Leisure time physical activity (LTPA) plays a vital role in preventing and managing chronic diseases in people with disabilities (PWD). Using virtual reality (VR) can help people feel more comfortable and confident about LTPA. The aim of this study is to identify research focusing on VR, LTPA, and people with motor disabilities. Methods: A scoping review was completed by searching MEDLINE, CINAHL, SportDiscuss, Academic Search Premier, and Web of Science in June 2024 (updated July 2025). Eighteen studies were included. Results: Most studies examined cycling (56%) and targeted post-stroke (28%) and spinal cord injury (22%) populations. VR interventions showed potential to improve various domains such as functional mobility, motor function, and psychosocial well-being. A total of 35 distinct outcome measures were identified, categorized into motor/balance, physiological, psychological, user experience, and performance themes. Conclusions: While most VR interventions used LTPA primarily as a therapeutic tool, some were designed to teach sport-specific skills to facilitate participation outside the clinical setting. Future research should examine how VR can aid rehabilitation and prepare PWD for sustained engagement in LTPA.

PURPOSE:This exploratory qualitative study examines the challenges faced by manual wheelchair (MWC) users and their clinicians, with a focus on mobility difficulties in both outdoor and indoor environments, as well as training priorities. METHODS:The study involved semi-structured interviews with 18 clinicians and 25 MWC users from various rehabilitation centres. The interviews, lasting between 30 and 60 minutes, explored specific aspects of MWC use, including mobility challenges, training needs, and psychological factors. RESULTS:Thematic analysis of the data revealed key patterns, such as indoor and outdoor navigation issues, had difficulty with basic propulsion skills, and the psychological impact of using an MWC. Participants emphasized the need for comprehensive training programs, addressing safety concerns, and ensuring proper MWC adjustments to improve mobility and comfort. CONCLUSION:The study highlights the importance of psychological support and public awareness campaigns to reduce stigma and promote inclusivity. The findings are crucial for developing a tailored training program for new MWC users, addressing both physical and psychological challenges to enhance their overall quality of life and independence.

INTRODUCTION:Participatory research is particularly relevant to understanding the challenges faced by people with disabilities (PWDs), as it actively involves them as partners. This collaboration enables research methodologies to be better adapted to their lived realities, producing more relevant and applicable results. By involving PWDs directly, participatory research helps reduce systemic barriers, promotes inclusion and leads to a deeper understanding and more thoughtful consideration of their specific needs within the research process. Yet, studies have identified hurdles associated with this approach, prompting questions about how organizations portray PWDs, the dynamics among research stakeholders, the distribution of decision-making power, and the actual impact of research on its partners. AIM:This study aims to identify the factors that influence the process and results of participatory research in the field of disability studies. METHODS:We conducted a mapping review following the PRISMA-ScR guidelines, and analyzed the results according to the input-throughput-outcomes Bergen model. RESULTS:42 studies were included in the analysis. We identified partners skills and training, power sharing and benefits of active involvement as facilitators of participatory research. On the other hand, contextual challenges, and lack of guidance are reported as obstacles. CONCLUSION:This study provides insight into the various facilitators and barriers to participatory research. It also explores how different research processes interact to produce positive, valid and rigorous results.

Although many barriers remain to the employment of people with disabilities, public transportation can play a key role for integration and retention of people with disabilities in employment. However, research is needed to better understand how public transportation influences access to work for people with disabilities. This study aims to identify public transportation-related barriers and facilitators to the employment of people living with disabilities. A scoping review approach was adopted, with a keyword search through six databases. Studies' characteristics, transportation barriers, and facilitators to employment of people with disabilities were extracted from the selected articles. The results were presented descriptively and narratively. In total, 74 studies were included. Barriers and facilitators were grouped under four themes: (1) public transportation, (2) employment, (3) personal factors, and (4) social network. This review highlights the key role of public transportation in accessing and maintaining employment for people with disabilities. It also reveals gaps in the literature and a need to investigate the issue through the lens of employers, public transportation services, and social environmental facilitators.

