained, relocations, and satellite additions. Access was measured by median/maximum travel times, proportion of users within 30/60 min of the nearest service, and demand-weighted Gini coefficient. RESULTS:At baseline, median travel time was 19.22 min (IQR 14.07), with a Gini coefficient of 0.3562. Individual clinic relocation produced negligible improvement in spatial equity across all four scenarios. Adding one satellite clinic in west Wales reduced median travel time in Pembrokeshire by 42.4 min and reduced the Gini coefficient to 0.329 without worsening access in any local authority. A second satellite in mid Wales further reduced the Gini coefficient to 0.2868; all configurations were stable under bootstrap demand sensitivity analysis. CONCLUSIONS:The geographic inequity in access to the All-Wales Posture and Mobility Service is driven by the absence of provision in west and mid Wales rather than by the suboptimal positioning of existing clinics. Satellite provision in west Wales is identified as the single most impactful reconfiguration available, with mid Wales representing the next priority location. These findings should inform further strategic service planning options for posture and mobility services.
PURPOSE:This study aims to qualitatively investigate how existing accessibility solutions affect the video game experiences, accessibility challenges, and gaming skills of visually impaired individuals, as well as their independence, performance, and socio-emotional participation. MATERIALS AND METHODS:The participant group consisted of 20 male individuals with varying levels of visual impairment, aged between 20 and 43, from the United States, the United Kingdom, and Türkiye. Data were collected through an open-ended questionnaire and a semi-structured online interview. The data were analysed using thematic analysis supported by qualitative analysis software (MAXQADA), resulting in the identification of four main themes and ten sub-themes. RESULTS:Findings indicate that participants generally began gaming at an early age and experience a wide range of emotions, including enjoyment, excitement, frustration, and anxiety, during gameplay. They prefer complex and story-driven game genres across multiple platforms. Accessibility is primarily facilitated through screen readers, navigation and aim assist systems, audio cues, and game modifications, while peer and community support plays a complementary role for some participants. CONCLUSION:The study concludes that accessibility in video games is strongly shaped by both technological provisions and institutional and social awareness. It emphasises the need for inclusive design practices, the integration of accessibility standards into game development processes and stronger collaboration between game developers, policymakers, and individuals with disabilities to promote digital inclusion and equitable participation in gaming culture.
PURPOSE:Many countries provide wearable assistive devices free of charge to their injured or disabled citizens. The present study examined the beliefs of a sample of members of the UK general public about why devices are often abandoned shortly after acquisition and related these beliefs (together with other variables) to the study participants' willingness to support the free-of-charge supply of devices to people in need. Beliefs were explored in relation to elderly and younger device wearers. Although the complexities of assistive technology abandonment have been researched extensively, studies have not explored how public perceptions of the reasons for abandonment influence attitudes towards free-of-charge provision. MATERIALS AND METHODS:Data for the study were collected by a commercial market research company using a questionnaire that included items assessing a participant's levels of ageism, ephebiphobia (i.e. intense dislike of young people), empathetic disposition, right-leaning political orientation, and demographic factors. The data were analysed descriptively and using regression analysis. RESULTS:A substantial number of participants reported differing beliefs about the presumed reasons for device abandonment among elderly and younger wearers. Often, sample members believed that certain operational factors applied more to abandonment decisions among older people than among younger people. Conversely, specific hedonic factors were believed to make young individuals more likely to abandon devices. CONCLUSION:State interventions, in the form of public information campaigns and communications, could be needed to encourage members of the public to support the continued provision of free-of-charge wearable assistive devices to people who need them.
PURPOSE:Caregiver-delivered interventions that support mobility may provide an opportunity for high-dosage practice and promote overall development for infants and toddlers with Down syndrome (DS). This single-arm feasibility study examined the implementation and acceptability of a home-based open-area partial body-weight support system intervention with the Portable Mobility Aid (PUMA, Enliten LLC) for toddlers with DS and their caregivers. A secondary analysis explored motor skills practiced and play partners during PUMA Playtime. MATERIALS AND METHODS:Six toddlers with DS (3 M/3F, Age 16.44-24.92 months) who were not yet walking independently and their caregivers completed this home-based trial. Participants were instructed to use the PUMA system for 30 min per day, 5 days per week over 4 weeks and reported their usage through a daily survey. Successful implementation was measured as adherence rates >80%. Acceptability was measured using four 11-point Likert-type scales following the intervention. RESULTS:Four of six families completed at least 95% of prescribed days (45 - 115%), and all participants averaged at least 28 min per day of use (28 - 38 min). Caregivers reported the PUMA was easy to use on their own, and that PUMA Playtime impacted their toddler's motor skills and provided benefit to their toddler. During PUMA Playtime, toddlers consistently practiced novel skills and multiple family members joined playtime. CONCLUSION:This feasibility study suggests that a home-based open-area partial body-weight support system intervention can be successfully implemented and is acceptable for toddlers with DS and their caregivers. TRIAL REGISTRATION:ClinicalTrials.gov identifier NCT06219863.
