Promotion and preservation of mobility and autonomy in old age through smart rollators : a qualitative study

Abstract

Background: Diseases and health limitations associated with ageing often result in loss of mobility and reduced social participation. The ongoing demographic shift towards an increasingly ageing population, combined with a declining number of healthcare professionals, highlights the need to integrate digital assistive solutions to reduce workload and healthcare costs. Smart rollators (SRs) equipped with sensor-based assistance systems (SAS) are considered a promising innovation for enhancing safety, mobility, and independence in older adults. Objective: The aim of this study was to explore the needs, experiences, and perspectives of rollator users (RU) and healthcare professionals (HP) in order to identify and evaluate user-centred requirements for the iterative development of a smart rollator. Methods: As part of a broader research project, a design-based research (DBR) approach was applied. Five focus groups with a total of 30 participants (15 RU, 15 HP) were conducted using semi-structured interviews, which were analysed using qualitative content analysis. Data collection occurred in two phases: first, to explore user requirements, and subsequently, to evaluate an initial SR prototype. The analysis followed a content-structuring approach, conducted independently by two researchers. Results: Three main categories emerged from the focus groups: use of the rollator in daily life, sensor-based assistance systems, and the application of digital assistive technologies. Participants generally assessed the integration of digital and sensor-based functions positively, provided that these increased perceived safety and remained easy to use. Desired features included navigation, environmental and fall detection, emergency call functionality, lighting, and haptic feedback. Barriers were primarily related to technological scepticism, limited digital literacy, and potential cognitive overload. Facilitating factors included training, simple user interfaces, and modular system structures. Conclusion: The findings indicate that participatory development processes are essential for improving the acceptance of smart rollators. Early involvement of users and nursing professionals ensures that technological innovations are designed to be practical, safe, and needs-oriented. The design-based research approach represents a suitable framework for the iterative development and evaluation of assistive technologies in healthcare settings.