Mapping the development process of transcutaneous neuromuscular electrical stimulation devices for neurorehabilitation, the associated barriers and facilitators, and its applicability to acquired dysarthria: a qualitative study of manufacturers’ perspectives
Creators: name: Balzan, Pasquale
name: Tattersall, Catherine
name: Palmer, Rebecca
name: Murray, Michael
Publisher: name: Taylor & Francis
Year: 2023
Subjects: Space Science
Medicine
Cell Biology
Biotechnology
Environmental Sciences not elsewhere classified
Biological Sciences not elsewhere classified
Developmental Biology
Science Policy

description: The fragmented nature of the medical device market limits our understanding of how particular sub-markets navigate the device development process. Despite the widespread use of transcutaneous neuromuscular electrical stimulation (NMES), its use for acquired dysarthria treatment has not been sufficiently explored. This study aims to provide a preliminary understanding of the stages involved in the development of NMES devices designed for neurorehabilitation. It also aims to investigate manufacturers’ perceptions concerning factors that facilitate or impede its development and determine its applicability for acquired dysarthria. In-depth semi-structured online interviews were conducted with eight NMES device manufacturers located across Europe, North America and Oceania. The interviews were video-recorded, automatically transcribed, manually reviewed, and analysed using a qualitative content analysis. NMES device development for neurorehabilitation involves six complex phases with sequential and overlapping activities. Some emerging concepts were comparable to established medical device models, while others were specific to NMES. Its adaptability to different neurological disorders, the positive academia-industry collaborations, the industry’s growth prospects and the promising global efforts for standardised regulations are all key facilitators for its development. However, financial, political, regulatory, and natural constraints emerged as barriers. Indications and challenges for the applicability of NMES for acquired dysarthria treatment were also discussed. The findings provide a foundation for further investigations on the NMES market sub-sector, particularly in the context of neurorehabilitation. The study also provides insights into the potential adoption of NMES for acquired dysarthria, which can serve as a reference for future research. The mapped neuromuscular electrical stimulation (NMES) development phases and processes can serve as a framework for new device development initiativesOpportunities for NMES development included its adaptability to neurological disorders, its growth prospects, academia-industry relationships and regulatory standardisation initiativesFinancial, political, regulatory, and natural barriers were barriers for concern.From an anatomical and practical standpoint, it seems feasible to use NMES to treat several features of acquired dysarthria, however, clinicians’ limited education on the use of electrical stimulation for neurorehabilitation may pose several constraints. The mapped neuromuscular electrical stimulation (NMES) development phases and processes can serve as a framework for new device development initiatives Opportunities for NMES development included its adaptability to neurological disorders, its growth prospects, academia-industry relationships and regulatory standardisation initiatives Financial, political, regulatory, and natural barriers were barriers for concern. From an anatomical and practical standpoint, it seems feasible to use NMES to treat several features of acquired dysarthria, however, clinicians’ limited education on the use of electrical stimulation for neurorehabilitation may pose several constraints.