A Brain Computer Interface Neuromodulatory Device for Stroke Rehabilitation: An Iterative User-Centred Design Approach

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aut.relation.articlenumbere49702
aut.relation.journalJMIR Rehabilitation and Assistive Technologies
aut.relation.startpagee49702
aut.relation.volume10
dc.contributor.authorAlder, Gemma
dc.contributor.authorTaylor, Denise
dc.contributor.authorRashid, Usman
dc.contributor.authorOlsen, Sharon
dc.contributor.authorBrooks, Thonia
dc.contributor.authorTerry, Gareth
dc.contributor.authorNiazi, Imran Khan
dc.contributor.authorSignal, Nada
dc.date.accessioned2024-01-14T22:28:05Z
dc.date.available2024-01-14T22:28:05Z
dc.date.issued2023-12-11
dc.description.abstractBACKGROUND: Rehabilitation technologies for people with stroke are rapidly evolving. These technologies have the potential to support higher volumes of rehabilitation to improve outcomes for people with stroke. Despite growing evidence of their efficacy, there is a lack of uptake and sustained use in stroke rehabilitation and a call for user-centered design approaches during technology design and development. This study focuses on a novel rehabilitation technology called exciteBCI, a complex neuromodulatory wearable technology in the prototype stage that augments locomotor rehabilitation for people with stroke. The exciteBCI consists of a brain computer interface, a muscle electrical stimulator, and a mobile app. OBJECTIVE: This study presents the evaluation phase of an iterative user-centered design approach supported by a qualitative descriptive methodology that sought to (1) explore users' perspectives and experiences of exciteBCI and how well it fits with rehabilitation, and (2) facilitate modifications to exciteBCI design features. METHODS: The iterative usability evaluation of exciteBCI was conducted in 2 phases. Phase 1 consisted of 3 sprint cycles consisting of single usability sessions with people with stroke (n=4) and physiotherapists (n=4). During their interactions with exciteBCI, participants used a "think-aloud" approach, followed by a semistructured interview. At the end of each sprint cycle, device requirements were gathered and the device was modified in preparation for the next cycle. Phase 2 focused on a "near-live" approach in which 2 people with stroke and 1 physiotherapist participated in a 3-week program of rehabilitation augmented by exciteBCI (n=3). Participants completed a semistructured interview at the end of the program. Data were analyzed from both phases using conventional content analysis. RESULTS: Overall, participants perceived and experienced exciteBCI positively, while providing guidance for iterative changes. Five interrelated themes were identified from the data: (1) "This is rehab" illustrated that participants viewed exciteBCI as having a good fit with rehabilitation practice; (2) "Getting the most out of rehab" highlighted that exciteBCI was perceived as a means to enhance rehabilitation through increased engagement and challenge; (3) "It is a tool not a therapist," revealed views that the technology could either enhance or disrupt the therapeutic relationship; and (4) "Weighing up the benefits versus the burden" and (5) "Don't make me look different" emphasized important design considerations related to device set-up, use, and social acceptability. CONCLUSIONS: This study offers several important findings that can inform the design and implementation of rehabilitation technologies. These include (1) the design of rehabilitation technology should support the therapeutic relationship between the patient and therapist, (2) social acceptability is a design priority in rehabilitation technology but its importance varies depending on the use context, and (3) there is value in using design research methods that support understanding usability in the context of sustained use.
dc.identifier.citationJMIR Rehabilitation and Assistive Technologies, ISSN: 2369-2529 (Print); 2369-2529 (Online), JMIR Publications, 10, e49702-. doi: 10.2196/49702
dc.identifier.doi10.2196/49702
dc.identifier.issn2369-2529
dc.identifier.issn2369-2529
dc.identifier.urihttp://hdl.handle.net/10292/17099
dc.languageen
dc.publisherJMIR Publications
dc.relation.urihttps://rehab.jmir.org/2023/1/e49702
dc.rights©Gemma Alder, Denise Taylor, Usman Rashid, Sharon Olsen, Thonia Brooks, Gareth Terry, Imran Khan Niazi, Nada Signal. Originally published in JMIR Rehabilitation and Assistive Technology (https://rehab.jmir.org), 11.12.2023. This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Rehabilitation and Assistive Technology, is properly cited. The complete bibliographic information, a link to the original publication on https://rehab.jmir.org/, as well as this copyright and license information must be included.
dc.rights.accessrightsOpenAccess
dc.rights.urihttps://creativecommons.org/licenses/by/4.0/
dc.subjectBCI
dc.subjectbrain computer interface
dc.subjectmobile app
dc.subjectnear live
dc.subjectrehabilitation technology
dc.subjectsemistructured interviews
dc.subjectstroke
dc.subjectthink-aloud
dc.subjectuser-centered design
dc.subjectwearable technology
dc.subject40 Engineering
dc.subject4003 Biomedical Engineering
dc.subjectRehabilitation
dc.subjectClinical Research
dc.subjectStroke
dc.subjectBrain Disorders
dc.subjectBehavioral and Social Science
dc.subjectBioengineering
dc.subjectAssistive Technology
dc.subjectStroke
dc.subject4003 Biomedical engineering
dc.subject4201 Allied health and rehabilitation science
dc.subject4203 Health services and systems
dc.titleA Brain Computer Interface Neuromodulatory Device for Stroke Rehabilitation: An Iterative User-Centred Design Approach
dc.typeJournal Article
pubs.elements-id525243
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NISAN - the National Institute for Stroke and Applied Neurosciences