14. A Pilot Trial of Home-based Hand Therapy Using Surface Electromyography

PURPOSE: Engaging and motivating home-based rehabilitation therapies are critically needed. We hypothesize that a biofeedback device using surface EMG that interfaces with simple app-based games would be easy to use and enjoyable as a therapeutic modality for patients with upper extremity weakness. METHODS: This pilot study seeks to assess usability, acceptability, and feasibility of a surface EMG-driven therapeutic gaming system designed for individuals to use at home. Our platform features a wireless, wearable surface EMG sensor that connects via Bluetooth to mobile devices and drives several therapeutic gaming apps. After baseline physical exam and brief instructions on setup, participants took the system home for four weeks. At the conclusion of the four weeks, usage data was collected, and participants completed surveys to assess their experience. RESULTS: Our pilot study enrolled 13 participants with upper extremity weakness secondary to brachial plexus/peripheral nerve injury, spinal cord injury, Parsonage Turner syndrome, and cancer; 1 withdrew and 1 failed to return for follow up. On average, participants used the system on 20 days out of the 28-day trial period (71% of days), with mean gameplay time of 13 minutes per day. Compared to baseline, participants showed improvements in quantitative muscle strength following the four-week therapy period. Our system received a System Usability Scale score of 74, within the range of acceptability, and when asked how likely they were to recommend the system to others, participants rated this 8 on a 10 point scale. CONCLUSION: In our pilot study, our surface EMG-driven therapeutic gaming system was successfully used at home by participants on their own. Overall, participants found the system usable and would recommend it to others. Although muscle strength was improved at the end of the four-week therapy period, this may be due to spontaneous improvements in muscle strength associated with nerve recovery, not directly caused by usage of our rehabilitation system.