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  4. Combining functional electrical stimulation with visual feedback balance training: a qualitative study of end-­user perspectives on designing a clinically feasible intervention

Combining functional electrical stimulation with visual feedback balance training: a qualitative study of end-­user perspectives on designing a clinically feasible intervention

BMJ Open, 2025 · DOI: 10.1136/bmjopen-2024-090791 · Published: March 14, 2025

Assistive TechnologyNeurologyRehabilitation

Simple Explanation

This study explores how to make a balance training system, which uses electrical stimulation and visual feedback, more practical for use in clinics and homes for people with stroke or spinal cord injury. The research team gathered feedback from patients, therapists, and a hospital administrator to identify potential challenges and solutions for using the system in real-world settings. The findings will help to improve the design of the balance training system, making it more user-friendly and likely to be adopted by both clinicians and patients.

Study Duration
Not specified
Participants
Two individuals with chronic SCI, one individual with chronic stroke, two physical therapists, and one hospital administrator
Evidence Level
Qualitative study

Key Findings

  • 1
    End-users identified challenges such as lack of knowledge about the system, safety concerns, technical difficulties, cost, limited time and space, and suggested solutions at different levels.
  • 2
    Solutions included education, training, wireless technology, adaptable system parameters, progress tracking, safety features, purchasing options, and guidelines.
  • 3
    The study highlights the importance of involving end-users in the design process to ensure the technology is clinically relevant and user-friendly.

Research Summary

This study used a participatory design approach to identify potential challenges and solutions for implementing a functional electrical stimulation with visual feedback balance training (FES+VFBT) system in clinical settings. The research involved focus group meetings with individuals with stroke and SCI, physical therapists, and a hospital administrator to explore their perspectives on the feasibility and challenges of implementing FES+VFBT. The results identified potential challenges at the intrapersonal and organizational levels, and possible solutions at all levels of the social ecological model (SEM).

Practical Implications

Technology Design

Incorporate wireless technology and adjustable system parameters to improve usability and safety.

Clinical Implementation

Develop training resources and standardized protocols to address knowledge gaps and optimize therapy time.

Healthcare Policy

Offer flexible purchasing options and seek foundation grants to alleviate cost barriers.

Study Limitations

  • 1
    Small number of participants.
  • 2
    Lack of purposeful recruitment of socially disadvantaged individuals.
  • 3
    Absence of ranking desired system features by importance.

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