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The British Journal of Occupational Therapy logoLink to The British Journal of Occupational Therapy
. 2024 Nov 13;88(3):149–157. doi: 10.1177/03080226241296361

User perceptions of aspects related to the use of the activity chair: A descriptive cross-sectional study

Stina Bjørnskov 1,✉, William Ben Mortenson 2, Tina Helle 1
PMCID: PMC12033720  PMID: 40343153

Abstract

Introduction:

Little is known about the use and aspects impacting the use of the activity chair, which is a device supporting seated activities in everyday life. The aim was to understand (a) purpose of provision, (b) frequency and magnitude of use, (c) barriers impacting use, (d) instruction provided and (e) overall satisfaction with the activity chair.

Method:

This is a cross-sectional study involving 141 adult activity chair users. Data were collected through telephone interviews using a study-specific questionnaire with 21 items. Descriptive statistics were used to summarise the quantitative results, and data-driven text analysis was conducted to analyse open-ended question responses.

Results:

Most respondents (87%) were provided the activity chair for kitchen work, 87% used the device on a daily basis, 75% used the device for additional activities beyond the provision purpose, 65% experienced barriers impacting use, instructions varied, with 28% receiving none and 16% had received activity-based training, 85% were satisfied with the activity chair.

Conclusion:

The activity chair appears to be regularly utilised and appreciated by respondents. However, improved device provision, particularly concerning activity-based training in relevant context and systematic follow up, may be required to reduce barriers impacting use. Findings emphasise the importance of learning from users.

Keywords: Assistive technology, assistive device, service delivery process, activities of daily living, occupational performance, occupational therapy

Introduction

Assistive technology serves to compensate for functional limitations and promote occupational performance, enhance independence and improve participation in daily life (World Federation of Occupational Therapists, 2019). Assistive technology is defined as any item, piece of equipment or product system whether acquired commercially off the shelf, modified or customised that is used to increase, maintain or improve functional capabilities of individuals with disabilities (Cook et al., 2020).

The activity chair is an assistive technology supporting individuals living with physical functional limitations, such as difficulties with stamina, balance, bending and kneeling, which impact standing activities such as cooking, cleaning or working at a countertop (Assistive Technology Data – Denmark, 2022). Activity chairs offer several settings to support seated activities in flexible and safe ways. For instance, adjustable seat height, either electrically or manually, allows users to lower or elevate the chair to easily and safely access items such as pots in lower cupboards or bowls placed in upper cupboards. Additionally, the tilt function of the seat supports both dynamic activity performance and a fixed, stable position when transitioning from a seated to a standing position. This feature is often used in combination with the easily operated central brake. While activity chairs have small wheels, they are larger than those on office chairs, enabling the user to ‘walk’ the chair around, such as during kitchen work, thus allowing hands-free mobility. To see and learn more about activity chairs, please visit https://hmi-basen.dk/en/news.asp?newsid=3871&x_newstype=33.

