Therapist perspectives on the clinical utility of hand performance information from at-home egocentric video in outpatient neurorehabilitation: a multi-methods evaluation study

Restoring hand function is a primary focus of rehabilitation after neurological injuries, such as stroke and spinal cord injury. However, monitoring hand use outside the clinic remains challenging. This study aims to evaluate how therapists perceive and would utilise information from a clinical decision support system (CDSS) that uses egocentric video to monitor patients’ hand use at home. Five patient-therapist dyads were recruited. Patients recorded daily activities using head-mounted cameras. Therapists reviewed dashboards of processed video data from their patients and completed semi-structured interviews and structured questionnaires. A multi-methods approach with thematic analysis was used to evaluate the CDSS’s clinical usefulness. Qualitative analyses revealed four main themes: therapists strongly preferred observational video data over quantitative metrics, valued insights into home environments that cannot be captured in-clinic, identified ways the information could tailor therapy to real-world activities, but noted practical implementation challenges including time constraints and patient burden. The system achieved high usability scores (mean SUS: 80.0, 85-89th percentile). This study demonstrates the potential of using egocentric video to inform clinical decision-making in neurorehabilitation, particularly for hand function. The strong preference for video over metrics suggests clinical decision support systems should prioritize interpretable, observation-based information aligned with clinical reasoning processes. Despite implementation challenges, therapists across technical familiarity levels expressed trust in the system and willingness to use it regularly. These findings indicate that egocentric video systems can bridge the clinic-home divide when designed to match interest-holder priorities. Not applicable.