Implications for Care Relationships in Technology-Supported Stroke Rehabilitation: A Qualitative Interview Study

This study explores how technology-supported rehabilitation reshapes the relationships between patients and therapists. Additionally, it examines how empirical findings can inform early design decisions. Qualitative interviews with patients and therapists identified their perceptions of PhysioMio, a wearable sensor-based rehabilitation device that detects muscle activity to monitor rehabilitation progress and enable independent home-based training. Adapting an ethics of care perspective, we focus on the significance of therapeutic relationships when discussing ethical nuances that emerge with the introduction of technology. Our findings show that, while patients value enhanced opportunities for agency and involvement, they do not seek full detachment from therapists. The successful integration of technology into rehabilitation hinges on strong, trust-based relationships, in which therapists take on an expanded role as contextual evaluators. This illustrates that rather than replace physical therapists, technology demands them to assume new roles. While participants generally prioritized purposeful and beneficial data collection over abstract privacy concerns, this acceptance was challenged when monitoring risked shifting therapists' roles toward judging supervisors. Visualizing the rehabilitation process through data raised fears of information overload and sparked mixed reactions regarding motivation and peer comparisons. These insights influenced design choices, including tailoring data granularity to specific purposes and reassessing whether comparative feedback supports or undermines motivation. In conclusion, the ethical use of technology to support recovery and strengthen care relationships must be embedded within trusting therapeutic relationships, and adapted attentively and responsibly to the individual's context, needs, abilities and values.