Patient Feedback Design for Stroke Rehabilitation Technology

Introduction: There is little foundational evidence describing needs, wants, and concerns of stroke survivors and their carers regarding stroke rehabilitation technology. The aim of the STORIES Project (Stroke Tech- Overviews in Rehabilitation, Insights, and Experiences of Survivors & carers) was to identify, characterize, and prioritize these needs and concerns, as well as differences in characterizations across subgroups, to inform socially inclusive design. Methods: Mixed-method, semi-structured interviews were conducted with 29 stroke survivors and 16 carers, including 12 matched patient-carer dyads. Participants used a 1-5 scale to rate confidence and interest in using technologies for stroke rehabilitation and to rate the importance of 41 aspects of rehabilitation technology use. Differences between subgroups were compared via student t-tests. Qualitative data was coded to add depth of understanding to quantitative results. Results: Across all participants, aspects rated most important were clear instructions, ability to return a product from home, ease of use, ability to see progress over time, and that technology use did not replace time with a therapist. Human interaction in rehabilitation was deeply important for motivation, effectiveness, and mental health. Compared to carers, patients found the following less important: training carers in rehabilitation technology use ( p =.006), ability to share progress ( p =.001), and ability to do exercises with therapists rather than carers ( p =.001). Non-whites more strongly valued including music in the rehabilitation technology experience ( p =.001). Medicaid beneficiaries cared more about time & financial risk-minimization strategies ( p <.000), but not direct cost ( p =.72). People without a Bachelor’s degree had less technology familiarity and interest ( p =.003). Finally, patients and carers of patients less than 12 months post-stroke were less interested in stroke rehabilitation technologies ( p <.000). Conclusion: To increase adoption of stroke rehabilitation technologies, development should focus on improving multiple parts of the product experience, including clear instructions, ease of use, progress tracking, music inclusion, free trials, and free returns from home.

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Stroke Patients’ Experiences in an Adaptive Healing Room in a Stroke Rehabilitation Unit

HERD Health Environments Research & Design Journal ◽

10.1177/1937586719879060 ◽

2019 ◽

Vol 13 (2) ◽

pp. 170-185

Author(s):

Ifah Arbel ◽

Bing Ye ◽

Alex Mihailidis

Keyword(s):

Stroke Rehabilitation ◽

Well Being ◽

Stroke Recovery ◽

Structured Interviews ◽

Stroke Patients ◽

Rehabilitation Unit ◽

Healing Environment ◽

Healthcare Settings ◽

Patient Feedback ◽

Healing Environments

Objectives: This study evaluated the user experiences (UX) of stroke patients residing in the adaptive healing room (AHR) and compared them to the UX of patients residing in standard private rooms (SPRs). Background: Healing environments in healthcare settings can promote patients’ healing processes, outcomes, and psychological well-being. The AHR was designed as a healing environment for stroke patients and has been previously evaluated in laboratory settings. This study was the first to evaluate it in its intended context—a stroke rehabilitation unit. Methods: The UX of 10 patients residing in the AHR and 15 patients residing in SPRs were collected via structured interviews with a set of open-ended questions and analyzed using quantitative and qualitative methods. Results: The AHR design features (orientation screen, skylight, and nature view) were rated positively by most patients. The skylight emerged as the least favorable. Responses to open-ended questions revealed that UX may be further improved if patients have more control over some of the settings (e.g., light intensity and nature views), and if the system allowed for more stimulation for patients at later stages of their recovery. Additionally, the results suggest that patients in the AHR have better UX than patients in the SPRs. Conclusion: The AHR has the potential to improve UX in the stroke rehabilitation unit. Patient feedback can be used to refine the AHR before carrying out clinical trials to assess the effect of the AHR on patient outcomes (e.g., sleep, mood, and length of stay) and stroke recovery.

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Reducing False Triggering Caused by Irrelevant Mental Activities in Brain-Computer Interface Based on Motor Imagery

10.21203/rs.3.rs-89367/v1 ◽

2020 ◽

Author(s):

Lujia Zhou ◽

Xuewen Tao ◽

Feng He ◽

Peng Zhou ◽

Hongzhi Qi

Keyword(s):

Steady State ◽

Motor Imagery ◽

Stroke Rehabilitation ◽

Evoked Potential ◽

Brain Computer Interface ◽

Recognition Rate ◽

Computer Interface ◽

Task Specificity ◽

Rehabilitation Technology ◽

The Brain

Abstract Background: In recent years, the brain-computer interface (BCI) based on motor imagery (MI) has been considered as a potential post-stroke rehabilitation technology. However, the recognition of MI relies on the event-related desynchronization (ERD) feature, which has poor task specificity. Further, there is the problem of false triggering (irrelevant mental activities recognized as the MI of the target limb). Methods: In this paper, we discuss the feasibility of reducing the false triggering rate using a novel paradigm, in which the steady-state somatosensory evoked potential (SSSEP) is combined with the MI (MI-SSSEP). Data from the target (right hand MI) and nontarget task (rest) were used to establish the recognition model, and three kinds of interference tasks were used to test the false triggering performance. In the MI-SSSEP paradigm, ERD and SSSEP features modulated by MI could be used for recognition, while in the MI paradigm, only ERD features could be used. Results: The results showed that the false triggering rate of interference tasks with SSSEP features was reduced to 29.3%, which was far lower than the 55.5% seen under the MI paradigm with ERD features. Moreover, in the MI-SSSEP paradigm, the recognition rate of the target and nontarget task was also significantly improved. Further analysis showed that the specificity of SSSEP was significantly higher than that of ERD (p<0.05), but the sensitivity was not significantly different. Conclusions: These results indicated that SSSEP modulated by MI could more specifically decode the target task MI, and thereby may have potential in achieving more accurate rehabilitation training.

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Multidisciplinary Evidence to Treat Bilingual Individuals with Aphasia

Perspectives on Communication Disorders and Sciences in Culturally and Linguistically Diverse Populations ◽

10.1044/cds15.3.66 ◽

2008 ◽

Vol 15 (3) ◽

pp. 66-72 ◽

Cited By ~ 1

Author(s):

José G. Centeno

Keyword(s):

Stroke Rehabilitation ◽

Culturally Diverse ◽

Treatment Strategies ◽

The United States ◽

Intervention Strategies ◽

Steady Increase ◽

Clinical Procedures ◽

Bilingual Speakers ◽

Aphasic Clients

Abstract The steady increase in linguistic and cultural diversity in the country, including the number of bilingual speakers, has been predicted to continue. Minorities are expected to be the majority by 2042. Strokes, the third leading cause of death and the leading cause of long-term disability in the U.S., are quite prevalent in racial and ethnic minorities, so population estimates underscore the imperative need to develop valid clinical procedures to serve the predicted increase in linguistically and culturally diverse bilingual adults with aphasia in post-stroke rehabilitation. Bilingualism is a complex phenomenon that interconnects culture, cognition, and language; thus, as aphasia is a social phenomenon, treatment of bilingual aphasic persons would benefit from conceptual frameworks that exploit the culture-cognition-language interaction in ways that maximize both linguistic and communicative improvement leading to social re-adaptation. This paper discusses a multidisciplinary evidence-based approach to develop ecologically-valid treatment strategies for bilingual aphasic individuals. Content aims to spark practitioners' interest to explore conceptually broad intervention strategies beyond strictly linguistic domains that would facilitate linguistic gains, communicative interactions, and social functioning. This paper largely emphasizes Spanish-English individuals in the United States. Practitioners, however, are advised to adapt the proposed principles to the unique backgrounds of other bilingual aphasic clients.

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