Technologies in upper limb rehabilitation post-stroke: the users' perspective

Background Technologies may address some current and future challenges in upper limb stroke rehabilitation by providing cost-effective and motivating opportunities for intensive practice, suitable for home-use and without the supervision of a therapist. The potential for technologies has therefore excited development and clinical testing. The aim of this study was to explore the perceptions of patients, their informal carers and healthcare professionals (HCPs) regarding barriers and opportunities of using these technologies in the future. Method Within four weeks of an interactive exhibition of 27 different upper limb technologies appropriate for use with stroke patients, four focus groups with people who: had not used technologies (n= 4 patients and 3 carers); had used technologies (n= 4 patients and 2 carers); carers (n=5) and HCPs (n=7) were conducted. Each group discussed the barriers to and opportunities for upper limb technology use. Transcriptions of each group were analysed using thematic analysis. Overall findings came from comparing and contrasting themes across the groups Results The potential for technologies to support self-management was a key theme. Barriers to achieving including lack of: information and ‘joined up’ approach between device providers, HCPs and service users; knowledge/confidence of HCPs; patient and carer’s exposure during rehabilitation and poor service delivery models. Device design was considered key to effective use, especially in home settings. Conclusions Although participants were interested in technology (attended the exhibition), and identified benefits of technologies (informing which technologies should be evaluated in a clinical trial), their overall response was that systemic barriers prevented the development of technology use in service provision. The findings form the basis of two wider questionnaires for HCPs and patients & carers and will inform the development of new technologies, ensuring that they are designed to satisfy both users and clinical needs.