To improve inclusion of persons with disabilities (PWD), it is important to create suitable physical and social environments. This can be done by improving awareness about disability, specifically for employees working in the service and cultural sectors. Virtual reality (VR) simulation can be advantageous by providing an engaging experience highlighting physical accessibility issues, as well as social interactions with virtual avatars. This study’s objective was to validate the content of two disability awareness VR scenarios in museum employees and individuals with disabilities in terms of perceived usefulness. Five PWD and seven museum employees experienced two VR scenarios illustrating a museum visit for a person with low vision or using a wheelchair. The scenarios consisted of different scenes such as finding an accessible entrance and interacting with virtual employees. Participants were interviewed about their experience, with questions related to the realism of the scenarios and their perceived usefulness. Four main themes were identified specifically: emotions, experience, usefulness, and realism. Our scenarios were seen as useful in describing social and physical barriers experienced by PWD. VR can be a valid tool to promote disability awareness among employees in a sociocultural setting, representing a step towards the inclusion of PWD.

Transportation is integral to the employment accessibility and sustainability of people with disabilities. This study aims to identify barriers, facilitators, and solutions to commuting for people with disabilities, drawing from their perspectives as well as those of employers and transportation providers. Through semi-structured individual interviews, insights were gathered from sixteen individuals with disabilities, seven employers, two job integration agents, and four transporters. Qualitative analysis of the interview transcripts revealed factors influencing commuting, including personal attributes and environmental factors. This study underscores the significant impact of environmental factors, particularly the role of social networks and transport infrastructure in either supporting or hindering public transportation use for people with disabilities who commute to work. For example, employers’ limited awareness of their employees’ commuting challenges contrasts with their recognition of their potential role in supporting it. Training and disability awareness initiatives emerge as pivotal solutions to empower individuals within the social network, including transport personnel, fellow passengers, and employers, to facilitate public transportation use by people with disabilities for work commutes.

Background: Stroke can lead to lasting sensorimotor deficits of the upper limb (UL) persisting into the chronic phase despite intensive rehabilitation. A major impairment of reaching after stroke is a decreased range of active elbow extension, which in turn leads to the use of compensatory movements. Retraining movement patterns relies on cognition and motor learning principles. Implicit learning may lead to better outcomes than explicit learning. Error augmentation (EA) is a feedback modality based on implicit learning resulting in improved precision and speed of UL reaching movements in people with stroke. However, accompanying changes in UL joint movement patterns have not been investigated. The objective of this study is to determine the capacity for implicit motor learning in people with chronic stroke and how this capacity is affected by post-stroke cognitive impairments. Methods: Fifty-two subjects who have chronic stroke will practice reaching movements 3x/wk. for 9 wk. in a virtual reality environment. Participants will be randomly allocated to 1 of 2 groups to train with or without EA feedback. Outcome measures (pre-, post-and follow-up) will be: endpoint precision, speed, smoothness, and straightness and joint (UL and trunk) kinematics during a functional reaching task. The degree of cognitive impairment, lesion profile, and integrity of descending white matter tracts will be related to training outcomes. Conclusions: The results will inform us which patients can best benefit from training programs that rely on motor learning and utilize enhanced feedback. Trial status: Ethical approval for this study was finalized in May 2022. Recruitment and data collection is actively in progress and is planned to finish in 2026. Data analysis and evaluation will occur subsequently, and the final results will be published.

