A usability study on mobile EMG-guided wrist extension training in subacute stroke patients－MyoGuide

Abstract

Abstract Background: Effective stroke rehabilitation requires high-dose, repetitive-task training, especially during the early recovery phase. However, the usability of upper-limb rehabilitation technology in acute and sub-acute stroke survivors remains relatively unexplored. In this study, we introduce sub-acute stroke survivors to the “MyoGuide”, a mobile training platform that employs surface electromyography (sEMG)-guided neurofeedback training for post-stroke wrist extension. Notably, the study places a strong emphasis on evaluating the platform’s usability within clinical contexts. Methods: We report the results of seven sub-acute post-stroke participants. The MyoGuide mobile training platform provided participants with real-time feedback, gamification features, and user control. Participants underwent wrist extension training, which encompassed calibration, stability assessment, and dynamic tasks. The training was conducted in supervised 1:1 sessions, spanning ten days. All training records were recorded within the application, usability was assessed through System Usability Scale (SUS) and a questionnaire administered during the final session. Daily written reports were provided by the therapist throughout the study duration. Results: The usability analysis yielded positive results, with a median SUS score of 82.5. Across the training sessions, patients progressed as indicated by significant increases in both the Stability Assessment Scores and the Level of Difficulty (LoD) that could be achieved in the dynamic task. The rate of progression differed based on initial impairment levels of the patient. During the training sessions, therapists documented not only the day-to-day performance of participants but also the extent of support required, particularly for those with lower baseline motor function. In parallel, participants who had experienced stroke expressed a keen interest in continuing home-based training. However, they also acknowledged challenges related to independently using the Myo armband and software. Conclusions: This study introduces the MyoGuide training platform and demonstrates its usability in a clinical setting for stroke rehabilitation, with the assistance of a therapist. The findings support the potential of MyoGuide for wrist extension training in patients across a wide range of impairment levels. However, certain usability challenges, such as donning/doffing the armband and navigating the application, need to be addressed to enable independent MyoGuide training requiring only minimal supervision by a therapist.