Therapists’ perspectives on using brain‑computer interface‑triggered functional electrical stimulation therapy for individuals living with upper extremity paralysis: a qualitative case series study

Journal of NeuroEngineering and Rehabilitation, 2022 · DOI: https://doi.org/10.1186/s12984-022-01107-2 · Published: November 21, 2022

Neurology Neurorehabilitation

Simple Explanation

Brain-computer interface-triggered functional electrical stimulation therapy (BCI-FEST) shows promise for improving upper extremity function in stroke or spinal cord injury patients. The study explores therapists' opinions on using BCI-FEST and potential limitations to its broader use. Semi-structured interviews were conducted with physical and occupational therapists who have delivered BCI-FEST, using the COM-B model to analyze capability, opportunity, and motivation. The study identified factors influencing BCI-FEST delivery, suggesting that education, training, support networks, and environmental restructuring (e.g., scheduling) should be targeted as interventions to facilitate clinical implementation.

Study Duration

Not specified

Participants

6 therapists (3 PTs, 3 OTs)

Evidence Level

Level IV, Qualitative Case Series

Key Findings

1
Therapists generally felt capable and motivated to use BCI-FEST, but recognized the need for more support, particularly concerning physical and social opportunities, to implement BCI-FEST clinically.
2
Set-up time for the BCI-FEST system was identified as a potential barrier, alongside the resource-intensive nature requiring both a therapist and a BCI operator.
3
Therapists suggested that a BCI-FEST therapist community development, including mentorship and support networks, would promote clinical use.

Research Summary

This qualitative study explored therapists' perspectives on using Brain-Computer Interface-triggered Functional Electrical Stimulation Therapy (BCI-FEST) for upper extremity rehabilitation in individuals with stroke or spinal cord injury. The study identified facilitating and limiting factors to BCI-FEST delivery in a clinical setting, including the need for increased social opportunity and further support for physical opportunity and psychological capability. The findings suggest that education, training, support networks, and restructuring the physical environment are essential to promote sustainable long-term clinical use of BCI-FEST for upper extremity rehabilitation.

Practical Implications

Targeted Interventions

Future interventions should focus on addressing the identified barriers, such as long setup times and the need for specialized personnel, to improve the efficiency and feasibility of BCI-FEST in clinical settings.

Community Building

Creating a BCI-FEST therapist community or support network could enhance the social opportunity for therapists, facilitating knowledge sharing, mentorship, and problem-solving.

Further Research

Future research should investigate the perspectives of individuals receiving BCI-FEST and involve other members of the care team to comprehensively assess barriers to knowledge use and ensure a sustainable intervention.

Study Limitations

1
Interviews were conducted over the phone, precluding the observation of non-verbal cues.
2
The therapists were from the same representative environment, so their perspectives may not be generalizable to clinical practice in other settings.
3
The study is limited by the small sample size.

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