Scholarly practice (SP) is considered a key competency of occupational therapy and physiotherapy. To date, the three sectors—education/research, practice, and policy/regulation—that support SP have been working relatively independently. The goals of this project were to (a) understand how representatives of the three sectors conceptualize SP; (b) define each sector’s individual and collective roles in supporting SP; (c) identify factors influencing the enactment of SP and the specific needs of how best to support SP; and (d) co-develop goals and strategies to support SP across all sectors. We used interpretive description methodology. Consistent with an integrated knowledge translation approach, partners representing the three sectors across Canada recruited individuals from each sector, developed the content and questions for three focus groups, and collected and analyzed the data. Inspired by the Consolidated Framework for Implementation Research, we developed the questions for the second focus group. We analyzed the data using an inductive thematic analysis method. Thirty-nine participants from the three sectors participated. Themes related to participants’ conceptualization of SP included (a) ongoing process, (b) reflective process, (c) broad concept, and (d) collective effort. Themes describing factors influencing and supporting SP were (a) recognition, (b) appropriate conceptualization, (c) social network, (d) accessibility to resources, and (e) forces outside of practitioners’ effort. Goals to support SP included (a) further recognizing SP, (b) sustaining SP competency, and (c) ensuring access to information. SP requires collaborative and integrated intersectoral support and further recognition of its importance through the collaboration of multiple stakeholders.

Objectives: To evaluate the effectiveness of a home-based simulator training, in comparison with a videogame-based training, in terms of pow-ered wheelchair driving skills, skills use in a real-world setting, and driving confidence. Design: Single-blinded randomized controlled trial. Setting: Community. Participants: New powered wheelchair users (N=47) randomly allocated to simulator group (n=24, 2 drop-out) and control group (n=23, 3 drop-out). Interventions: The miWe wheelchair simulator (simulator group) or a kart driving videogame (control group) was setted-up at participants' homes (computer + joystick). They were instructed to use it at least 20 minutes every 2 days, during a period of 2 weeks. Primary Outcome Measure(s): Assessments were done at baseline (T1) and post-training (T2) using the Wheelchair Skills Test Questionnaire (WST-Q, version 4.1), Wheelchair Confidence Scale (WheelCon), Assistive Technology Outcomes Profile for Mobility, and Life-Space Assess-ment (LSA). The time necessary to complete 6 WST tasks was measured with a stopwatch. Results: Participants of the simulator group significantly increased their WST-Q capacity score at T2 by 7.5% (P<.05), whereas the control group remained at the same score (P=.218). Participants of both groups rolled backward and went through a door significantly faster at T2 (P=.007; P=.016), but their speed did not change for the other skills. The WheelCon score significantly increased after training (+4% for the control group and +3.5% for the simulator group, P=.001). There was no T1-T2 difference between groups for the WST-Q performance scores (P=.119), the ATOP-Activity (P=.686), the ATOP-Participation scores (P=.814), and the LSA score (P=.335). No adverse events or side effects were reported during data collection or training. Conclusions: Participants of both groups improved some skills and their wheelchair driving confidence. The simulator training group also demon-strated a modest post-training gain in their WST-Q capacity, but more studies would be needed to explore the long-term effects of the McGill immersive wheelchair simulator (miWe) simulator on driving skills.

Purpose: The Inclusive Society partnership research model aims to promote change in society for people with disabilities by supporting research teams composed of researchers and partner organizations. The objective of this article is to identify the strengths and limitations of this research model.Material and methods: An autoethnography approach was used. Thematic analysis of four methods was undertaken: semi-directed interviews with members of the research teams funded by Inclusive Society (researchers, partners), a focus group with the Inclusive Society's intersectoral collaboration agents, their logbooks, and Inclusive Society's annual reports.Results: Strengths and limitations of the Inclusive Society model were identified through their networking activities, the role and support of the intersectoral collaboration agents and the partnership research program.Conclusions: Networking activities are an essential element of Inclusive Society. They are indispensable for composing intersectoral research teams that will work on answering needs of people with disabilities. Intersectoral collaboration agents are also a strength of the model, but their role could be clarified to better frame what tasks are in their scope of practice and what the research teams could ask from them. Finally, the research program eligibility criteria could be improved to support, among others, the projects' appropriation phases.

