A Qualitative Exploration of EMG Visual Feedback for Spinal Cord Injury Rehabilitation

Sustaining motivation during hand function rehabilitation after a Spinal cord injury (SCI) can be challenging, particularly when natural movement feedback is impaired. Augmented feedback, such as through visual feedback of electromyography (EMG) muscle activity, may support motor (re-) learning and user motivation, but its impact on SCI rehabilitation remains underexplored. This study involved the design of an EMG-based visual feedback tool and an exploration of its suitability in rehabilitation and potential impact on user motivation. Using a qualitative approach informed by Self-Determination Theory (SDT) and a customdeveloped EMG visualization interface, data were collected through semi-structured interviews with five quadriplegic participants and a focus group with seven occupational therapists (OT). Findings revealed that EMG visual feedback functions as an extrinsic motivator, providing tangible progress indicators, and has the potential to enhance intrinsic motivation by fostering enjoyment and aligning with personal interests. Themes highlight EMG feedback's potential in various rehabilitation contexts, from pre-functional muscle awareness to improved patient-therapist communication, offering a promising tool for advancing SCI rehabilitation.