Research on the design and innovative transformation path of shoulder rehabilitation wall-climbing ladders for postoperative breast cancer patients based on design thinking

To develop a shoulder rehabilitation wall-climbing ladder for postoperative breast cancer patients using a design thinking–driven approach, and to evaluate its usability, feasibility, and translational application in clinical and home settings. This study integrated a design thinking framework (Empathize–Define–Ideate–Prototype–Test) with real-world implementation. Clinical observations, literature review, and semi-structured interviews with patients and nurses were conducted to identify limitations of existing wall-climbing approaches and define core design requirements. Following iterative prototyping and optimisation, the final product was implemented across multiple hospitals. Patient satisfaction and nurse user experience were assessed using self-developed questionnaires. The device was implemented in 148 hospitals, with 5,555 units distributed. A total of 199 patients reported a mean satisfaction score of 42.66 ± 5.30 (out of 50), with 86.0% indicating high satisfaction. Among 119 nurses, the mean user experience score was 47.88 ± 3.49, with 96.6% reporting high endorsement. Users highlighted ease of use, improved comfort, and facilitation of standardized rehabilitation and home-based exercise. Suggested improvements focused on enhancing quantitative assessment and recording functions. This study demonstrates a feasible nursing innovation pathway integrating design thinking with real-world implementation. The device shows good usability in both ward and home settings and may support standardized postoperative rehabilitation after breast cancer surgery. Further studies are needed to evaluate its clinical effectiveness.