The activity chair is a commonly provided assistive technology in Denmark (Funch et al., 2019; Pilegaard et al., 2022) and, to some extent, in many other European countries and parts of Canada and the United States. However, there is limited knowledge regarding the extent to which activity chairs are used for their intended purposes, as well as for other activities. Feedback from users and clinicians suggests that while activity chairs are typically provided for use in the kitchen, they may also be employed for a range of other domestic activities beyond their initial purpose. Unintended use of assistive technology can be positive by supporting additional activities, as this may also raise safety concerns. The phenomenon of unintended use is not unique to activity chairs, and a recent literature review revealed that mobility devices are often used in ways that extend beyond their intended functions, supporting a wide range of activities such as carrying objects, pets, and children, exercising, reaching for items and even self-defence (Helle et al., 2023). Given human creativity and the diverse needs of users, it is challenging to foresee all potential uses of assistive technology, making it essential to understand how users employ these devices in their daily lives. Furthermore, despite the intent of assistive technology provision, technologies are not always used to their full extent, or in some cases, not used at all. Non-use is a complex phenomenon defined differently across the literature (Wessels et al., 2003). In this study, non-use refers to the assistive technology not being used at the moment or at all (Phillips and Zhao, 1993). Non-use can leave users feeling frustrated and still unable to perform the daily activities the technology was intended to facilitate (Association for the Advancement of Assistive Technology in Europe and European Assistive Technology Information Network, 2010; Sawadogo et al., 2022; Sugawara et al., 2018). From a societal perspective, non-use may result in unnecessary healthcare expenditures when these devices remain unused in people’s homes without addressing the underlying problem. This situation may further necessitate additional interventions or home care services to compensate for the unmet needs (Association for the Advancement of Assistive Technology in Europe and European Assistive Technology Information Network, 2010). Previous studies have indicated that optimal assistive technology use is impacted by barriers such as poor design and adjustment, legislation, and service delivery processes, including inadequate training and instructions (Abrilahij and Boll, 2019; Wessels et al., 2003). Non-use has also been linked to barriers related to the characteristics of the device, user populations, acceptance, and contexts, resulting in non-use rates of up to 30% (Dijcks et al., 2006; Scherer, 2014). Regarding activity chairs, a previous Danish study indicated a non-use rate of 9.2% (Pilegaard et al., 2022). However, this finding was derived from a relatively small and homogeneous sample of 65 home-dwelling users living with advanced cancer, leaving uncertainty about the prevalence of non-use in a more diverse population. While non-use is a crucial aspect to consider in assistive technology provision, it is important to bear in mind that non-use is not necessarily negative, as it may reflect that a person’s condition has improved, a new assistive technology has replaced the original one, or the environment has changed (Wessels et al., 2003).

Therefore, gaining knowledge about the overall and actual use of the activity chair, including non-use and the factors impacting its use in the context of users’ everyday lives, is crucial for improving assistive technology provision. This may identify potentially unsafe uses of the activity chair, suggest alternative uses, and inform training strategies. Additionally, it is important to understand potential barriers hindering optimal use and learn from instances of non-use, which may perpetuate unmet user needs and lead to unnecessary healthcare expenditures. This knowledge can enhance the quality of the service delivery process, benefitting both users and society at large. To the best of our knowledge, this is the first study to explore aspects related to the use of the activity chair in a heterogeneous group of users. Specifically, we sought to understand: (a) the purpose of provision, (b) the frequency and magnitude of use, (c) the barriers impacting use, (d) the instructions provided and (e) the overall satisfaction with the activity chair.

Method and material

This cross-sectional survey study followed the methodological approach outlined by Dillman et al. (2014). The findings have been reported in accordance with the consensus-based guidelines and checklist for reporting survey studies (Sharma et al., 2021).

Respondents

Recruitment of respondents was conducted across 16 municipalities throughout Denmark, using convenience sampling (DePoy and Gitlin, 2020). Respondents were eligible if they were at least 18 years old and had been provided with an activity chair through the municipality. They needed to have had the activity chair for at least four months. In each municipality, an occupational therapist generated a list of all the activity chairs provided in the past approximately 5 years and contacted eligible respondents to inform them about the study and ask if they were willing to participate. Since assistive technologies are not provided based on diagnoses in Denmark, generating a list of all activity chairs provided sought to capture a diverse range of reasons for provision. This approach was intended to enhance the diversity of the sample in terms of activity-related challenges, age, gender, educational background and use of other mobility devices. Upon consent, respondents’ contact information was passed on to the last author. The data collectors then called each of the potential respondents to provide information about the survey, confirm the inclusion criteria and the informed consent, allow the respondents to ask any questions and schedule appointments for data collection.

Survey

A study-specific questionnaire was developed following Dillman’s recommendations (Dillman et al., 2014) and drawing inspiration from items in existing assistive technology instruments, such as the Quebec User Evaluation of Satisfaction with Assistive Technology (QUEST; Demers et al., 1999). Input was also gathered from occupational therapists who work with assistive technology provision in clinical practice. First, in a pragmatic and informal manner, the relevance and accuracy of the questionnaire items were critically discussed and elaborated upon with four clinical occupational therapists working within assistive technology provision. Next, prior to the actual data collection, the last author trialled the questionnaire with four individuals representing the target population of the study, to examine the need for any further adjustments regarding the content validity and the overall administration of the questionnaire. No changes were recommended by these respondents. These four respondents were not invited to the survey.

