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

Area of Science:

• Neuroscience and Rehabilitation Engineering
• Human-Computer Interaction in Healthcare
• User-Centered Design Methodologies

Background:

• Rehabilitation technologies for stroke survivors are advancing, offering potential for increased therapy volume and improved outcomes.
• Despite proven efficacy, adoption and sustained use of these technologies in stroke rehabilitation remain limited.
• User-centered design is crucial for developing effective and integrated rehabilitation technologies.

Purpose of the Study:

• To evaluate the exciteBCI, a novel neuromodulatory wearable technology for stroke rehabilitation, using an iterative, user-centered design approach.
• To explore user perspectives and experiences with exciteBCI and its integration into rehabilitation.
• To identify necessary modifications for exciteBCI design features based on user feedback.

Main Methods:

• An iterative usability evaluation of exciteBCI was conducted in two phases with stroke survivors and physiotherapists.
• Phase 1 involved usability sessions and semistructured interviews across three sprint cycles with iterative device modification.
• Phase 2 utilized a 3-week "near-live" rehabilitation program with subsequent interviews, analyzed using conventional content analysis.

Main Results:

• Participants generally perceived exciteBCI positively, viewing it as a valuable tool that fits well within rehabilitation practice.
• The technology was seen as a way to enhance engagement and challenge, thereby maximizing rehabilitation benefits.
• Key themes emerged regarding the technology's role relative to the therapist, the balance between benefits and burden, and the importance of social acceptability in design.

Conclusions:

• Rehabilitation technology design must prioritize supporting the patient-therapist relationship.
• Social acceptability is a critical design consideration, though its importance is context-dependent.
• Employing design research methods that assess usability within sustained use contexts is highly valuable.