Abstract
Background Individuals with neurological injury or disease are at increased risk of experiencing falls, highlighting the need for effective balance interventions. A novel system integrating functional electrical stimulation and visual feedback balance training (FES+VFBT) is a promising balance intervention; however, this lab-based system requires a redesign to increase clinical utility. Objective To identify possible challenges and solutions to implementing the FES+VFBT system as a balance intervention, from the perspective of end users. Design/Methods This qualitative study involved three semi-structured focus group meetings to explore participants’ perspectives on the feasibility and potential challenges of implementing FES+VFBT in neurorehabilitation. Two individuals with spinal cord injury (SCI), one individual with stroke, two physiotherapists and one hospital administrator participated. Interview transcripts were analyzed using a deductive-inductive content analysis. The levels of the Social Ecological Model (SEM) were used as themes for the deductive analysis. Categories and codes were detected using an inductive approach. Results The themes spanned the four levels of the SEM: intrapersonal, interpersonal, organizational/training environment and society/policy. Identified categories consisted of possible challenges mapped to the intrapersonal (e.g., lack of knowledge, tolerance of user) and organizational/training environment (e.g., cost, need for space and time, technical challenges) levels. Categories also reflected possible solutions mapped to all SEM levels: intrapersonal (e.g., reading and research), interpersonal (e.g., practicing together), organizational/training environment (e.g., tailoring system parameters, social support), and society/policy (e.g., create guidelines, provide cost options). Conclusion The findings will be used to improve the FES+VFBT system design and facilitate implementation of the intervention in neurorehabilitation.
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