Participant Feedback in the Evaluation of Novel Stroke Rehabilitation Technologies

Purpose: Stroke participant perspectives are used to evaluate a novel rehabilitation system employing electrical stimulation (ES) technology combined with robotic assistance and virtual reality. The broader implications of such feedback for future technological development are discussed. Method: While supported by a robot, ES was applied to the triceps and anterior deltoid muscles of 5 chronic stroke participants with upper limb impairment to assist them in completing functional, virtual reality tracking tasks. Advanced ES controllers adjusted the amount of ES applied on each attempt to improve accuracy and maximise voluntary effort. The system was evaluated in terms of participants' perspectives, expressed during a semi-structured interview, and clinical outcome measures. Results: The rehabilitation system was well accepted by participants and viewed positively, despite mixed opinions regarding effectiveness. Feedback demonstrated an alignment in participants' perceptions of reduced impairment and clinical outcomes, in which a significant (p < 0.001) mean change of 9.3 in Fugl-Meyer scores was observed. Participant feedback also provided insight into individual differences observed in clinical outcomes. From our findings six key issues regarding effectiveness, muscles trained, system flexibility and portability, possible discomfort and the value of participant perspectives emerged that may be relevant for researchers developing new rehabilitation technologies. Conclusion: Participant feedback via a semi-structured interview provided important insight into the usability and effectiveness of using this system as a platform for upper limb stroke rehabilitation.