Mixed methods usability evaluation of an assistive wearable robotic hand orthosis for people with spinal cord injury
Abstract Background Robotic hand orthoses (RHO) aim to provide grasp assistance for people with sensorimotor hand impairment during daily tasks. Many of such devices have been shown to bring a functional benefit to the user. However, assessing functional benefit is not sufficient to evaluate the usa...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-12-01
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| Series: | Journal of NeuroEngineering and Rehabilitation |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12984-023-01284-8 |
| _version_ | 1827604177484775424 |
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| author | Jan Dittli Jan T. Meyer Jessica Gantenbein Tobias Bützer Raffaele Ranzani Anita Linke Armin Curt Roger Gassert Olivier Lambercy |
| author_facet | Jan Dittli Jan T. Meyer Jessica Gantenbein Tobias Bützer Raffaele Ranzani Anita Linke Armin Curt Roger Gassert Olivier Lambercy |
| author_sort | Jan Dittli |
| collection | DOAJ |
| description | Abstract Background Robotic hand orthoses (RHO) aim to provide grasp assistance for people with sensorimotor hand impairment during daily tasks. Many of such devices have been shown to bring a functional benefit to the user. However, assessing functional benefit is not sufficient to evaluate the usability of such technologies for daily life application. A comprehensive and structured evaluation of device usability not only focusing on effectiveness but also efficiency and satisfaction is required, yet often falls short in existing literature. Mixed methods evaluations, i.e., assessing a combination of quantitative and qualitative measures, allow to obtain a more holistic picture of all relevant aspects of device usability. Considering these aspects already in early development stages allows to identify design issues and generate generalizable benchmarks for future developments. Methods We evaluated the short-term usability of the RELab tenoexo, a RHO for hand function assistance, in 15 users with tetraplegia after a spinal cord injury through a comprehensive mixed methods approach. We collected quantitative data using the Action Research Arm Test (ARAT), the System Usability Scale (SUS), and timed tasks such as the donning process. In addition, qualitative data were collected through semi-structured interviews and user observations, and analyzed with a thematic analysis to enhance the usability evaluation. All insights were attributed and discussed in relation to specifically defined usability attributes such as comfort, ease of use, functional benefit, and safety. Results The RELab tenoexo provided an immediate functional benefit to the users, resulting in a mean improvement of the ARAT score by 5.8 points and peaking at 15 points improvement for one user (clinically important difference: 5.7 points). The mean SUS rating of 60.6 represents an adequate usability, however, indicating that especially the RHO donning (average task time = 295 s) was perceived as too long and cumbersome. The participants were generally very satisfied with the ergonomics (size, dimensions, fit) of the RHO. Enhancing the ease of use, specifically in donning, increasing the provided grasping force, as well as the availability of tailoring options and customization were identified as main improvement areas to promote RHO usability. Conclusion The short-term usability of the RELab tenoexo was thoroughly evaluated with a mixed methods approach, which generated valuable data to improve the RHO in future iterations. In addition, learnings that might be transferable to the evaluation and design of other RHO were generated, which have the potential to increase the daily life applicability and acceptance of similar technologies. |
| first_indexed | 2024-03-09T05:55:22Z |
| format | Article |
| id | doaj.art-74c8effd2e6e4503bb06e275fc463edc |
| institution | Directory Open Access Journal |
| issn | 1743-0003 |
| language | English |
| last_indexed | 2024-03-09T05:55:22Z |
| publishDate | 2023-12-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of NeuroEngineering and Rehabilitation |
