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Background: Because of the adverse environmental conditions present in less-resourced environments (LREs), the World Health Organization (WHO) has recommended that specialised wheelchair test methods may need to be developed to support product quality standards in these environments. A group of experts identified caster test methods as a high priority because of their common failure in LREs, and the insufficiency of existing test methods described in the International Organization for Standardization (ISO) Wheelchair Testing Standards (ISO 7176).Objectives: To develop and demonstrate the feasibility of a caster system test method.Method: Background literature and expert opinions were collected to identify existing caster test methods, caster failures common in LREs and environmental conditions present in LREs. Several conceptual designs for the caster testing method were developed, and through an iterative process using expert feedback, a final concept and a design were developed and a prototype was fabricated. Feasibility tests were conducted by testing a series of caster systems from wheelchairs used in LREs, and failure modes were recorded and compared to anecdotal reports about field failures.Results: The new caster testing system was developed and it provides the flexibility to expose caster systems to typical conditions in LREs. Caster failures such as stem bolt fractures, fork fractures, bearing failures and tire cracking occurred during testing trials and are consistent with field failures.Conclusion: The new caster test system has the capability to incorporate necessary test factors that degrade caster quality in LREs. Future work includes developing and validating a testing protocol that results in failure modes common during wheelchair use in LRE.

Background: Premature failures of wheelchairs in less-resourced environments (LREs) may be because of shortcomings in product regulation and quality standards. The standards published by the International Organization for Standardization (ISO) specify wheelchair tests for durability, safety and performance, but their applicability to products used in the rugged conditions of LREs is unclear. Because of this, wheelchair-related guidelines published by the World Health Organization recommended developing more rigorous durability tests for wheelchairs.Objectives: This study was performed to identify the additional tests needed for LREs.Methods: First, a literature review of the development of ISO test standards, wheelchair standards testing studies and wheelchair evaluations in LREs was performed. Second, expert advice from members of the Standards Working Group of the International Society of Wheelchair Professionals (ISWP) was compiled and reviewed.Results: A total of 35 articles were included in the literature review. Participation from LREs was not observed in the ISO standards development. As per wheelchair testing study evidence, wheelchair models delivered in LREs did not meet the minimum standards requirement. Multiple part failures and repairs were observed with reviewed field evaluation studies. ISWP experts noted that several testing factors responsible for premature failures with wheelchair parts are not included in the standards and accordingly provided advice for additional test development.Conclusion: The study findings indicate the need to develop a wide range of tests, with specific tests for measuring corrosion resistance of the entire wheelchair, rolling resistance of castors and rear wheels, and durability of whole wheelchair and castor assemblies.