The questionnaire contained 21 items, grouped into six sections and included both open-ended and closed questions. The initial questions addressed sociodemographic and background information, including age, gender, educational level, use of mobility devices and characteristics of the activity chair. The remaining questions concerned: (a) the purpose of provision, (b) the overall use of the activity chair including magnitude and frequency, (c) barriers potentially impacting optimal use of the activity chair during activity, (d) the character of the instructions provided in relation to receiving the activity chair and (e) satisfaction in terms of the extent to which the activity chair met the user’s expectations. To give some examples of items:

Do you use your activity chair for other activities besides the purpose it was provided for?

☐ Yes   ☐ No

If yes, please describe the activities?

Do you experience any barriers or challenges that limit the use of your activity chair?

☐ Yes   ☐ No

If yes, please describe the barriers or challenges?

Did you receive instructions on how to use the activity chair when it was delivered to you?

☐ Yes   ☐ No

If yes, please describe the character of the instructions?

Data collection

Data were collected over a period of 6 months using a study-specific questionnaire for telephone interviews, with an average duration of 20 minutes. The data collectors were three occupational therapy research assistants who were trained for the specific study by the last author. The overall data collection material, including procedures and ethics, was presented to the data collectors, who initially administered the material to each other to become familiar with it. The paper-based questionnaire was used during the interviews. The data collector marked and wrote down the respondents’ answers verbatim to ensure accuracy and integrity of the responses. In case of any uncertainty regarding the responses, the data collectors probed for precision and clarification.

At the beginning of the interview, respondents were asked to place themselves in a quiet setting to avoid the presence of other people and disturbances that could potentially impact the data collection. Thorough information regarding the aim of the study and the length of the interview was provided, and any questions or uncertainties were clarified. Respondents were informed that they could withdraw from the study at any time without consequences and that their data would be fully anonymised and treated confidentially. It was emphasised that neither their participation nor any information would be passed on to the municipality. Oral informed consent was obtained first during recruitment and again just before the actual telephone interviews. The study complies with the general data protection regulation (GDPR), and no formal ethical approval is required for this type of research in Denmark.

Data analysis

For data processing, the individual responses were entered into Microsoft Excel (Microsoft Corporation, 2016). Descriptive statistics were used to characterise the sample and summarise the findings (Kirkwood et al., 2003). The transformation of data derived from the open-ended questions were stepwise aggregated into units of analysis categories based on a data-driven thematic text analysis to create quantifiable data (Popping, 2015). Each open-ended question was analysed to identify and code recording units. Subsequently, codes were sorted into categories, and thereby representing data on nominal scale. First, the three research assistants coded the open-ended questions together. Next, the coding was elaborated in an iterative process with the authors. Any uncertainties were discussed among the authors until agreement about categorisation was achieved.

Results

Respondents

All 141 respondents who initially consented to be contacted by a data collector chose to participate in the study. The mean age was 63 years (ranging from 31 to 92 years), and the majority were female. The level of education was diverse. A substantial proportion of the respondents used one or more mobility devices, with the most frequent being walkers/rollators (56.7%, n = 80) and canes/crutches (40.4%, n = 57). The time since provision of the activity chair varied, with approximately one-third in each category of ‘less than 1 year’, ‘between one and 5 years’, and ‘more than 5 years’, and most of the respondents had an activity chair with manual height adjustment (80.9%, n = 114). Table 1 displays the characteristics of the 141 study respondents.

Table 1.

Characteristics of study respondents, n = 141.

Characteristic Mean (SD)
Age, years 63.0 (14.4)
n (%)
Gender
 Female 113 (80.1)
Education
 Primary school 60 (42.6)
 Highschool 9 (6.4)
 Short further education 41 (29.1)
 Medium/long further education 31 (22.0)
Use of other mobility devices*
 Cane/crutches 57 (40.4)
 Walker 80 (56.7)
 Wheelchair 27 (19.1)
 Electric wheelchair 2 (1.4)
 Mobility scooter 22 (15.6)
 Another device 4 (2.8)
 No mobility device 30 (21.3)
Time since the provision of the activity chair
 <1 year 45 (31.9)
 1–2 years 18 (12.8)
 3–5 years 32 (23.0)
 >5 years 45 (31.9)
 I do not recall 1 (0.7)
Type of activity chair
 Electric height setting 27 (19.1)
 Manual height setting 114 (80.9)
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*

Respondents could indicate the use more than one mobility device.

