Assessing the Usability of a Novel Sensor-Enabled Garment for Knee Rehabilitation

Research Objectives: To obtain clinician and patient perspectives on the usability of a sensor-enabled-garment platform for knee rehabilitation

Design: Interview/Focus Groups

Setting: Home and Hospital-Based Outpatient Rehabilitation Center

Participants: Patients with knee pathologies AND physical therapists who actively treat them

Interventions: The platform consists of a cloud server (data processing), web portal/dashboard, mobile application (exercise guidance and session feedback), machine-washable garment embedded with inertial measurement units, and a removable/rechargeable smart hub. Participants demoed the platform during a physical therapy session and subsequently used the system during their home exercise program (up to 7 days). Activities were remotely monitored.

Main Outcome Measures: Responses to open-ended user experience and usability questions

Results: A total of 23 participants (9 patients|14 physical therapists) were recruited. Patients had either a total-knee arthroplasty (n=5), osteoarthritis (n=2), meniscal injury (n=1), or anterior cruciate ligament reconstruction (n=1) and ranged from 47 to 76 years. Patients had mean KOOS-ADL, WOMAC, and PROMIS-Mobility scores of 82.3, 19.3, and 44.6, respectively. Overall, both patients and therapists reported positive feedback about the platform acknowledging that it was useful, easy to use, and would generally intend to use it if available. Therapists identified pre-existing time constraints as a potential barrier to adoption, however over 90% of therapists would use the platform with additional enhancements. The garment was largely well received, though 2 patients expressed difficulties donning the garment secondary to scars/incisions and limited range of motion. Patients proposed alternative form factors (i.e., knee sleeves) as a potential solution whereas therapists preferred to modify the current garment (i.e., Velcro or zippers). Implementing real-time feedback was considered essential by patients and therapists alike.

Conclusions: The platform demonstrated good overall usability for knee rehabilitation and was well-accepted by all. Further studies are needed to evaluate its ability to improve clinical outcomes in this context.

Author(s) Disclosures: EF, PB: received support from a research agreement with the department of Physical Medicine and Rehabilitation at Spaulding Rehabilitation Hospital to develop and execute the study.
NR, JF, AV, DB, AH: developed and loaned the tested platform.