Towards an upper limb rehabilitation tool after stroke based on surface electromyography biofeedback and virtual reality

Purpose: The impaired motor function of upper limbs caused by stroke reduces the performance of daily activities. Therefore, recent development in post-stroke rehabilitation works with exercises using virtual reality environment and surface electromyography biofeedback. This work aims to evaluate the usability of an upper limb rehabilitation tool, based on surface electromyography biofeedback and virtual reality, designed for post-stroke patients. Methods: The tool was developed based on the requirements raised in the conception and design phase. Virtual reality is used to motivate the patient to perform elbow extension movements. Twenty-eight participants without motor or neurological impairment and five rehabilitation professionals performed experiments and usability tests for evaluation purposes. The usability tests used were the questionnaires Goal Attainment Scale and the System Usability Scale that were filled by the volunteers after the evaluation. Results: In the trials, the volunteers evaluated the developed tool, elbow extension and flexion movements were performed, and both the user and the rehabilitation professional received outcomes feedback and electromyography biofeedback. The feedback results showed that there is no significant difference (p = 0.9216) between playing with the dominant and non-dominant arms. However, significant differences (p = 0.0003 and p = 0.0018) were observed when comparing the unilateral movement with the coordinated bilateral movement. Furthermore, the result of the System Usability Scale for participants showed a result of 82.59 ± 14.31, which is above the average of the scale (68 points), while for the professionals it was 71.25 ± 6.15. On the other hand, the results of the Goal Attainment Scale—where the score is analyzed from the T value (T value > 50 means that the result was better than expected)—presented a T value of 72.25 ± 2.77 and 73.56 ± 6.13, for participants and professionals, respectively. The maximum scores for each scale were 96.9 for SUS and 78.38 for GAS. Conclusion: A new rehabilitation tool is presented here, which is based on the raised requirements for post-stroke patients. The tool proved to be easily configurable, and results of usability and attainment scales showed high levels of usability for end-users. © 2022, Sociedade Brasileira de Engenharia Biomedica.