Table 3 Overview of the included sources (n = 25)

Albouys-Perrois, Laviole et al. [47] – 2018, France

To design an accessible interactive map, using a participatory design approach.

Participatory design,

includes participants in the design phase

15 visually impaired students (6 females and 9 males, age range 11–40), 3 orientation and mobility instructors, 22 special education teachers and orientation and mobility instructors, 1 orthoptist, 2 tactile transcribers, and 1 technical advisor (unknown characteristics)

Visual impairment

Using a participatory design approach, the researchers have designed an augmented reality map based on the needs of people with visual impairment. A usability test shows that the participants evaluated the usability of the solution to be good.

Arnott, Malone et al. [52] – 2018, UK

To present strategies to adapt research processes to suit people with cognitive and communication impairments when developing smartphone apps to give access to health promotion information.

Unknown

Unknown

Cognitive and speech impairment

To involve participants with cognitive impairments in the development process, the researchers implemented strategies to make information more accessible to the participants. This included simplified language at all levels of the research process, alternative forms of language representation, and the use of an app to enable participants to experience unfamiliar technology.

Bhattacharjya, Stafford et al. [39] – 2019, USA

To create technology that supports individuals with sensorimotor deficits self-manage upper limb rehabilitation at home.

Experimental design,

includes participants in the idea creation phase

4 older adults (gender unknown, age range 66–87) and 4 individuals with stroke (gender unknown, age range 54–68)

Motor impairment

Usability ratings from the participants led the researchers to modify the design of the 3D printed items and improve the clarity of the mRehab app.

Blair and Abdullah [44] – 2019, USA

To understand how and why people with hearing impairments use conversational agents.

Qualitative design (interview)

4 adults with hearing impairment (3 females and 1 male, age range 53–63)

Hearing impairment

Female voices are default for most solutions, but these high-pitched voices are often hard to hear with hearing aids or cochlear implants. The speed of the participants’ conversational agents was often too fast, so they had to repeat the message.

Daveler, Salatin et al. [49] – 2015, USA

To understand the conditions and barriers electric powered wheelchair (EPW) users find difficult to drive in/over in the outdoor environment (phase I), create a computer-aided design prototype of an EPW with advanced features that increase the users’ safety and ease navigation when encountering such conditions and barriers (phase II), and validate the newly designed EPW and its advanced features by gathering further input from EPW users (phase III).

Participatory design,

includes participants in the idea creation phase

Phase I: 31 EPW users (5 females, 26 males, average age 55.8)

Phase III: 12 EPW users (5 females, 7 males, average age 46.9)

Motor impairment

The researchers have designed an EPW based on EPW users’ needs. The designed EPW received positive feedback from the users.

DeForte, Sezgin et al. [28] – 2020, USA

To evaluate the user experience of the Hear Me Read app.

Qualitative design (focus group),

includes participants in the evaluation phase

8 children with hearing impairment (4 females and 4 males, age range 2–13), 8 caregivers (unknown characteristics)

Hearing impairment

The children found the swiping motion hard to use, so they had difficulties navigating the app. Children instinctively pressed a single point to navigate.

Ferati, Babar et al. [43] – 2018, Sweden

To identify the type of smart product that mostly increases people with impairments independence at home.

Participatory design,

includes participants in the idea creation phase

6 adults with different types of impairment (3 females and 3 males, age range 20–87)

Motor, visual and cognitive impairment

The results showed that the participants needed a smart shower. The buttons on the smart shower were designed to have distinctive shape, colour, and dimension to be accessible and usable by people with visual impairment. The researchers describe that involvement of participants in identifying the need helped them to understand the participants’ ways of doing things in their homes. Cartographic mapping was useful to understand the differences among the participants, even those with the same impairment. This indicates that people with similar impairments should not be treated homogeneously as their wishes and issues might differ.

Furberg, Ortiz et al. [41] – 2018, USA

To describe the design and development process of a tablet-based decision support tool to enhance shared decision making and decisional capacity for those with Fragile X Syndrome participating in the informed consent process.

User-centred design,

includes participants in the idea creation phase

6 adults with Fragile X syndrome (1 female and 5 males, age range 16–28), 3 clinician stakeholders (unknown characteristics)

Cognitive impairment

Even though the participants were included in the idea creation process, the perspectives of the persons with Fragile X Syndrome are in lesser degree described. The researchers highlight the importance of a user-centered approach, appreciation of interdisciplinarity, and stakeholder engagement and input as central key findings in the design and development process of this decision support tool.

Glaser, Schmidt et al. [46] – 2017, USA

To design, develop, and evaluate the Epilepsy Journey intervention for adolescents with epilepsy and executive functioning deficits at a Midwestern epilepsy centre.

