Assistive Robotic Arm to Support Activities of Daily Living in Individuals With Tetraplegia: Protocol for a Real-World Convergent Parallel Mixed Methods Feasibility Study
Bibliographic record
Abstract
Background: Tetraplegia, often resulting from cervical spinal cord injury, may lead to significant motor and sensory loss, severely impacting independence and quality of life (QoL). Assistive technologies, 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 hospitalization, is still lacking. Objective: This study aims to explore the feasibility, usability, and user experience of a WMRA for individuals with tetraplegia in real-life posthospitalization settings. It aims to evaluate its support in activities of daily living and conduct a preliminary health economic analysis comparing cost-effectiveness and QoL outcomes with standard care. Methods: This mixed methods feasibility study will be conducted in posthospitalization 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 6 consecutive days. An equal number of participants will be recruited for the economic analysis group. Quantitative data will be collected at baseline and postintervention via standardized questionnaires (Post-Study System Usability Questionnaire, National Aeronautics and Space Administration Task Load Index, European Quality of Life 5-Dimension 5-Level questionnaire, Visual Analogue Scale, adapted version of the Canadian Occupational Performance Measure, and Client Socio-Demographic and Service Receipt Inventory-European Version), while qualitative feedback will be gathered through an informal questionnaire and semistructured interviews. Feasibility will be assessed through task performance and health economic analysis. The latter will include quality-adjusted life years, which quantify quality and length of life, and modeling the Incremental Cost-Effectiveness Ratio, which compares the cost-effectiveness of the intervention based on cost per quality-adjusted life years gained. Findings will be integrated in line with the convergent parallel mixed methods design. Results: Recruitment began in April 2025 and is ongoing as planned; full feasibility, usability, and economic results will be reported upon study completion. We expect the robotic system to reduce caregiver time and associated costs, while enhancing autonomy, QoL, and mental well-being. Potential technical and recruitment challenges have been identified and mitigation strategies planned. Evaluating real-life use of a WMRAs, this study could support the wider adoption of assistive robotic technologies. Conclusions: 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.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.009 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.002 | 0.003 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".