Accepted for/Published in: JMIR Rehabilitation and Assistive Technologies
Date Submitted: May 23, 2025
Open Peer Review Period: May 23, 2025 - Jul 18, 2025
Date Accepted: Feb 19, 2026
(closed for review but you can still tweet)
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
A smart textile biofeedback training system for upper limb rehabilitation after stroke – a co-design development and evaluation
ABSTRACT
Background:
An increasing number of rehabilitation technologies are being developed to support upper limb rehabilitation after stroke, with smart textile solutions for surface electromyography (sEMG) emerging as a promising approach. Early end-user involvement is crucial for developing user-friendly and clinically valid rehabilitation tools.
Objective:
To refine and evaluate the prototype design and usability of a smart textile biofeedback system for self-administered upper limb training after stroke.
Methods:
The training system includes a knitted smart textile sleeve with integrated electrodes over the forearm muscles, an sEMG unit, and tablet-based biofeedback software. An iterative co-design process was followed, including initial testing, demo sessions with end-users (nine clinicians and ten individuals with stroke), and a final evaluation of the co-design process. Participants' experiences were gathered through semi-structured interviews, analyzed with content analysis, and the User Experience Questionnaire. The co-design team included experts in stroke rehabilitation, textile engineering, biomedical engineering, software development, and human factors, and a research partner with lived experience after stroke.
Results:
The perspectives of the end-users and expert team were collectively integrated into prototype refinements of the sleeve and training software to meet the needs of the intended target group. The experiences of end-users formed two main categories: “This could be an exciting new training tool for stroke rehabilitation” and “The tool works well, but some changes could enhance independent training.” End-users found the smart textile sleeve and biofeedback system easy to use and saw potential for integrating it into their training routines. Both end-user groups rated the system as attractive, stimulating and novel.
Conclusions:
The results of this study established a necessary ground towards the development of a smart textile sEMG biofeedback system for self-administered upper limb training after stroke. Findings from the co-design process support the continued development and evaluation of the system as a self-administered training tool for people with stroke.
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Copyright
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