Participatory action research,

includes participants in the idea creation phase

11 adolescents with epilepsy (gender unknown, age range 13–17), 5 primary caregivers and 1 usability expert (unknown characteristics)

Cognitive impairment

The results provide instructional designers insight into how a user-centric formative design approach can be used for the development of individually tailored web-based interventions for sensitive populations.

Groussard, Pigot et al. [40] – 2018, Canada

To design an assistive device, SAMI (Services Assistance Mobile and Intelligent), to improve the social participation of people with traumatic brain injury, and to conduct a proof of concept to show how this assistive device fulfilled the needs of some people with traumatic brain injury.

Participatory design,

includes participants in the idea creation phase

4 adults with head injury (4 males, age range 30–70), 3 caregivers (unknown characteristics)

Cognitive impairment

The process was adapted to propose tangible and short activities that do not challenge memory and abstraction. Focus groups solicited active participation by gathering reviews on existing applications. The votes on the various solutions proposed were a good way to obtain engagement from all the participants. This process enabled involvement of the people with cognitive impairments and their caregivers during all the development phases.

Hill and Breslin [29] – 2016, Australia

To explore the usability and acceptability of an app from the perspective of participants with aphasia and speech-language pathologists.

End-user design,

includes participants in the evaluation phase

5 adults with aphasia (1 female and 4 males, age range 67–78), 3 speech-language pathologists (3 females, unknown age range)

Communication impairment

Barriers to use: scroll-bare, the one-screen keyboard, the tablets responsiveness to touch and limited previous experience with use of tablets or PC. Facilitators to use: the large screen size and support to access and use of the system.

Kerkhof, Bergsma et al. [30] – 2017, Netherlands

To explore what people with dementia find important in their choice and use of apps.

Qualitative exploratory design

8 people with dementia (2 females and 6 males, age range 60–82,), 10 informal carers (6 females and 4 males, age range 62–79)

Cognitive impairment

The people with dementia encountered several problems in navigating the apps (unclear symbols for buttons, sensitivity of the touchscreen, use of links, updates). They mentioned lay-out features that make apps attractive to use: the use of clear pictures and photos, readable letter types and sizes, a calm interface and background, contrast between text and background. Foreign language can be a barrier.

Kim, Kim et al. [51] – 2018, South Korea

To analyse the compliance rate of 120 health apps from 12 countries with the UX design guidelines and to conduct an experiment to examine whether the UX design guidelines improve the accessibility to visual information.

Experimental design,

includes participants in the evaluation phase

23 people with low vison and 23 people with no impairment (unknown characteristics)

Visual impairment

The researchers have developed guidelines to make apps accessible for people with visual impairment. The study successfully confirmed the increase in the actual information recognition speed from both test groups after applying UX design guidelines to selected health apps.

Lam, Tatla et al. [45] – 2015, Canada

To establish the current use and perceptions of gaming, social media, and robotics technologies for rehabilitative purposes from the perspective of adults and children with upper limb impairments to identify barriers and enablers to their adoption and use.

Qualitative design (focus group),

includes participants in the idea creation phase

7 children with motor impairment (1 female and 6 males, age range 6–16), 8 adults with motor impairment (2 females and 6 males, age range 45–75)

Motor impairment

Based on the feedback from the study’s participants, a successful gaming system should consider the following: incur low cost, demonstrate improved recovery, be simple to operate, be space-efficient, prescribe unique exercises, offer challenging and motivating games, incorporate the unaffected limb(s), create social connections, and demonstrate a clear distinction between gaming for therapy and for leisure.

Lazar, Woglom et al. [42] – 2018, USA

To describe the user-centred design process of developing a smart phone app that can potentially help people with Down syndrome make better nutritional decisions when dining out at a restaurant.

User-centred design,

includes participants in the idea creation phase

10 adults with Down syndrome (5 females and 5 males, age range 18–30), caregivers (unknown number and characteristics)

Cognitive impairment

This project documents how user-centered design processes can occur for complex projects involving people with Down syndrome and potentially persuasive technology.

Leporini and Buzzi [50] – 2018, Italy

To collect blind users’ expectations and habits regarding home automation technology.

Participatory study

42 adults with visual impairment (15 females and 27 males, age range 18 < 70)

Visual impairment

Based on the to the feedback from the participants, a set of general suggestions for designers and developers of home automation and remote-control systems has been proposed to enhance accessibility and usability for the blind user.

Lu, Lin et al. [31] – 2017, Taiwan

To design an optimised and user-friendly cognitive training game for older adults.

