Predisposition to the Use/Non-Use of Mobility Aids in People with Neurological Impairment

Abstract

Assistive technologies are commonly used as a compensatory strategy for individuals with neurological conditions. However, several negative factors have been associated with their use, leading to their non-use or interruption. Therefore, the aim of the present study was to examine the potential of the Assistive Technology Device Predisposition Assessment (ATD-PA) as an outcome measure to identify psychosocial and user-perceived factors associated with the non-use or interruption of assistive technology, particularly mobility devices. Methods: A descriptive, cross-sectional and non-experimental design was employed, as no variables were manipulated. The sample was selected using non-probability convenience sampling and consisted of 80 participants, of which 14 participants discontinued or interrupted the use of assistive technology. An ad hoc sociodemographic questionnaire was administered, along with the Assistive Technology Device Predisposition Assessment, based on the Matching Person and Technology (MPT) model. Results: Factors related to non-use or interruption appeared to be associated with higher perceived levels of global health, self-care, and physical well-being. Findings from the ATD-PA, used as an indicator of subjective satisfaction, showed strong associations between the perceived level of loss and the need for assistive technologies in domains such as comfort, self-care, and general health (r = 0.72–0.90). The perceived benefit of the device was closely linked to knowledge of its use, safety, fit with personal habits, and perceived capability and stamina (r = 0.69–0.94). Comfort using the device was mainly reported in familiar environments such as with family and friends. In contrast, comfort in broader community contexts did not demonstrate meaningful associations. Conclusions: Findings are consistent with Lauer’s model of non-use and highlight the importance of psychosocial determinants such as perceived health, safety, support, and contextual comfort in understanding the interruption or non-use of assistive technology, in line with the International Classification of Functioning, Disability and Health framework. The ATD-PA shows potential as an outcome-oriented tool to support follow-up and the early identification of risk factors for non-use. Longitudinal studies are needed to better understand usage patterns over time. In Spain, the lack of standardized outcome evaluation protocols and systematic follow-up processes underscore the need for structured monitoring strategies in assistive technology provision.