Assistive Technology for the Upper Extremities After Stroke: Systematic Review of Users' Needs.
Anne L van Ommeren, Laura C Smulders, Gerdienke B Prange-Lasonder and 3 others
PMID 30497993WHAT IT FOUND
Stroke survivors, carers and clinicians prioritise upper-limb assistive devices that are easy to use, fit home life, support real tasks, and feel safe.
Cost, evidence and trust decide adoption.
Key findings
01The review grouped user needs into five themes: promoting hand and arm performance, attitude toward technology, decision process, usability, and practical applicability.
02Stroke survivors and carers wanted independent home use and advice from clinicians they trust.
03Usability problems such as setup, donning and doffing, comfort, weight and portability can lead to abandonment.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
Only nine studies were included, and most had at most 20 participants, so this is not a broad population survey. Two studies scored below 5 of 10 on methodological quality, and several gave little detail about recruitment, researcher bias, ethics or analysis. Participants in the reviewed studies may have been more interested in technology than typical patients, so barriers such as low familiarity or distrust may be understated. The review did not separate devices used for therapy from devices used for daily tasks, so some factors may matter differently in each setting. It could not rank which needs are most important, and most data came from expectations before actual use, not long-term home use. End users were not included when the final themes were defined; a design and research team interpreted them.
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not read this review as proof that upper-limb assistive technology improves recovery. It reports users' preferences and barriers before or around use, not clinical outcomes from tested devices.