Provision purpose, use and satisfaction with the activity chair

The vast majority of the respondents reported that the activity chair had been provided for kitchen work (87.2%, n = 123) and that they used it for the purpose for which it had been provided (90.8%, n = 128). However, 75% (n = 106) of the respondents utilised the device for at least one additional activity or purpose beyond its original intent. The chair was used to a large extent not only to support specific activities regarding both household chores and recreation but also for more general purposes such as relaxation, exercise and as a mobility device to get around the house. The chair was most often used during not only meals (51.1%, n = 72) but also activities such as doing laundry, hobbies and paperwork. In general, the activity chair was predominantly used on a daily basis (87.2%, n = 123). Non-use of the activity chair in this population was low and most respondents reported that the frequency of use had remained the same or increased over time. In terms of overall satisfaction with the activity chair, about 84% (n = 118) of the respondents indicated either high or very high satisfaction, whereas about 6% (n = 9) indicated low or very low satisfaction. Table 2 describes the outcomes regarding provision purpose, use and satisfaction with the activity chair.

Table 2.

Outcomes regarding provision purpose, use and satisfaction with the activity chair, n = 141.

Outcomes n (%)
What was the primary purpose of provision?
 Kitchen work 123 (87.2)
 Paper work 7 (5.0)
 Eating 3 (2.1)
 Mobility in the home 3 (2.1)
 Other/ Do not recall 5 (3.5)
Do you use the activity chair for the primary provision purpose?
 Yes 128 (90.8)
 No 13 (9.2)
How often do you use your activity chair?
 Every day 123 (87.2)
 Every week (but not every day) 13 (9.2)
 Every month (but not every week) 1 (0.7)
 Never 4 (2.8)
Has the frequency of use changed over time?
 Yes, I use it more 54 (38.3)
 No, it is the same 76 (53.9)
 Yes, I use it less 11 (7.8)
How is your satisfaction with the activity chair?
 Very low 3 (2.1)
 Low 6 (4.3)
 Medium 14 (9.9)
 High 48 (34.0)
 Very high 70 (49.6)
Did you use the chair for activities and purposes other than the provision purpose?*
 Eating 72 (51.1)
 Laundry 26 (18.4)
 Hobbies 26 (18.4)
 Desk chair/ paperwork 22 (15.6)
 Mobility 18 (12.8)
 TV and relaxation 15 (10.6)
 Cleaning 11 (7.8)
 Personal care 6 (4.3)
 Ironing 5 (3.5)
  Kitchen work 5 (3.5)
 Other (e.g., Watering flowers, Dressing/undressing, Exercising) <5
 Do not use for other purposes 35 (24.8)
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*

Respondents could indicate use of the activity chair for more than one other purpose.

Barriers impacting use of the activity chair

Regarding barriers or challenges following from the use of the activity chair, about two-thirds of the respondents (n = 91) experienced one or more barriers. The most frequent barriers were related to the layout of the physical home environment, but barriers also stemmed from the design of the activity chair itself. Furthermore, a third type of barrier was identified and characterised as ‘the interaction between chair and environment’. This type of barrier denotes a misfit between the activity chair and the environment that impacts activity. Examples include, when the activity chair blocks opening of kitchen drawers or when the design of dining tables conflicts with the armrests of the activity chair, which prevents individuals from getting close enough to the dining table to be able to eat. ‘Other barriers’ include when larger amounts of dust and hair over time caused the activity chair to ride poorly or if it was broken. Table 3 displays numbers and types of barriers reported by respondents when using the activity chair.

Table 3.

Number and type of experienced barriers impacting use of the activity chair, n = 141.

