An Intensive Upper Extremity Program Coupled With A Wearable Device for Poststroke Rehabilitation: A Qualitative Study of the Perspectives of People With Stroke

The Virtual Arm Boot Camp program (V-ABC) was one of the first virtually-delivered upper extremity exercise programs coupled with a novel wearable device that provided reach-to-grasp feedback for individuals with stroke. Understanding the experience of participants is critical to improve the implementation of rehabilitation interventions that embed biosensor technology within rehabilitation. A qualitative study embedded within a multi-center randomized controlled trial conducted on the CanStroke Recovery Trials Platform was used to investigate the experiences of participants poststroke with the V-ABC program. A qualitative descriptive methodology was used to examine the acceptability of the program, factors influencing its effectiveness, and key elements for practical implementation. Semi-structured interviews were conducted via video conferencing with participants who had completed the program. Conventional content analysis was conducted to analyze the data. Strategies including triangulation, regular analytical meetings, peer examination, and reflexivity were used to increase the trustworthiness. Interviews were conducted via videoconferencing using Zoom software. Nineteen participants poststroke (10 males/8 females, mean age = 60.2 [SD = 12.2] years; mean length of time since stroke = 217.0 [SD = 109.2]) after completion of the program. The 3-week V-ABC program consisted of exercise, feedback from a wearable device on the use of the paretic upper extremity, and therapist support. Three themes describing the experiences of participants with the program were identified: (1) V-ABC provided motivating practice; (2) equipment and technology setup provided accessibility but posed challenges; and (3) increased use of the paretic hand can be integrated into daily life with varying degrees of success. An intensive, virtually delivered upper extremity exercise program coupled with biosensing feedback on hand use from a wearable device was reported to be motivating, accessible, and facilitated use of paretic hands in daily life. The findings may help improve the future implementation of the V-ABC program and similar approaches involving telerehabilitation and wearable technology.