OT Students’ Perceptions of Functional Electrical Stimulation Cycle Technology

PURPOSE: Functional Electrical Stimulation (FES) has been shown to be beneficial in restoring physical functioning in people who have paresis and paralysis (Lee et al., 2013; Yeh, et al., 2012; Zehr, et al., 2015). Occupational therapists use FES to help clients regain movement related to self-care activities or to prevent further decline in the case of irreversible nerve damage (Marquez-Chin & Popovic, 2020). Despite this, little research has been done to determine occupational therapy education exposure to FES cycle technology. This exploratory study examined occupational therapy (OT) students’ knowledge and perceptions of FES cycle technology.

DESIGN: This mixed methods study surveyed participants about their experiences with FES cycle technology as OT students. The participants were recruited via AOTA forums from September 14, 2021 to October 18, 2021. Participants met the following inclusion criteria: students currently enrolled in an OT masters, doctorate, post-professional, or OT assistant program in the United States (US). Exclusion criteria included those who were not currently enrolled in an OT program in the US at the time of the survey.

METHOD: Participants consented to complete a Qualtrics survey. Quantitative data were analyzed using descriptive statistics in SPSS. Qualitative data were hand-coded and themes were identified. The survey consisted of 19 quantitative questions using descriptive and ordinal data and 2 qualitative questions with open-ended responses.

RESULTS: Twenty-one participants responded to the survey and 20 met inclusion criteria and completed the survey. Demographic variables included education: Master’s (n = 5), doctorate (n = 15), first year (n = 4), second year (n = 10), third year (n = 5), fourth year (n = 1); familiarity with FES cycle technology: 50% unfamiliar (n = 10) and 50% familiar. Participants who answered unfamiliar did not continue on with the survey. Of the 10 participants who were familiar with FES cycle technology, 60% (n = 6) of participants reported FES cycle technology education was implemented in their curriculum. Additionally, 70% (n = 7) of participants reported they had hands on interaction with an FES cycle. Participants reported they experienced the FES cycle in: didactic study 60%(n = 6), fieldwork 40% (n = 4), and in other ways 30% (n = 3) (observation hours, ‘rehab tech,’ or self-discovery). When asked what types of experiences they had with the FES cycle, participants reported the following experiences: 60% (n = 6) PowerPoint presentation, 70% (n = 7) hands on experience, 60% (n = 6) lecture, 0% (n = 0) course webinar or training, 10% (n = 1) no experience, and 20% (n = 2) reported other (’small intro video’ and ‘mentioned in passing’). Ten percent (n = 1) of participants reported they were extremely comfortable and 60% (n = 6) reported they were somewhat comfortable using FES cycle technology.

CONCLUSION: Results of the survey indicate a lack of awareness regarding FES cycle technology in participants. Half of the participants were not familiar with FES cycle technology. Of the participants who were familiar with the technology, only one felt extremely comfortable and six felt somewhat comfortable with the technology. Of clinical relevance, 70% (n = 7) of the participants who were familiar with FES technology also reported hands on experience with an FES cycle. This study demonstrates a lack of US OT student knowledge of and exposure to FES cycle technology despite its proven effectiveness. Lack of OT student training may have a negative impact on clients’ ability to access this technology. More research is needed to determine how OT students’ perceptions and educational experiences impact their use of the FES technology upon graduation.

References

Lee, S. Y., Kang, S. Y., Im, S. H., Kim, B. R., Kim, S. M., Yoon, H. M., & Han, E. Y. (2013). The effects of assisted ergometer training with a functional electrical stimulation on exercise capacity and functional ability in subacute stroke patients. Annals of Rehabilitation Medicine, 37(5), 619–627. https://doi.org/10.5535/arm.2013.37.5.619

Marquez-Chin, C., & Popovic, M. R. (2020). Functional electrical stimulation therapy for restoration of motor function after spinal cord injury and stroke: A review. Biomedical Engineering Online, 19(1), 34. https://doi.org/10.1186/s12938-020-00773-4

Yeh, C. Y., Tsai, K. H., Su, F. C., & Lo, H. C. (2010). Effect of a bout of leg cycling with electrical stimulation on reduction of hypertonia in patients with stroke. Archives of Physical Medicine and Rehabilitation, 91(11), 1731–1736. https://doi.org/10.1016/j.apmr.2010.08.003

Zehr, P. & Loadman, P. (2012). Neural control of rhythmic arm cycling after stroke. Journal of Neurophysiology, 108(3):891-905 https://doi.org/10.1152/jn.01152.2011