Outcomes n (%)*
No barriers 50 (35)
Barriers in the home environment
 Lack of space/furnishing 28 (20)
 Doorsteps 27 (19)
 Floor covering 9 (6)
 Elevation differences 9 (6)
Barriers related to the activity chair
 The break 12 (9)
 Width of chair 11 (8)
 Weight of chair 10 (7)
 Height-adjustment 5 (4)
 Other limitations of the chair 6 (4)
Interaction between chair and environment 30 (21)
Other barriers 8 (6)
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*

Respondents could indicate more than one barrier.

Instructions provided

The respondents reported on what had transpired during the provision of the activity chair including aspects such as instructions and activity-based training. This varied among the respondents as demonstrated in Table 4.

Table 4.

The character of the service delivery process, n = 141.*

Outcomes n (%)*
Delivery of chair 40 (28.4)
Fitting of the activity chair to the person 7 (5.0)
Instructions in functions (verbal or written) 48 (34)
Both fitting of the activity chair and instructions in functions 20 (14.2)
Activity-based training in own home 23 (16.3)
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*

2.1% of the participants (n = 3) did not recall the character of the service delivery process.

The lowest level of participant engagement during the service delivery process, termed ‘delivery of the chair’, refers to instances where the activity chair was simply delivered to the user’s home address. In this situation, users had to set up the chair and learn its functions independently. This applied to more than one in four respondents (n = 40). ‘Fitting of the activity chair to the person’ occurred for approximately 1 in 20 respondents (n = 7) and involved individually adjusting the chair to the user. ‘Instructions in functions’ involved users receiving either written or verbal instructions on how to use the activity chair’s functions. This applied to about one-third of the respondents (n = 48). Furthermore, about 14% of the respondents (n = 20) received both ‘fitting of the activity chair to the person’ and ‘instructions in functions’. ‘Activity-based training’ involved a combination of trying out the chair and receiving actual activity-based training in the user’s own home environment, facilitated by an occupational therapist. This was the case for about one in six respondents (n = 23).

Discussion

This is the first study aimed at understanding and describing user perceptions and aspects related to the use of the activity chair, including the purpose of provision, frequency and magnitude of use, barriers impacting use, instructions provided and overall satisfaction. The findings revealed that 87% of respondents were provided with the activity chair primarily for kitchen work. Additionally, a substantial 75% of respondents used the activity chair for activities beyond its originally intended purpose, which confirms our initial assumptions. A significant proportion (87%) used the activity chair daily, and the non-use rate was only 2.8%. The variability in the instructions provided was notable, with 28% receiving no instructions and only 16% benefitting from activity-based training. Despite 65% of respondents encountering barriers impacting the use of the activity chair, user satisfaction remained high, with 85% of respondents expressing satisfaction. These results will be elaborated upon and discussed in the following sections.

From the results, it is evident that activity chairs are primarily used for the purpose for which they were provided, with kitchen work being the most common provision purpose. It is unclear whether this reflects a custom or tradition in Danish provision practice that favours this particular use. Interestingly, three out of four respondents reported using the activity chair for at least one additional activity or purpose beyond its original provision purpose. Similarly, a narrative literature review found that users of mobility devices often invent new uses for them (Helle et al., 2023). The review demonstrated how mobility devices were employed for various additional purposes, such as exercising in the living room by walking back and forth with a rollator, using a cane for self-defence, and carrying objects and pets on rollators and wheelchairs during activities. Thus, assistive technology may support multiple activities beyond its intended use. Understanding these additional uses can help occupational therapists ensure that users gain optimal benefit from the activity chair while avoiding overuse, barriers or unsafe practices. This underscores the need for follow-up and ongoing assessment to ensure the assistive technology continues to meet the user’s needs effectively and safely.

