Stroke survivors' experience using mechanically-assisted devices as a component of their upper limb motor rehabilitation program.

Abstract

High-dose, repetitive motor retraining is recommended to improve upper limb motor function after stroke. Robotics and other non-gamified mechanically-assisted devices are one way of delivering this intensive motor training in the busy inpatient rehabilitation setting. This study aimed to explore stroke survivors' perspectives on using such devices for achieving high-dose training. Using a descriptive design with inductive thematic coding, qualitative data were collected through semi-structured interviews with stroke survivors who had completed repetitive upper limb training using a mechanically-assisted device (SMART Arm^™). Eleven participants (mean age 63.2 years, less than 6 months post-stroke) were interviewed. Overall, there were five major themes: mastery of my own practice (e.g., intrinsic motivation, autonomy), benefits of the device for practice (e.g., ease of use, goal-oriented feedback), drawbacks of device practice (e.g., setup complexity, physical discomfort), people influence device practice experience (e.g., effective communication and support), and suggestions to enhance device practice (e.g., preparation, personal adjustments). This qualitative study highlights the importance of the role of the clinician alongside use of devices. Stroke survivors reported both positive and negative experiences with mechanically‑assisted repetitive motor training. With major themes emphasizing the importance of internal motivation, goal‑oriented feedback, and the complexity of set-up.