Purpose: Young people with neurodevelopmental disabilities (ND) and functional support needs (FSN) present low physical activity (PA), high sedentary behaviour, and poor dietary patterns. Mobile health (mHealth) technologies may support lifestyle behaviour change; however, evidence remains fragmented. To systematically evaluate the effectiveness of mHealth interventions for improving PA, sedentary behaviour, and dietary outcomes in young people with ND and FSN. Materials and methods: A PRISMA-guided systematic review (PROSPERO: CRD42024557182) identified studies involving participants aged 4-36 years with ND and documented FSN. Eligible interventions included mobile applications, wearable systems linked to smartphones, and telehealth approaches. Outcomes comprised PA, sedentary behaviour, dietary behaviours, and health indicators. Risk of bias was assessed using RoB 2, ROBINS-I, or JBI tools. Results: Fourteen studies (N = 278), including eight randomised controlled trials and six feasibility, mixed-methods, quasi-experimental, or single-case intervention studies, met the inclusion criteria. Interventions commonly incorporated human support, including caregiver, peer, or telehealth guidance. PA outcomes were most frequently assessed and generally showed favourable findings, including increases in daily steps, moderate-to-vigorous physical activity (MVPA), functional balance, and motor skills. Sedentary behaviour outcomes were assessed, with mixed findings. Dietary outcomes were reported in two studies, with one describing dietary intake improvements among highly engaged participants and another reductions in weight, body mass index, waist circumference, LDL cholesterol, and HbA1c. Conclusions: mHealth interventions appear promising but remain an emerging approach for targeting lifestyle behaviours in young people with ND and FSN. Evidence remains preliminary and heterogeneous, highlighting the need for trials, standardised outcome measures, and transparent reporting of intervention components, support structures, and implementation procedures.
OBJECTIVE:Sign Pulse is a hybrid AI-driven educational framework designed to enhance STEM learning for deaf and hard-of-hearing (DHH) students in grades 1-4 (approximately 6-10 years of age) through native sign language interaction. Addressing the limited availability for low-resource sign languages, the system is among the first to focus on Palestinian Sign Language (PSL) within a classroom-ready learning environment. METHODS:Sign Pulse integrates real-time sign language recognition with intelligent pedagogical feedback by combining a Siamese Vision Transformer and a β-Variational Autoencoder (β-VAE) for robust spatial-temporal gesture modelling, together with Large Language Models (LLMs) augmented through Retrieval-Augmented Generation (RAG) to deliver curriculum-aligned explanations, questions, and feedback. The system was evaluated on a newly developed PSL dataset consisting of 434 annotated classroom video samples covering foundational STEM concepts. IMPACT:Experimental results demonstrate strong recognition and verification performance, achieving a Top-1 accuracy of 90%, Top-5 accuracy of 99.65%, an AUC of 92%, and an equal error rate (EER) of 7.8%. Beyond technical performance, the integration of RAG-enhanced LLMs significantly improved the quality of educational feedback, yielding a BERT Score F1 of 88% and a ROUGE-Recall of 55%, substantially outperforming baseline fixed-response systems. These results demonstrate that Sign Pulse effectively transforms sign language recognition from a standalone accessibility tool into an interactive learning system that supports personalised, concept-driven STEM education. By unifying low-resource sign language data, advanced vision-based recognition, and generative pedagogical reasoning within a single framework, Sign Pulse offers a scalable and replicable model for inclusive AI-powered education for DHH learners in underrepresented linguistic communities.
BACKGROUND/OBJECTIVE:To explore gender-segmented perceptions of improvement through technological devices among stroke survivors, focusing on how these devices influence self-perceived health status and daily life activities. DESIGN:Cross-sectional analysis of survey data. SETTING:Community-based data collected from a national disability survey conducted in 2020. PARTICIPANTS:A sample of 971 individuals (464 men, 507 women) aged 18 years and older, diagnosed with stroke and disability resulting from stroke or another condition. INTERVENTIONS:Not applicable. MAIN OUTCOME MEASURES:Self-reported perception of improvement in daily activities (mobility, self-care, domestic life) associated with the use of technological devices, segmented by gender. The primary outcome is based on a single self-reported item. RESULTS:Participants reporting greater difficulties in daily activities, including mobility, self-care, and domestic life, exhibited a lower perception of improvement through the use of technological devices. Older women, in particular, reported additional barriers to technology adoption. CONCLUSION:The findings underscore the need for inclusive, gender-sensitive, and personalised technological solutions in stroke rehabilitation. Current technologies show potential for enhancing daily functionality and mobility but have limited perceived benefits among stroke survivors, particularly older women facing adoption challenges.