The high frequency and magnitude of use of the activity chair observed in this study, combined with the high level of satisfaction, suggest that users find it useful. This is further supported by the low non-use rate identified in both this study (2.8%) and a previous study (9.2%) (Pilegaard et al., 2022). However, owing to the use of convenience sampling (DePoy and Gitlin, 2020), the findings may be influenced by positive self-selection bias, where satisfied users may have been more likely to participate in the study (Elston, 2021), which should be taking into consideration when interpreting the results. Nevertheless, the non-use of activity chairs appears fairly low compared to other assistive technologies reported in the literature, such as walkers and shower seats (de Craen et al., 2006; Martin et al., 2011; Scherer, 2014; Sugawara et al., 2018). In addition to the actual utility and need for the assistive technology, another possible explanation could be that activity chairs are primarily used for domestic activities within users’ own homes rather than in public spaces. Previous research has shown that users of wheeled mobility devices may face negative societal attitudes (Widehammar et al., 2020) and experience feelings of stigma, discrimination, pity, discomfort and invisibility when using their mobility devices in public settings (Ripat et al., 2018). Besides, the look of the activity chair is similar to that of an ordinary office chair, which may reduce the perception of being an ‘assistive technology user’. This similarity may allow users to be perceived as more able-bodied, potentially reducing feelings of stigma from both themselves and others (Jeawon et al., 2024). Consequently, using the activity chair may not necessitate the same adjustment in self-image as, for example, the use of mobility devices, which have been shown to significantly impact users’ self-perception (Ripat et al., 2018; Tuazon et al., 2019).

However, it is important to consider that other factors, such as barriers impacting use, may also play a significant role. These barriers can be multifaceted, involving aspects such as aesthetics, self-stigma, social environments and the design of both the assistive technology and the physical environment (dos Santos et al., 2022; Elnady et al., 2018; Helle et al., 2014; Howard et al., 2022; Nierling and Maia, 2020; Orellano-Colón et al., 2016; Widehammar et al., 2019). In our study, two-thirds of respondents identified barriers related either to environmental factors, such as lack of space and level differences, or to the design of the activity chair itself, such as the brake design, width and weight. Additionally, more than 20% of respondents reported barriers arising from the interaction between the environment and the assistive technology during activities, highlighting a type of relational barrier that is often overlooked (Widehammar et al., 2019) despite its prominence in the Human Activity Assistive Technology (HAAT) model (Cook et al., 2020). The HAAT model emphasises that the successful use of assistive technology depends not only on the device itself but also on how well it integrates with the user’s abilities, the demands of the activity and the characteristics of the environment. If any one of these elements is misaligned, as observed with the reported barriers in this study, the effectiveness of the assistive technology can be significantly compromised. Many respondents reported discovering new activities for which they could use the activity chair beyond its initially intended purpose, suggesting that this unintended use might have contributed to the magnitude of the reported barriers. This is likely because the suitability of the extended environments for activity chair use was not evaluated by the occupational therapist. These findings underscore the need for improved service delivery processes, highlighting the importance of follow-up, as emphasised by the World Health Organization (Smith and Pearlman, 2023). Although the study did not directly investigate follow-up practices, we argue that the identified barriers would likely have been detected during such follow-ups, indicating potential inadequacies in current practices. Furthermore, a lack of follow-up appears to be a widespread issue. Howard et al. (2022) found that users commonly report insufficient follow-up from assistive technology providers, and Larsson Ranada and Lidström (2019) concluded that follow-up in clinical assistive technology practice is often inadequate.

The study also revealed significant issues related to instructions and training, with over a quarter of respondents receiving their activity chair without any accompanying instructions, fitting, or training. Given the complexity of matching the right technology to the user’s activities and context, as outlined in the HAAT model (Cook et al., 2020), insufficient instructions and the lack of individualised fitting are particularly concerning. These issues can lead to unsafe and inappropriate use, especially for users with balance, stamina and mobility issues (Hedberg-Kristensson et al., 2006). Although instructions and training are known to enhance participation in daily activities (Brandt et al., 2015; Larsson Ranada and Lidström, 2019), only 16% of respondents reported receiving activity-based training at home. Activity-based training in the relevant environment is critical, as it is the only way to accurately assess the transactional interaction between the person, technology, activity and environment, as described in the HAAT model (Cook et al., 2020). This type of training ensures that the assistive technology is not only suitable for the intended activities but is also safe and effective within the specific contexts in which it will be used. The lack of such tailored training highlights a critical gap in current service delivery practices, underscoring the need for more effective training methods that account for the unique circumstances of each user and environment (Brandt et al., 2020). However, it is noteworthy that despite the identification of several barriers and the provision of limited instructions and training, which are factors that would typically lower assistive technology satisfaction, overall satisfaction with the activity chair was reported as high or very high. This suggests that the utility of the activity chair may outweigh the barriers impacting its use. Additionally, the high satisfaction may reflect the intuitiveness of the activity chair’s features, which are similar to those found on many office chairs.