Purpose To identify partnership research challenges and facilitators, as experienced by members of the Inclusive Society (IS) initiative.Materials and methods A case study was conducted on all partnership research projects conducted between 2017 and 2019 under the IS initiative through surveys, interviews with the IS community, logbooks, and focus group. Thematic analysis and descriptive analysis were undertaken.Results To work effectively with a diversity of stakeholders, winning conditions must be created for the project from the outset. These include determining the team functioning, project objectives, the expectations of each party, and agreeing on a realistic action plan. Project implementation with concern for sustained stakeholder commitment, good working relationships, and achieving project objectives requires organizational planning that favours partner involvement, shared leadership, agreed methods for communicating, conflict resolution methods, recognition of each participant's expertise, and creating a climate of trust. Upon concluding a partnership research project, it is essential to devote time to implement project results in local environments and to ascertain their usefulness to partners.Conclusions: IS partnership research challenges and facilitators are similar to those identified in past research. Despite this knowledge, challenges persist. Future research could explore tools and practices from other domain to overcome partnership research challenges.

Purpose Power wheelchairs (PWCs) can enhance independent mobility. The World Health Organization recommends training PWC users. However, current PWC training approaches do not always meet the needs of PWC users with complex mobility and cognitive impairment. The aim was to co-develop an innovative approach to PWC training for individuals with complex mobility and cognitive impairments. Materials and methods A two-phase mixed method research, involving PWC users, clinicians and researchers throughout all aspects of the research, was realized. (1) Interviews and focus groups were used. (2) The Delphi method was followed to refine the PWC training approach. Results Phase 1: Twenty-six stakeholders indicated that PWC training should consider the client as a partner, the learning environment, the proposed activities, interactions with the trainer and intervention format. Phase 2: two hundred and seven participants agreed that the PWC training should be goal directed, should be client-centred and occupation-based, should enhance client-therapist relationships and should be realized in a safe and adapted environment. Conclusions Stakeholders on PWC use came to agreement on key components that should be applied when training people with cognitive impairments.

Abstract Purpose Individuals with impaired mobility often require assistance for getting around. The skilled use of a manual wheelchair (MW) is required in order to gain independence while preventing injuries. Training in a virtual reality (VR) setting allows for safe practice of MW skills in a wide range of environments. We developed a low-cost MW simulator which includes visual and haptic feedback. Our objectives were to assess the usability and fidelity of the VR simulator, by clinicians and expert MW users, and to determine whether the addition of haptic feedback would positively improve the user’s experience. Materials and Methods This mixed method study investigated the sense of presence, overall experience and ease of use of the experience in six MW users, as well as five clinicians (wheeled mobility experts) who practiced in the simulator. Results Participants reported a positive perception of usefulness, sense of presence, and immersion during the MiWe simulator experience. The addition of haptic feedback to the simulator significantly enhanced fidelity of the overall experience, compared to the no-feedback condition. Conclusion Our low-cost simulator was well perceived by clinicians and MW users and was considered as a potentially useful tool to complement MW skill training. IMPLICATIONS FOR REHABILITATION We developed a low-cost, virtual reality simulator with visual and haptic feedback, for the practice of manual wheelchair skills. Expert clinicians and wheelchair users reported a positive experience after practicing in the wheelchair simulator, in terms of presence, realism and usability. Participants highlighted the potential usefulness of our low-cost simulator in the training of manual wheelchair skills.