Qualitative approach of design-based research, includes participants in the evaluation phase

9 adults (7 females and 2 males, age range 61–90), 5 stakeholders and interaction designers (2 females and 3 males, unknown age range)

All older adults receive care, 4 had cognitive impairment

The older adults responded that they preferred larger icons and words. Small icons were hard to read and tap.

Madrigal-Cadavid, Amariles et al. [35] – 2020, Colombia

To design and develop a mobile app of drug information for people with visual impairment, which allows them to access information for the appropriate use of medicine.

User-centred design,

includes participants in the idea creation phase

48 adults with visual impairment (23 females and 25 males, mean age 42)

Visual impairment

A mobile app of drug information for people with visual impairment using a user-centred design process was designed and developed.

Malu and Findlater [32] – 2016, USA

To assess the accessibility of mobile and wearable fitness tracking for users with mobility impairments.

Participatory design,

includes participants in the evaluation phase

14 adults with mobility impairments (7 females and 7 males, age range 22–72)

Motor impairment

Manual input of data on a mobile app is challenging. Existing solutions were not relevant to their abilities. Participants’ designs and rationale suggest that: an unobtrusive wearable form factor is best, but it needs to be easy to put on and take off; preferences related to mobility level suggest that it will be important to cater to the needs of each user.

Singanamalla, Potluri et al. [36] – 2019, India

To investigate the state of accessibility of ATM machines in India and describe low-cost design changes that could potentially improve the accessibility of these machines for visual impaired persons in India.

Mixed methods,

includes participants in the idea creation phase

22 adults with visual impairment (5 females and 17 males, age range 18–50)

Visual impairment

Based on surveys with visually impaired persons the researchers developed a solution and perform a usability evaluation with the persons that participated in the survey.

Stearns, Findlater et al. [48] – 2018, USA

To investigate the design possibilities for augmented reality magnification tools enabled by registering virtual content in real 3D space.

Iterative design,

includes participants in the design phase

7 adults with visual impairment (4 females and 3 males, age range 28–68)

Visual impairment

The researchers first designed a prototype of a solution. Thereafter, the solution was further developed based on design sessions with persons with visual impairment. The persons tested the solution and based on their feedback the researchers updated the solution and some of the persons then tested the solution again.

Thirumalai, Rimmer et al. [38] – 2018, USA

To describe the development process of the TEAMS (Tele-Exercise and Multiple Sclerosis) app, which is being used by people with multiple sclerosis in a large randomised controlled trial to engage in home-based tele rehabilitation.

Parallel-iterative design,

includes participants in the design phase

21 adults with motor impairment (14 females and 7 males, mean age 54)

Motor impairment

Following several iterative evaluations, the project team and participants finalised an exercise app that can be easily operated in the convenience of the home and tailored to the functional needs of individuals with multiple sclerosis.

Winberg, Kylberg et al. [33] – 2017, Sweden

To describe how persons ageing with neurological disorders experience barriers and facilitators in relation to using apps in everyday life.

Qualitative design (focus group)

16 adults with neurological disease (5 females and 11 males, age range 51–74)

Fine motor skills, motor and cognitive impairment

The usability of apps was impacted by impairments in fine motor skills and sensory functions. Difficulties with fine motor skills and sensory functions made it hard to operate smartphones or tablets with two hands. The participants agreed that apps need to be easy and intuitive to use.

Zafeiridi, Paulson et al. [34] – 2018, UK

To explore the usability and user-friendliness of the CAREGIVERSPRO-MMD platform through evaluations performed by people with dementia or mild cognitive impairment, informal caregivers, and health and social care professionals.

Mixed methods design,

includes participants in the evaluation phase

24 older adults with dementia or mild cognitive impairment (14 females and 10 males, age range 55–91), 34 informal caregivers (20 females and 4 males, age range 30–77), 10 professionals (7 females and 3 males, age range 26–53)

Cognitive impairment

People with dementia preferred bigger colour contrasts and font sizes, as well as images and icons rather than text menus. Emoticons were used in the platform to like or not-like messages, but people with dementia found this confusing.

Zhou, Saptono et al. [37] – 2020, USA

To identify an approach that can be generally applied to improve the accessibility of mHealth apps.

Participatory design,

includes participants in the idea creation phase

5 adults with cerebral palsy or spinal cord injury (3 females and 2 males, age range 16–41)

Motor impairment (fine motor skills)

The study participants tested an app and experienced various levels of difficulty related to font size and style, spacing, button and selection option arrangement, colour and contrast, data input, page navigation and handedness. The accessibility of the apps was improved after the participants’ desired accessibility features were added into the app.