Clinicians’ perceptions of a potential wearable device for capturing upper limb activity post-stroke: a qualitative focus group study

Abstract

Background There is growing interest in the use of wearable devices that track upper limb activity after stroke to help determine and motivate the optimal dose of upper limb practice. The purpose of this study was to explore clinicians’ perceptions of a prospective wearable device that captures upper limb activity to assist in the design of devices for use in rehabilitation practice. Methods Four focus groups with 18 clinicians (occupational and physical therapists with stroke practice experience from a hospital or private practice setting) were conducted. Data were analyzed thematically. Results Our analysis revealed three themes: (1) “Quantity and quality is ideal” emphasized how an ideal device would capture both quantity and quality of movement; (2) “Most useful outside therapy sessions” described how therapists foresaw using the device outside of therapy sessions to monitor homework adherence, provide self-monitoring of use, motivate greater use and provide biofeedback on movement quality; (3) “User-friendly please” advocated for the creation of a device that was easy to use and customizable, which reflected the client-centered nature of their treatment. Conclusions Findings from this study suggest that clinicians support the development of wearable devices that capture upper limb activity outside of therapy for individuals with some reach to grasp ability. Devices that are easy to use and capture both quality and quantity may result in greater uptake in the clinical setting. Future studies examining acceptability of wearable devices for tracking upper limb activity from the perspective of individuals with stroke are needed.

Stakeholders’ perspectives of a prospective interactive wearable system for upper extremity rehabilitation following stroke: A qualitative study

“…Aligned with a growing emphasis in rehabilitation literature, therapists also expressed the need for capturing the amount of movement to monitor the therapy dose and actual use of affected UE outside of therapy sessions (10,23). Consistent with our previous qualitative paper (12), the ability of a prospective wearable system to capture the quality of UE movements was salient among participants. This is also aligned with our ndings that the therapists want to detect trunk movements during UE movements to differentiate compensatory and normal movement patterns in Theme 2 (The device should capture UE and trunk movements).…”

“…Among the myriad of available rehabilitation treatment options, it is still challenging to decide the most optimal intervention (20). In addition, a client's personal preferences for movements of interest and feedback types were brought out consistently, which is in line with our previous qualitative paper (12). A few therapists highlighted the differential roles of dominant and nondominant hands in real-life activities that might in uence how therapists set tailored goals for clients.…”

“…One qualitative study by our group has previously examined the perceptions of clinicians regarding a speci c prototype for detecting the number of grasp and release movements in individuals with stroke (12) and led to the development of a "grasp counter" (13). Our current study aims to explore stakeholders' perspectives (i.e., rehabilitation therapists, individuals with stroke, and caregivers of stroke patients) of a prospective interactive wearable system for stroke to understand what upper limb movements (including those of the arm, hand, and nger movements) and functional activities would be essential to capture.…”

ARMIA: A Sensorized Arm Wearable for Motor Rehabilitation

“…The use of haptic feedback has also been a matter of interest in some studies to show quantitative improvements in children with neuromotor disorders [ 29 ]. What seems to be clear is that there is a consensus that this kind of device offers improvements in physical rehabilitation [ 21 , 22 , 30 , 31 ].…”

Perspectives of users for a future interactive wearable system for upper extremity rehabilitation following stroke: a qualitative study

“…Some studies have investigated the perceptions of users for technologies designed to help people with stroke recover movement of their upper limb [ 11 – 13 ]. One qualitative study exploring the perceptions of stroke patients on existing wearable robotic devices for upper extremity identified a need to develop new devices for UE rehabilitation [ 11 ].…”