Many children with physical disabilities lack independent mobility. Powered mobility can be a viable option, but to become proficient drivers, children need opportunities to practice. As is often the case, practice powered wheelchairs are scarce and direct therapy hours dedicated to powered mobility are often limited. Hence, alternative options are needed to enable safe, unsupervised practice. Simulator-based learning has been shown to be an effective training method for powered mobility and other skill-based tasks for adults. The goal of this study was to compare two training methods of powered mobility, powered wheelchair (control group) versus simulator-based (experimental group) practice to determine whether simulation is a feasible and effective method for youth. Method Participants included 30 children and adolescents (23 males, 13 females) with cerebral palsy and other neuromuscular diseases, aged 6-18. Data were collected and compared at baseline and after 12 weeks of home-based practice via a powered wheelchair or a simulator. Powered mobility ability was determined by the Powered Mobility Program (PMP), the Israel Ministry of Health's Powered Mobility Proficiency Test (PM-PT) and the Assessment of Learning Powered Mobility (ALP). Results All participants practiced for the required amount of time and both groups reported a similar user experience. Both groups achieved significant improvement following the practice period as assessed by the PMP and PM-PT assessments, with no significant differences between them. A significant improvement was found in the ALP assessment outcomes for the powered wheelchair group only. Conclusions This is the first study, to our knowledge, that compares two different wheelchair training methods. Simulator-based practice is an effective training option for powered mobility for children with physical disabilities aged 6-18 years old, demonstrating that it is possible to provide driving skill practice opportunities safe, controlled environments.

This study aimed to investigate clinical stakeholders' acceptance of an immersive wheelchair simulator as a potential powered wheelchair skills training tool. Focus groups, conducted in four rehabilitation centers, were used to obtain a rich understanding of participants' experiences and beliefs. Then, a cross-sectional survey of the simulator acceptability for clinical practice was created. Twenty-three rehabilitation therapists and clinical program directors participated in the focus groups and thirty-three responded to the survey. Participants generally expressed that use of the simulator would be complementary to training in an actual powered wheelchair, and that it could be useful for challenging situations in rehabilitation centers (e.g. anxious clients; when there is uncertainty around their potential to drive a powered wheelchair; tasks that cannot be assessed in a real-life environment). They also provided suggestions to improve the simulator (e.g. more feedback during tasks; possibility of adjusting control settings such as speed and sensitivity; possibility of adding varied control interfaces). Feedback received from key stakeholders clearly indicated that the wheelchair simulator would be complementary to training provided in a real context of use. However, some important limitations must be addressed to improve the simulator and promote its adoption by clinical programs, therapists and clients.

Virtual reality (VR) simulators can help train manual wheelchair skills. Transfer of skills from the virtual to the real world may depend on the sense of presence, or of being "in" the virtual environment.OBJECTIVES:To compare 1) the usability (in terms of performance, overall experience, and satisfaction), as well as 2) the sense of presence, in a wheelchair simulator with two display conditions: a head-mounted display (HMD) or a computer monitor.METHODS:Sixteen healthy adults practiced in the wheelchair simulator, first with a computer monitor display and then with an HMD. Task performance, cybersickness, presence, and overall experience in VR were assessed.RESULTS:Four of the participants were unable to complete all tasks in the HMD condition. When comparing the two display conditions, performance was the same, except for one task (bathroom) which took longer with the computer monitor. The HMD condition was rated as significantly higher in terms of sense of presence and VR experience but provoked more intense symptoms of cybersickness.DISCUSSION:Use of an HMD increased symptoms of cybersickness, with small gains in wheelchair performance. Thus, the use of an HMD may be warranted for the training of wheelchair skills, if tolerated by participants.

