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Open Access Research article

Usability of therapy controllers in elderly patients with deep brain stimulation

Iris Kaiser12*, Ilse Kryspin-Exner2, Thomas Czech1 and Francois Alesch1

Author Affiliations

1 Department of Neurosurgery, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Wien, Austria

2 Institute of Clinical, Biological and Differential Psychology, Faculty of Psychology, University of Vienna, Liebiggasse 5, 1010 Wien, Austria

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BMC Neurology 2012, 12:4  doi:10.1186/1471-2377-12-4

Published: 13 February 2012

Abstract

Background

Technical devices are becoming more prevalent in society and also in medical care. Older adults need more support to learn new technologies than younger subjects. So far, no research has been done on the usability of patient controllers in deep brain stimulation in an elderly population. The aim of the study was to investigate the factors influencing the performance of elderly DBS patients with respect to usability aspects of Medtronic Access therapy controllers.

Methods

Time, mistakes and frequency of use of the controller were compared in 41 elderly DBS patients who prior to the study had already owned a therapy controller for more than six years. One group (n = 20, mean age = 66.4 years) was watching an instructional video and then completed practical assignments on a model implantable pulse generator (IPG). The other group (n = 21, mean age = 65.9 years) completed the tasks without having seen the video before. Any errors that patients made were documented and also corrected so that all of them received hands-on training. After six months all patients were re-evaluated on the dummy IPG in order to compare the effects of hands-on alone vs. video-based training combined with hands-on.

Results

The group that had seen the video before significantly outperformed the control group at both assessments with respect to number of errors. Both groups performed faster after six months compared to baseline and tend to use the controller more often than at baseline.

Conclusion

Our results indicate that elderly DBS patients who have been using the controller for several years still have various difficulties in operating the device. However, we also showed that age-specific training may improve the performance in older adults. In general, the design of DBS patient controllers should focus on the specific needs of the end-users. But as changes to medical devices take a long time to be implemented, video instructions with age-specific content plus hands-on training may improve learning for older adults.