Motivating Mobility - An exploration of developing upper limb rehabilitation technology tailored to individual stroke patients needs

Abstract

Introduction Half of all patients commencing stroke rehabilitation have marked impairment of the hemiplegic arm, with only 5% of those with severe paralysis regaining useful function. Current opinion in motor learning, reinforced by clinical evidence supports the use of repetitive movement practice, feedback and goal orientation to improve rehabilitation. This study aims to motivate people to practise their rehabilitation by extending their activities using a combination of technology and interactive personal games. The multi-disciplinary team comprises physiotherapists, design engineers and computer scientists. Method Two chronic hemiplegic stroke participants were selected via an interview and screening criteria. Ethical approval and written informed consent were obtained. Participative user centred design techniques were used over three months to assess patients’ rehabilitation aims, movement abilities and interests. Notes, photos and video were recorded. Results Two prototype technologies were designed: i) A device enabling a severely impaired patient to play with her toddler using her hemiplegic arm to guide balls down a shute. ii) A chess game in which the participant uses his hemiplegic hand to select a piece using a pressure sensitive sensor, whilst the unaffected hand keys in the move. Conclusion A user centred approach enabled technologies to be designed with stroke patients which addressed their rehabilitation aims as well as their real life interests. These technologies will now be deployed in the home for one month with physiotherapy outcome measures being taken before and after the deployment along with a semi structured interview to assess users’ perceptions of comfort, usability and acceptability