Designing an Egocentric Video-Based Dashboard to Report Hand Performance Measures for Outpatient Rehabilitation of Cervical Spinal Cord Injury

Background: Functional use of the upper extremities (UEs) is a top recovery priority for individuals with cervical spinal cord injury (cSCI), but the inability to monitor recovery at home and limitations in hand function outcome measures impede optimal recovery. Objectives: We developed a framework using wearable cameras to monitor hand use at home and aimed to identify the best way to report information to clinicians. Methods: A dashboard was iteratively developed with clinician (n = 7) input through focus groups and interviews, creating low-fidelity prototypes based on recurring feedback until no new information emerged. Affinity diagramming was used to identify themes and subthemes from interview data. User stories were developed and mapped to specific features to create a high-fidelity prototype. Results: Useful elements identified for a dashboard reporting hand performance included summaries to interpret graphs, a breakdown of hand posture and activity to provide context, video snippets to qualitatively view hand use at home, patient notes to understand patient satisfaction or struggles, and time series graphing of metrics to measure trends over time. Conclusion: Involving end-users in the design process and breaking down user requirements into user stories helped identify necessary interface elements for reporting hand performance metrics to clinicians. Clinicians recognized the dashboard's potential to monitor rehabilitation progress, provide feedback on hand use, and track progress over time. Concerns were raised about the implementation into clinical practice, therefore further inquiry is needed to determine the tool's feasibility and usefulness in clinical practice for individuals with UE impairments.