Rehabilitation via home based gaming exercise for the upper-limb post stroke (RHOMBUS): qualitative findings of an intervention feasibility trial
Cherry Kilbride(1), Alex Nowicky(1), Alyson Warland(1),, Thomas Butcher(1), Meriel Norris(1), Guillem Buxarrais Singla(3), Daniel Scott(1,3), Karen Baker(1,3), Dimitris Athanasiou(3), Nana Anoyke(1), Jennifer Ryan(1,2) Elizabeth Cassidy(4)
(1) Department of Health Sciences, Brunel University London, UK.
(2) Department of Epidemiology and Public Health Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland.
(3) Neurofenix, London, UK.4Freelance academic, London, UK.
Introduction
Poor arm recovery post-stroke can lead to increased dependence, reduced quality of life, and is a strong predictor of lower psychological wellbeing following stroke. Effective treatment interventions are characterised by repetitive practice. This repetitive nature can make doing exercises boring, and coupled with a lack of community resources ongoing rehabilitation of the arm is challenging. The RHOMBUS study aimed to determine the safety, feasibility and acceptability of the Neurofenix platform, a novel, portable and affordable non-immersive virtual reality device for home-based rehabilitation of the upper-limb poststroke. This paper reports on the exploration of participants’ experiences of taking part in the RHOMBUS study.
Methods
Eighteen participants were sampled and invited to semi-structured interviews. Purposive sampling involved key criteria such as gender, age, amount of use, and level of upper-limb impairment and function. Carers or spouses involved in the intervention were also invited to take part as a dyad. Interviews were conducted at the participants house, audio-recorded, transcribed and analysed through the 5 stages (Familiarisation, Thematic framework, Indexing, Charting, Mapping and Interpretation) of the Framework Method1.
Results and discussion
Eighteen participants (10 male, age 39-85 years) undertook interviews, four carers or spouses participated as a dyad. This paper focuses on three themes related to engagement. The value of independent activity described the importance of training to facilitate desired independent use. Games as motivation to exercise described the enjoyable gameplay encouraging upper limb exercise. The third theme, maintaining the challenge, explored the ability of the platform to sustain challenge and its influence on engagement. In addition to perceived upper-limb improvements, specific recommendations regarding trial procedures and future platform improvements were also captured. Furher detailed analysis will be available by June.
Conclusions
Participants overall reported a positive experience about receiving the intervention and being involved in the trial and made practical suggestions for intervention design and delivery. However, the interviewers were part of the trial team, provided technical support and undertook the assessments. This prior relationship may have influenced how freely participants talked about or elaborated upon negative experiences related to the trial.
References
[1] Gale NK, Heath, G, Cameron, E, Rashid S and Redwood S (2013) Using the framework method for the analysis of qualitative research data in multi-disciplinary health research. BMC Medical Research Methodology, 13, 117 hyyp://www.biomedcentral.com/1471-2288/13/117.
