Protocol for a multi-perspective exploration of technology requirements for home-based upper-limb tabletop functional...

Upper-limb (UL) impairment following stroke significantly limits independence in activities of daily living (ADLs). Although tabletop functional task-oriented training (FTOT) is a cornerstone of neurorehabilitation, both conventional therapist-led and technology-supported FTOT face limitations in consistency, supervision, progression and continuity across settings. The objectives are to characterise current clinical practices in UL tabletop FTOT and identify stroke survivor-caregiver dyads' needs, constraints and support requirements across clinical and home contexts to inform user-centred technology development.

A multi-phase mixed-methods design will be employed. Phase-A will be an explanatory sequential design including a quantitative online survey of rehabilitation therapists (target minimum n=100) to characterise UL tabletop training delivery (eg, task selection, dose, progression). Survey findings will inform subsequent data collection through virtual qualitative interviews with a purposive subsample of therapists (anticipated n≈10-20) to examine task orchestration, adaptation and clinical decision-making in depth. Phase-B will use a descriptive qualitative design involving semi-structured interviews of stroke survivor-caregiver dyads (target n=15 dyads) to explore FTOT experiences across clinical and non-clinical contexts. Quantitative data will be analysed descriptively, and qualitative data will be analysed using inductive content analysis. Mixed-methods integration, within Phase-A and between the two phases, will examine convergence, complementarity, expansion and divergence. Integration will be illustrated using joint displays, visual tools that present the findings from both strands side-by-side using a table or figure. Patient and public involvement activities (n=5) and a pilot dyadic interview (two dyads) were completed to refine study materials and procedures.

Ethical approval was obtained from the Institutional Review Board of Christian Medical College, Vellore (IRB Min No. 2511113). Electronic informed consent will be obtained from therapists for the survey and qualitative interviews. Written informed consent will be obtained from the dyadic participants before the interviews. All study procedures will adhere to ethical principles for human research. Study findings will be disseminated through conference presentations and publication in peer-reviewed journals, with stakeholder-oriented dissemination to support clinical and technology development.