PURPOSE:This research aimed to investigate the perception of visually impaired individuals regarding high-relief tactile 2D images produced by 3D printing, in order to identify design parameters (contour line height, line width and texture density) that optimize tactile comprehension. MATERIALS AND METHODS:An experiment was developed and applied to 28 participants with visual impairments. Tasks were designed based on skills whose foundations are needed and used in daily life, such as scanning, tactile discrimination, icon/object comprehension and copy finding. The tactile images were produced by additive manufacturing and printed on 180 g/m² sulphite paper, varying contour line height, line width and texture density. RESULTS:The best performances were obtained when: (1) contour line heights were between 0.2 and 0.4 mm; and (2) texture densities were between 10% and 50%, when used alone, or between 10% and 90%, when combined with another texture. The tested line widths (0.8 and 1.2 mm) did not show statistically significant differences. Vision status (low vision or blindness) and moment of vision loss (congenital or late blindness) did not influence the results; schooling, however, affected performance in object identification and copy location tasks. CONCLUSIONS:A detailed set of recommendations for the production and application of tactile materials is presented, ranging from the simplification of forms to the encouragement of bimanual exploration during content assimilation.
PURPOSE:This study examined the role of trust, technology anxiety (TA), social influence (SI) and facilitating condition (FC) in shaping the acceptance of telephysiotherapy among older adults. METHODS:In this study, a research model integrating trust, FC, TA and SI into the technology acceptance model was created to elucidate telephysiotherapy acceptance among older adults. A questionnaire survey was conducted for data collection from 398 older adults aged 60 years or above. The data analysis was conducted with partial least squares-structural equation modelling. RESULTS:Results showed that FC and SI positively influenced perceived usefulness (PU), perceived ease of use (PEOU) and trust, whereas TA negatively influenced PEOU and PU. In addition, trust positively influenced attitude towards and behavioural intention to use telephysiotherapy. CONCLUSION:FC, SI and TA are important factors influencing telephysiotherapy acceptance among older adults. This study provides several useful recommendations based on the findings to enhance the use of telephysiotherapy among older adults.
INTRODUCTION:A mobile application and online platform ConnectUp supports people with disabilities (PwD) and carers to socially connect for physical activity. The platform will be optimised, implemented and evaluated between 2025 and 2027 aiming to integrate social connection, physical activity, and accessibility within a single platform. The primary aim of this study was to explore the perspectives of PwD and carers on the user experience and usefulness of the platform, and ideas for optimising and operationalising additional features. The secondary aim was to explore co-designers' experience of participating in the co-design workshops. METHODS:Twelve workshops were held with twelve participants developing additional features and improvements to the platform through participatory design activities. At the time of the workshops, participants tested an early prototype of ConnectUp that included basic features such as profile creation, user search, and matching with nearby users for shared physical activity. Co-designers completed a workshop experience survey after each workshop. Data were analysed using reflexive thematic analysis. RESULTS:Overall, co-designers wanted ConnectUp to be broadly usable and a safe, inclusive community for all PwD and carers, with trustworthy and relevant accessibility information. The workshop feedback emphasised the importance of transparency, learning, working collaboratively, and flexibility in the co-design process. CONCLUSION:The findings of this study contribute to the development of future online platforms for PwD and carers to increase usability and inclusion for diverse end-users, and to inform future co-design projects with PwD and carers for an improved experience of co-design.
PURPOSE:Assistive and accessible environments for wheelchair users are still commonly dimensioned from general-adult seated anthropometry. This study provides population-specific reference values for wheelchair users with spinal cord injury (SCI) and links these to assistive-technology (AT) and accessibility decisions. MATERIALS AND METHODS:Using the public 8th Size Korea survey, sex-specific percentiles for 26 seated measures, two functional reaches and hand strength were derived for 338 wheelchair users with SCI (246 men, 92 women); 19 dimensions were compared with a general adult sample (40-69 years) using age-adjusted models with false-discovery-rate control. Work-surface targets were translated to floor-referenced values against accessibility criteria; grip strength was analysed as a two-part (zero-inflated) outcome. RESULTS:Seated heights were 9-27% lower than in the general sample, which was measured in an instructed erect posture, and trunk circumference and breadth were larger; upper-limb lengths differed modestly and lower-body seated dimensions were shorter. Under plausible seat heights, the height accommodating 90% of users fell below common accessible work-surface ranges. 8.3% of men produced no grip force. CONCLUSIONS:General-adult and standard accessibility assumptions may under-accommodate wheelchair users with SCI, although differing posture protocols preclude exact between-sample comparison. Population-specific percentiles can inform adjustable AT, accessible design, and low-force non-grasp interfaces, pending task-based validation.
