Barriers in Using Assistive Devices among a Group of Community-dwelling Persons with Lower Limb Disabilities in Sri Lanka

Inoka E Weerasinghe, Pushpa Fonseka, Samath Dharmaratne, J.A.M.S. Jayatilake, Andrea C Gielen


Purpose: Rehabilitation with assistive devices is of great benefit to people with limb disabilities, enabling them to lead independent and productive lives. While assistive devices improve the quality of life of persons with lower limb disabilities by facilitating activities of daily living, there are also many barriers to their use. This study aims to describe these barriers among community-dwelling persons with lower limb disabilities in central Sri Lanka.

Methods: A community survey was conducted among adults between 18 and 59 years of age, to find persons with lower limb disabilities in Kandy Municipal Council area, in the central province of Sri Lanka. This was followed by purposive sampling to select a sub-sample of 12 individuals with unilateral lower limb disabilities for a qualitative study using in-depth interviews. Unilateral lower limb disabilities were identified using a clinical examination and World Health Organisation Disability Assessment Schedule 2.0 (WHODAS 2.0). A qualitative thematic content analysis was used to evaluate the interview text.

Results: Participants described several barriers in using assistive devices, such as unaffordable assistive technology like wheelchairs and artificial limbs, unavailability of appropriate assistive technology, difficulties associated with repair and maintenance, and problems in accessibility. Limited knowledge of modern technology also restricted their choice of better devices. Psychological barriers and stigma in using assistive devices directly affected their social lives and day-to-day activities as well.

Conclusion and Implications: People with lower limb disabilities face multiple barriers in using assistive devices. These barriers need to be addressed by improving local infrastructure and accessibility facilities, public awareness and funding, and ensuring continuous supply and maintenance services.


Disability; accessibility; assistive technology

Full Text:



Bailey N (2000). Assistive technology, accommodations, and Americans with Disabilities Act. USA: Cornell University.

Baker J, Bass G (2003). Assistive technology and older adults: The journey through caregiving. ND: University of North Dakota.

Bateni H, Maki BE (2005). Assistive devices for balance and mobility: Benefits, demands, and adverse consequences. Arch Phys Med Rehabil; 86: 134-45. PMid: 5641004

Bates PS, Spencer JC, Young ME, Rintala DH (1993). Assistive technology and the newly disabled adult: Adaptation to wheelchair use. Am J OccupTher; 47: 1014 –1021. PMid: 8279496.

Baxter LA (1994). Content analysis. In: Montgomery BM, Duck S, eds. Studying interpersonal interaction. London: Guilford Press.

Bryen DN, DiCasimirro D (1997). Assistive technology: A positive approach for people with developmental disabilities. The Pennsylvania Journal on Positive Approaches; 1(2). Available from:

Burnard P (1991). A method of analysing interview transcripts in qualitative research. Nurse Educ Today; 11(6): 461–466. PMid: 1775125

Department of Census and Statistics, Sri Lanka (2005). Census of population and housing - Kandy District Report. Sri Lanka: Department of Census and Statistics.

Devi S, Goyal S, Ravindra S (2013).Evaluation of environmental barriers faced by wheelchair users in India. Disability, CBR & Inclusive Development; 24(3): 61-74. Available at:

Edwards TC, Patrick DL, Topolski TD (2003). Quality of life of adolescents with perceived disabilities. J. Pediatr. Psychol; 28(4): 233-241. PMid: 18608422

Hosain GMM, Atkinson D, Underwood P (2002). Impact of disability on quality of life of rural disabled people in Bangladesh. J Health Popul Nutr; 20(4): 297-305. PMid: 12659409

Lincoln YS, Guba EG (1985). Naturalistic inquiry. CA: Sage Publications.

Magnusson L, Ahlstrom G, Ramstrand N, Fransson EI (2013). Malawian prosthetic and orthotic users’ mobility and satisfaction with their lower limb assistive device. J Rehabil Med; 45: 385-391. PMid:23450432

Morse JM (1994). Designing funded qualitative research. In: Denzin NK, Lincoln YS (Eds). Handbook of Qualitative Research. CA: Sage Publications.

Pearlman J, Cooper RA, Krizack M, Lindsley A, Wu Y, Reisinger KD, Armstrong W, Casanova H, Chhabra HS, Noon J (2008). Lower limb prostheses and wheelchairs in low-income countries: An overview. IEEE Engineering in Medicine and Biology Magazine; 27: 12-22. PMid:18463017

Scherer MJ (1996). Outcomes of assistive technology use on quality of life. Disability and Rehabilitation; 18(9): 439-448. PMid:8877302

World Health Organisation (1999). WHODASII, Version 3.1a Phase Two Field Trials. Geneva: World Health Organisation.

World Health Organisation (2008). Guidelines on the provision of manual wheelchairs in less-resourced settings. Geneva: World Health Organisation. Available from: [Accessed on 10 January 2014]

World Health Organisation (2011a). World Report on Disability. Geneva: World Health Organisation. [Accessed on 26 January 2014]

World Health Organisation (2011b). Joint position paper on the provision of mobility devices in less-resourced settings. Geneva: World Health Organisation. Available from: [Accessed on 23 March 2014]


Copyright (c) 2015 Inoka E Weerasinghe, Pushpa Fonseka, Samath Dharmaratne, J.A.M.S. Jayatilake, Andrea C Gielen

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Supported by:


© Disability, CBR & Inclusive Development