Accepted for/Published in: JMIR Research Protocols
Date Submitted: Jun 5, 2025
Open Peer Review Period: Jun 5, 2025 - Jul 31, 2025
Date Accepted: Nov 30, 2025
(closed for review but you can still tweet)
Assistive Robotic Arm to Support Activities of Daily Living in Individuals with Tetraplegia: Protocol for a Real-World Convergent Parallel Mixed Methods Feasibility Study
ABSTRACT
Background:
Background:
Tetraplegia, often resulting from cervical spinal cord injury (SCI), may lead to significant motor and sensory loss, severely impacting independence and quality of life. Assistive technologies (ATs), such as wheelchair-mounted robotic arms (WMRAs), offer potential to enhance autonomy in daily living. However, adoption remains limited due to high costs, complex controls, and insufficient end-user involvement. Robust evidence on their real-world effectiveness, particularly post-hospitalisation, is still lacking.
Objective:
Objektives: This study explores the real-life use of a WMRA for individuals with tetraplegia. It aims to evaluate its support in activities of daily living (ADLs), assess usability and satisfaction, and conduct a preliminary health economic analysis comparing cost-effectiveness and quality of life outcomes with standard care.
Methods:
Methods:
This study will be conducted in post-hospitalisation settings in Switzerland. Up to 15 participants with upper limb impairments (SCI C0–Th1, AIS A–D) using powered wheelchairs will be recruited. They will use the robotic arm for six consecutive days. An equal number of participants will be recruited for the economic analysis group. A mixed methods approach will combine quantitative data collected via standardised questionnaires (PSSUQ, NASA-TLX, EQ-5D-5L, VAS, aCOMP, CSSRI-EU) at baseline and post-intervention, along with qualitative feedback gathered through an informal questionnaire and semi-structured interviews. Feasibility will be assessed through task performance and health economic analysis. The latter will include quality-adjusted life years (QALY), which quantify quality and length of life, and modelling the Incremental Cost-Effectiveness Ratio (ICER), which compares the cost-effectiveness of the intervention based on cost per QALY gained.
Results:
Results:
Recruitment was initiated in April 2025, with the enrolment period expected to conclude in December 2025. As of June 2025, no participants have been enrolled. We expect the robotic system to reduce caregiver time and associated costs, while enhancing autonomy, quality of life, and mental well-being. Potential technical and recruitment challenges have been identified and mitigation strategies planned. By evaluating real-life use of a WMRAs, this study may support the broader adoption of assistive robotic technologies.
Conclusions:
Conclusion: This research offers key insights into the feasibility, usability, and economic value of robotic assistance for individuals with tetraplegia and will help inform future development and scale-up studies.
Citation
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