Pre-Implementation Analysis of the Usability and Acceptability of a Poststroke Complex Telehealth Biofeedback Intervention

Miranda Rennie Donnelly; Octavio Marin-Pardo; Aisha Abdullah; Coralie Phanord; Amisha Kumar; Stuti Chakraborty; Sook-Lei Liew

doi:10.5014/ajot.2024.050501

Pre-Implementation Analysis of the Usability and Acceptability of a Poststroke Complex Telehealth Biofeedback Intervention

Am J Occup Ther. 2024 Mar 1;78(2):7802180210. doi: 10.5014/ajot.2024.050501.

Authors

Miranda Rennie Donnelly¹, Octavio Marin-Pardo², Aisha Abdullah³, Coralie Phanord⁴, Amisha Kumar⁵, Stuti Chakraborty⁶, Sook-Lei Liew⁷

Affiliations

¹ Miranda Rennie Donnelly, MS, OTR/L, is PhD Candidate, Chan Division of Occupational Science & Occupational Therapy, University of Southern California, Los Angeles; mrennie@usc.ed.
² Octavio Marin-Pardo, PhD, is Postdoctoral Researcher, Chan Division of Occupational Science & Occupational Therapy, University of Southern California, Los Angeles.
³ Aisha Abdullah, MA, OTR/L, is OTD Resident, Chan Division of Occupational Science & Occupational Therapy, University of Southern California, Los Angeles.
⁴ Coralie Phanord, BA, BE, is Graduate Student, Clinical Psychology, University of Colorado Boulder. At the time of this study, Phanord was Programmer Analyst, Chan Division of Occupational Science & Occupational Therapy, University of Southern California, Los Angeles.
⁵ Amisha Kumar is Undergraduate Research Assistant, Dornsife College of Letters, Arts, and Sciences, University of Southern California, Los Angeles.
⁶ Stuti Chakraborty, BOT, is PhD Student, Chan Division of Occupational Science & Occupational Therapy, University of Southern California, Los Angeles.
⁷ Sook-Lei Liew, PhD, OTR/L, is Associate Professor, Chan Division of Occupational Science & Occupational Therapy, University of Southern California, Los Angeles; sliew@usc.edu.

Abstract

Importance: Complex telehealth interventions can facilitate remote occupational therapy services and improve access for people living with chronic neurological conditions. Understanding the factors that influence the uptake of these technologies is important.

Objective: To explore the fit between electromyography (EMG) biofeedback and telerehabilitation for stroke survivors, optimize EMG biofeedback interventions, and, more broadly, support other efforts to develop complex telerehabilitation interventions.

Design: Pre-implementation mixed-methods analysis of usability and acceptability data collected during a pilot and feasibility study.

Setting: Community.

Participants: Adult stroke survivors with hemiparesis (N = 11; M age = 54 yr).

Intervention: Game-based EMG biofeedback system for arm sensorimotor rehabilitation, delivered via telehealth.

Outcomes and measures: Post-Study System Usability Questionnaire, an extended Unified Theory of Acceptance and Use of Technology model questionnaire, and semistructured interview. We coded the interview data using questionnaire constructs.

Results: Participants used an EMG biofeedback intervention at home. Quantitative measures show high levels of perceived usability and acceptability, supported by qualitative findings describing specific facilitators and barriers.

Conclusions and relevance: Pre-implementation studies can improve the design and relevance of complex telehealth interventions. One major conclusion from this study is the influence of therapy providers on acceptability and usability of complex telehealth interventions. Plain-Language Summary: This study contributes to an emerging body of literature that examines the use of complex telehealth interventions with survivors of neurological injury. The findings highlight the value and support the development and use of complex telehealth interventions, which have the potential to improve remote access to occupational therapy for clients living with chronic neurological conditions. Complex telehealth interventions can open doors for survivors of neurological injury who face barriers to accessing occupational therapy and would benefit from technology-enabled therapy at home.

MeSH terms

Adult
Biofeedback, Psychology
Humans
Middle Aged
Occupational Therapy*
Stroke*
Telemedicine* / methods
Telerehabilitation* / methods