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  4. Identifying priorities for balance interventions through a participatory co-design approach with end-users

Identifying priorities for balance interventions through a participatory co-design approach with end-users

BMC Neurology, 2023 · DOI: https://doi.org/10.1186/s12883-023-03312-5 · Published: July 18, 2023

Spinal Cord InjuryNeurologyRehabilitation

Simple Explanation

This study explores the views of individuals with spinal cord injuries/diseases (SCI/D) or stroke, physical therapists, and hospital administrators on balance interventions and technologies, particularly those involving functional electrical stimulation (FES) and visual feedback training. The goal is to understand what these end-users prioritize in balance interventions to improve the design of such interventions and make them more useful and feasible in clinical settings. The study uses focus group meetings to gather detailed qualitative data about their experiences with balance deficits, rehabilitation, and FES, to guide the development of effective balance interventions.

Study Duration
February – April 2021
Participants
Two individuals with SCI/D, one individual with stroke, two physical therapists (PT) and one hospital administrator
Evidence Level
Not specified

Key Findings

  • 1
    Balance is considered essential for daily life and rehabilitation, with participants emphasizing the importance of continued balance work even after hospital discharge.
  • 2
    Participants desired balance interventions that are tailored to individual needs and goals, engaging, relevant to their lives, and carefully balance safety with the need for challenge.
  • 3
    While initially apprehensive, participants reported numerous benefits from FES, though challenges such as wires, cost, and setup time were also noted.

Research Summary

This qualitative study used a participatory co-design approach to explore the perspectives of end-users (individuals with SCI/D or stroke, physical therapists, and hospital administrators) regarding balance interventions, particularly those involving functional electrical stimulation (FES). The study identified four key themes: the importance of balance for daily life and rehabilitation, desired characteristics of balance interventions, prior experiences with FES, and the potential role of FES in balance interventions. The findings highlight the need for tailored, engaging, and relevant balance interventions that carefully consider safety and risk, and suggest that FES could complement balance training if challenges like cost and setup time are addressed.

Practical Implications

Tailored Interventions

Balance interventions should be highly individualized to meet specific patient needs and goals.

Engaging Therapy Design

Incorporate elements of fun and engagement to improve patient adherence and motivation.

FES Integration

Explore and optimize the use of FES in balance training, addressing practical challenges such as cost and setup time.

Study Limitations

  • 1
    Small sample size
  • 2
    Participants lived or worked in urban areas in one Canadian province
  • 3
    COVID-19 pandemic limited participation

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