| spelling | doaj.art-74c8effd2e6e4503bb06e275fc463edc2023-12-03T12:14:30ZengBMCJournal of NeuroEngineering and Rehabilitation1743-00032023-12-0120111610.1186/s12984-023-01284-8Mixed methods usability evaluation of an assistive wearable robotic hand orthosis for people with spinal cord injuryJan Dittli0Jan T. Meyer1Jessica Gantenbein2Tobias Bützer3Raffaele Ranzani4Anita Linke5Armin Curt6Roger Gassert7Olivier Lambercy8Rehabilitation Engineering Laboratory, Department of Health Sciences and Technology, ETH ZurichRehabilitation Engineering Laboratory, Department of Health Sciences and Technology, ETH ZurichRehabilitation Engineering Laboratory, Department of Health Sciences and Technology, ETH ZurichRehabilitation Engineering Laboratory, Department of Health Sciences and Technology, ETH ZurichRehabilitation Engineering Laboratory, Department of Health Sciences and Technology, ETH ZurichSpinal Cord Injury Center, Balgrist University HospitalSpinal Cord Injury Center, Balgrist University HospitalRehabilitation Engineering Laboratory, Department of Health Sciences and Technology, ETH ZurichRehabilitation Engineering Laboratory, Department of Health Sciences and Technology, ETH ZurichAbstract Background Robotic hand orthoses (RHO) aim to provide grasp assistance for people with sensorimotor hand impairment during daily tasks. Many of such devices have been shown to bring a functional benefit to the user. However, assessing functional benefit is not sufficient to evaluate the usability of such technologies for daily life application. A comprehensive and structured evaluation of device usability not only focusing on effectiveness but also efficiency and satisfaction is required, yet often falls short in existing literature. Mixed methods evaluations, i.e., assessing a combination of quantitative and qualitative measures, allow to obtain a more holistic picture of all relevant aspects of device usability. Considering these aspects already in early development stages allows to identify design issues and generate generalizable benchmarks for future developments. Methods We evaluated the short-term usability of the RELab tenoexo, a RHO for hand function assistance, in 15 users with tetraplegia after a spinal cord injury through a comprehensive mixed methods approach. We collected quantitative data using the Action Research Arm Test (ARAT), the System Usability Scale (SUS), and timed tasks such as the donning process. In addition, qualitative data were collected through semi-structured interviews and user observations, and analyzed with a thematic analysis to enhance the usability evaluation. All insights were attributed and discussed in relation to specifically defined usability attributes such as comfort, ease of use, functional benefit, and safety. Results The RELab tenoexo provided an immediate functional benefit to the users, resulting in a mean improvement of the ARAT score by 5.8 points and peaking at 15 points improvement for one user (clinically important difference: 5.7 points). The mean SUS rating of 60.6 represents an adequate usability, however, indicating that especially the RHO donning (average task time = 295 s) was perceived as too long and cumbersome. The participants were generally very satisfied with the ergonomics (size, dimensions, fit) of the RHO. Enhancing the ease of use, specifically in donning, increasing the provided grasping force, as well as the availability of tailoring options and customization were identified as main improvement areas to promote RHO usability. Conclusion The short-term usability of the RELab tenoexo was thoroughly evaluated with a mixed methods approach, which generated valuable data to improve the RHO in future iterations. In addition, learnings that might be transferable to the evaluation and design of other RHO were generated, which have the potential to increase the daily life applicability and acceptance of similar technologies.https://doi.org/10.1186/s12984-023-01284-8UsabilityRobotic hand orthosisMixed methodsWearable robots |
| spellingShingle | Jan Dittli Jan T. Meyer Jessica Gantenbein Tobias Bützer Raffaele Ranzani Anita Linke Armin Curt Roger Gassert Olivier Lambercy Mixed methods usability evaluation of an assistive wearable robotic hand orthosis for people with spinal cord injury Journal of NeuroEngineering and Rehabilitation Usability Robotic hand orthosis Mixed methods Wearable robots |
| title | Mixed methods usability evaluation of an assistive wearable robotic hand orthosis for people with spinal cord injury |
| title_full | Mixed methods usability evaluation of an assistive wearable robotic hand orthosis for people with spinal cord injury |
| title_fullStr | Mixed methods usability evaluation of an assistive wearable robotic hand orthosis for people with spinal cord injury |
| title_full_unstemmed | Mixed methods usability evaluation of an assistive wearable robotic hand orthosis for people with spinal cord injury |
| title_short | Mixed methods usability evaluation of an assistive wearable robotic hand orthosis for people with spinal cord injury |
| title_sort | mixed methods usability evaluation of an assistive wearable robotic hand orthosis for people with spinal cord injury |
| topic | Usability Robotic hand orthosis Mixed methods Wearable robots |
| url | https://doi.org/10.1186/s12984-023-01284-8 |
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