Background A growing number of stroke survivors are left with little to no rehabilitation services upon discharge from stroke rehabilitation, although arm deficits may persist or develop from disuse once rehabilitation services have ceased. Virtual reality (VR)–based rehabilitation, combined with new technologies such as telerehabilitation, including serious games using VR environments that encourage users to practice functional movements from home with minimal supervision, may have an important role to play in optimizing and maintaining upper extremity (UE) function. Objective The primary objective of this study is to determine the extent to which a 1-month intervention using a VR-based serious game is effective in improving UE function compared with an evidence-based home exercise program. A secondary objective is to assess the feasibility of implementing the intervention for chronic stroke rehabilitation in participants’ homes. Methods A total of 51 chronic stroke participants were randomized to treatment (n=26, 51%; Jintronix system) or standard care (n=25, 49%; standardized Graded Repetitive Arm Supplementary Program kit home program) groups. The participants were evaluated at baseline (before), immediately after the intervention (after), and at follow-up (4 weeks). The primary outcome measure was the Fugl-Meyer Assessment for UE (FMA-UE). Secondary outcome measures included the Stroke Impact Scale and an abridged version of the Motor Activity Log-14. Self-reported number of sessions was logged for the standard care group. Results No statistically significant differences between groups were found across measures. Overall time effects were found for the FMA-UE (P=.045), specifically between preintervention and postintervention time points for both groups (P=.03). A total of 9 participants in the treatment group reached or surpassed the minimal clinically important difference in scores for the FMA-UE, with 7 (78%) of them having baseline low or moderate arm function, compared with 3 (33%) participants in the standard care group. Furthermore, 56% (9/16) of the participants in the treatment group who actively engaged with the system reached the minimal clinically important difference for the FMA-UE, compared with none for the 0% (0/10) less-active participants. Conclusions These findings suggest that UE training for chronic stroke survivors using virtual rehabilitation in their home may be as effective as a gold standard home exercise program and that those who used the system the most achieved the greatest improvement in UE function, indicating its relevance to being included as part of ongoing rehabilitation services. Trial Registration ClinicalTrials.gov NCT02491203; https://clinicaltrials.gov/ct2/show/NCT02491203 International Registered Report Identifier (IRRID) RR2-10.1016/j.cct.2015.12.006

BACKGROUND:Exergames are increasingly being used among survivors of stroke with chronic upper extremity (UE) sequelae to continue exercising at home after discharge and maintain activity levels. The use of virtual reality exergames combined with a telerehabilitation app (VirTele) may be an interesting alternative to rehabilitate the UE sequelae in survivors of chronic stroke while allowing for ongoing monitoring with a clinician. OBJECTIVE:This study aimed to determine the feasibility of using VirTele in survivors of chronic stroke at home and explore the impact of VirTele on UE motor function, quantity and quality of use, quality of life, and motivation in survivors of chronic stroke compared with conventional therapy. METHODS:This study was a 2-arm feasibility clinical trial. Eligible participants were randomly allocated to an experimental group (receiving VirTele for 8 weeks) or a control group (receiving conventional therapy for 8 weeks). Feasibility was measured from the exergame and intervention logs completed by the clinician. Outcome measurements included the Fugl-Meyer Assessment-UE, Motor Activity Log-30, Stroke Impact Scale-16, and Treatment Self-Regulation Questionnaire-15, which were administered to both groups at four time points: time point 1 (T1; before starting the intervention), time point 2 (after the intervention), time point 3 (1 month after the intervention), and time point 4 (T4; 2 months after the intervention). RESULTS:A total of 11 survivors of stroke were randomized and allocated to an experimental or a control group. At the onset of the COVID-19 pandemic, participants pursued the allocated treatment for 3 months instead of 8 weeks. VirTele intervention dose was captured in terms of time spent on exergames, frequency of use of exergames, total number of successful repetitions, and frequency of videoconference sessions. Technical issues included the loss of passwords, internet issues, updates of the system, and problems with the avatar. Overall, most survivors of stroke found the technology easy to use and useful, except for 9% (1/11) of participants. For the Fugl-Meyer Assessment-UE and Motor Activity Log-30, both groups exhibited an improvement in >50% of the participants, which was maintained over time (from time point 3 to T4). Regarding Stroke Impact Scale-16 scores, the control group reported improvement in activities of daily life (3/5, 60%), hand function (5/5, 100%), and mobility (2/5, 40%), whereas the experimental group reported varied and inconclusive results (from T1 to T4). For the Treatment Self-Regulation Questionnaire-15, 75% (3/4) of the experimental group demonstrated an increase in the autonomous motivation score (from T1 to time point 2), whereas, in the control group, this improvement was observed in only 9% (1/11) of participants. CONCLUSIONS:The VirTele intervention constitutes another therapeutic alternative, in addition to conventional therapy, to deliver an intense personalized rehabilitation program for survivors of chronic stroke with UE sequelae. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID):RR2-10.2196/14629.