Clinical implications

The results highlight the importance of understanding assistive technology use from the users themselves, given their unique ways of utilising the activity chair in everyday life. Consistent with previous findings (Larsson Ranada and Lidström, 2019; Widehammar et al., 2019), this study further underscores the need for implementing structured service delivery processes in assistive technology provision. Considering that activity chairs offer various application and adjustment options, it is crucial to enable users to fully benefit from the device in an efficient and safe manner. Therefore, we argue that by gathering insights from diverse users with different activity needs and contexts, occupational therapists will be better equipped to refine several steps of the service delivery process. These steps include (a) collecting relevant data about the person, activity, and environment to select the most suitable chair; (b) providing the user with necessary information, instructions and activity-based training, while also adapting the environment as needed; and (c) systematically following up to identify any overlooked or emerging barriers or risks.

Study strengths and limitations

The main strength of the study is the well-constructed nature of the survey. However, the study has some limitations. First, self-report data are known to be susceptible to recall bias (Adams et al., 1999), which can potentially distort the accuracy and reliability of the results, including memories regarding the character of instructions and training provided. Second, respondents may over-report their adherence to guidelines when data are based on self-report, particularly in interviews due to social desirability bias (Bispo Júnior, 2022). Third, selection bias could influence the results, as we cannot determine if our sample is fully representative of the broader population of activity chair users. Finally, the cross-sectional nature of the study limits the ability to make causal inferences, meaning we cannot determine if the provision of the chair led to increased frequency or ease of occupational performance.

Conclusion

The results of this study demonstrate that activity chairs are a type of assistive technology that is frequently used not only for their intended purposes but also for a range of additional activities. Despite encountering several barriers, respondents reported high satisfaction with the assistive technology. However, the study highlights a generally inadequate service delivery process, as only a few respondents received activity-based training in their own homes. Enhanced training and follow-up may be necessary to address the barriers impacting use. This study underscores the importance of incorporating user feedback into assistive technology practice. By understanding users’ experiences and identifying additional uses for assistive technology beyond its initial purpose, occupational therapists can improve clinical practice, promote more effective use of assistive technologies and ultimately enhance user outcomes.

Future directions

Future research is encouraged to explore key aspects of the service delivery process, such as the value of activity-based training tailored to individual user contexts and the importance of adequate follow-up procedures. Furthermore, there is a need for ecological relevant intervention studies assessing the effects and impact of assistive technologies on occupational performance from a user perspective. Addressing these matters will contribute to a deeper understanding of assistive technology provision, to optimise outcomes for individual users with respect to their diverse needs.

Key findings

  • Activity chairs were frequently used with high user satisfaction.

  • Users identified barriers for use related to the activity chair, environment and their interaction.

  • Only 16% received activity-based training at home.

What the study has added

This study highlights the value of learning from users’ experiences with assistive technology utilisation and the importance of providing instructions and activity-based training in relevant environments to reduce usage barriers.

Acknowledgments

The authors wish to thank the respondents who gave their time to participate in this study and the occupational therapists, who recruited the respondents.

Footnotes

Research ethics: The study complies with GDPR regulations, but no formal ethical approval is required for this type of research in Denmark.

Consent: Oral informed consent was obtained prior to data collection.

Patient and public involvement data: During the development, progress, and reporting of the submitted research, Patient and Public Involvement in the research was not included at any stage of the research.

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding: The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This study was funded by the Danish Occupational Therapy Association, University College North and VIA University College.

Contributorship: TH initiated the study. TH and SB processed and analysed data, discussing results with WBM. TH drafted the introduction and discussion, while SB drafted the method and result section. WBM wrote and elaborated critical parts of all sections and ensured proper English usage. All authors edited the manuscript by several iterations and approved the final version.

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