Our review protocol has been registered on the Open Science Framework [13] and will be guided by the Preferred Reporting Items for Systematic reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) checklist extension for Scoping Reviews [14]. We will use the scoping review framework originally developed by Arksey and O’Malley [15] and incorporate additional refinements recommended by Levac et al [16]. This process will include the following five steps: (1) identify the research questions; (2) identify relevant studies; (3) select studies; (4) chart the data; and (5) collate, summarize, and report the results. An optional sixth stage involving consultation with stakeholders may be included, as suggested by Levac et al [16].

The PRISMA-ScR is a guideline that provides a framework for reporting the methodology and results of a scoping review. Using the elements of PRISMA-ScR can help ensure transparency and improve the reporting quality of our scoping review. We will adapt the PRISMA-ScR guidelines to fit the specific objectives and design of the scoping review as this will be helpful in ensuring transparency and completeness in reporting the review process. Some of the elements of the PRISMA-ScR checklist that we will use to provide a clear and structured presentation of the review methodology are as follows:

We will include all articles that describe, assess, or explore the use of power-assist add-ons by older manual wheelchair users. Our definition of a power-assist add-on is a motorized device that can be attached to provide external power to a manual wheelchair. Our working definition of older adults will be anyone aged 65 years or older [17-19]. Based on a preliminary search of databases, we anticipate a dearth of literature focused solely on older adult wheelchair users. Hence, we will broaden the inclusion criteria to include studies done with adults and account for this approach in the discussion of our findings.

We will include older adults with all health conditions across any setting (eg, hospital, community, or rehabilitation facility). We will include the academic field of the studies, the general health-promotion programs the studies use, and the health care interventions designed for older adults with disabilities that the studies investigate.

Our literature search will use a broad approach and will be carried out in two phases.

Before we carry out the formal screening, a calibration exercise (pilot testing in 10% of identified studies) will be completed to ensure reliability. Percentage agreement will need to be >80% across reviewers to begin formal screening. Training, screening, and further development of criteria will occur until this interrater agreement threshold is met. The screening will be performed independently by 2 review authors, and discrepancies will be resolved by consensus or with the involvement of a third reviewer. The screening of articles will be completed in two stages. In the first stage, 2 researchers will independently screen the titles and abstracts, and conflicts will be resolved through dialogue or by a third researcher. In the second stage, full-text versions of the resulting articles will be obtained and reviewed by the 2 researchers. Articles will be selected based on the inclusion and exclusion criteria.

Data charting has four objectives: (1) we will enumerate the kinds of power-assist add-ons identified in the review, and we will create a list of names of all add-ons; (2) we will use thematic analysis to explore and identify themes and summarize attitudes toward uptake, efficacy, and/or effectiveness of power-assist add-ons for older adult wheelchair users [20,21]; (3) for any data on the limitations of power-assist add-ons, we will apply directed content analysis to describe the challenges associated with their use, areas for improvement, and strategies to improve quality, application, usability, and acceptance [22]; and (4) in aspects of this review where there is a paucity of data to answer our research question or where some specific methodologies or content are lacking, we will identify these as gaps.

For each of the included studies, we will extract the following data: study characteristics, including the study’s year and setting (hospital, rehabilitation facility, community, or other); type of add-on; type of health care provider (if applicable); condition studied or age group (as applicable); country or region of origin; funded vs unfunded status; and journal name. We will also record the study’s purpose and objectives, including its aim, questions, topic (or concept) addressed, and outcomes (ie, identified evidence gaps, future research opportunities, strengths and limitations, and implications for policy or practice), as well as the study’s methodology, approach, and scope.

The synthesis of this scoping review will focus on 3 key aspects: the uptake, effectiveness, and limitations of power-assist add-ons for older manual wheelchair users. Thematic analysis will be used to identify and organize key themes from the data, ensuring that the findings reflect a comprehensive understanding of users’ attitudes toward these devices.

Themes will emerge through an inductive, iterative process, with data coded and grouped based on similarities and patterns. Each theme will explore factors such as the perceived benefits, challenges, and barriers to adopting power-assist add-ons. The synthesis will also examine how factors like physical, emotional, and social considerations influence users’ experiences.

By ensuring methodological rigor and reflexivity, the synthesis will provide a clear, cohesive narrative of older adults’ experiences with power-assist add-ons, highlighting critical factors for adoption and their overall effectiveness. The final synthesis will contribute to a deeper understanding of this technology’s role in improving mobility for older wheelchair users.

Dissemination of our findings will include (1) producing versions of an executive summary that will be tailored to various groups, including educators, prescribers, and developers, as we expect that our findings will inform further collaboration with clinicians, prescribers, and dealers; (2) publishing in peer-reviewed journals focused on in rehabilitation and/or gerontology and on online platforms; and (3) presenting at relevant conferences (eg, the conference of the Canadian Association on Gerontology).

We foresee identifying several limitations related to the use of power-assist add-ons, including challenges with device integration, safety concerns, and insufficient training or support for users. These limitations are likely to be discussed in the context of how power-assist technologies are implemented in various settings, as well as the potential gaps in existing support systems.

Additionally, we expect this review to reveal mixed perceptions regarding the overall impact of power-assist add-ons on the quality of life and daily functioning of older adults. While some users may experience considerable improvements in these areas, others may face difficulties with the practicality and long-term sustainability of the devices.

We also expect that this scoping review will highlight gaps in the literature, particularly in the areas of long-term outcomes, cost-effectiveness, and the inclusion of older adults with diverse physical abilities and needs. This will help pinpoint areas requiring further research and development. Finally, the findings will inform recommendations for future research aimed at improving the design, usability, and accessibility of power-assist add-ons for older adults, with a focus on addressing identified barriers and enhancing user experience.

It is well known that older adults should be provided the opportunity to maximize independence, social connections, and quality of life. For older manual wheelchair users, these conditions for successful aging could potentially be enhanced by power-assist add-ons. We anticipate that the proposed review will summarize and provide key information to support future research and to enhance the knowledge base needed to further improve the use of power-assist add-ons.