scholarly journals Towards a platform for robot-assisted minimally-supervised therapy of hand function: design and pilot usability evaluation

2021 ◽  
Author(s):  
Raffaele Ranzani ◽  
Lucas Eicher ◽  
Federica Viggiano ◽  
Bernadette Engelbrecht ◽  
Jeremia P.O. Held ◽  
...  
Keyword(s):  
Real World ◽  
Motor Coordination ◽  
Hand Function ◽  
Usability Evaluation ◽  
Therapy Session ◽  
Preliminary Evaluation ◽  
Hand Rehabilitation ◽  
Robot Assisted ◽  
Perceived Workload ◽  
Minimally Supervised

AbstractBackgroundRobot-assisted therapy can increase therapy dose after stroke, which is often considered insufficient in clinical practice and after discharge, especially with respect to hand function. Thus far, there has been a focus on rather complex systems that require therapist supervision. To better exploit the potential of robot-assisted therapy, we propose a platform designed for minimal therapist supervision, and present the preliminary evaluation of its immediate usability, one of the main and frequently neglected challenges for real-world application. Such an approach could help increase therapy dose by allowing the training of multiple patients in parallel by a single therapist, as well as independent training in the clinic or at home.MethodsWe implemented design changes on a hand rehabilitation robot, considering aspects relevant to enabling minimally-supervised therapy, such as new physical/graphical user interfaces and two functional therapy exercises to train hand motor coordination, somatosensation and memory. Ten participants with chronic stroke assessed the usability of the platform and reported the perceived workload during a single therapy session with minimal supervision. The ability to independently use the platform was evaluated with a checklist.ResultsParticipants were able to independently perform the therapy session after a short familiarization period, requiring assistance in only 13.46(7.69-19.23)% of the tasks. They assigned good-to-excellent scores on the SUS to the user-interface and the exercises (85.00(75.63-86.88) and 73.75(63.13-83.75) out of 100, respectively). Nine participants stated that they would use the platform frequently. Perceived workloads lay within desired workload bands. Object grasping with simultaneous control of forearm pronosupination and stiffness discrimination were identified as the most difficult tasks.DiscussionOur findings demonstrate that a robot-assisted therapy device can be rendered safely and intuitively usable upon first exposure with minimal supervision through compliance with usability and perceived workload requirements. The preliminary usability evaluation identified usability challenges that should be solved to allow real-world minimally-supervised use. Such a platformcould complement conventional therapy, allowing to provide increased dose with the available resources, and establish a continuum of care that progressively increases therapy lead of the patient from the clinic to the home.

scholarly journals Towards a Platform for Robot-Assisted Minimally-Supervised Therapy of Hand Function: Design and Pilot Usability Evaluation

2021 ◽  
Vol 9 ◽  
Author(s):  
Raffaele Ranzani ◽  
Lucas Eicher ◽  
Federica Viggiano ◽  
Bernadette Engelbrecht ◽  
Jeremia P. O. Held ◽  
...  
Keyword(s):  
Real World ◽  
Motor Coordination ◽  
Hand Function ◽  
Usability Evaluation ◽  
Therapy Session ◽  
Preliminary Evaluation ◽  
Robot Assisted ◽  
System Usability Scale ◽  
Perceived Workload ◽  
Minimally Supervised

BackgroundRobot-assisted therapy can increase therapy dose after stroke, which is often considered insufficient in clinical practice and after discharge, especially with respect to hand function. Thus far, there has been a focus on rather complex systems that require therapist supervision. To better exploit the potential of robot-assisted therapy, we propose a platform designed for minimal therapist supervision, and present the preliminary evaluation of its immediate usability, one of the main and frequently neglected challenges for real-world application. Such an approach could help increase therapy dose by allowing the training of multiple patients in parallel by a single therapist, as well as independent training in the clinic or at home.MethodsWe implemented design changes on a hand rehabilitation robot, considering aspects relevant to enabling minimally-supervised therapy, such as new physical/graphical user interfaces and two functional therapy exercises to train hand motor coordination, somatosensation and memory. Ten participants with chronic stroke assessed the usability of the platform and reported the perceived workload during a single therapy session with minimal supervision. The ability to independently use the platform was evaluated with a checklist.ResultsParticipants were able to independently perform the therapy session after a short familiarization period, requiring assistance in only 13.46 (7.69–19.23)% of the tasks. They assigned good-to-excellent scores on the System Usability Scale to the user-interface and the exercises [85.00 (75.63–86.88) and 73.75 (63.13–83.75) out of 100, respectively]. Nine participants stated that they would use the platform frequently. Perceived workloads lay within desired workload bands. Object grasping with simultaneous control of forearm pronosupination and stiffness discrimination were identified as the most difficult tasks.DiscussionOur findings demonstrate that a robot-assisted therapy device can be rendered safely and intuitively usable upon first exposure with minimal supervision through compliance with usability and perceived workload requirements. The preliminary usability evaluation identified usability challenges that should be solved to allow real-world minimally-supervised use. Such a platform could complement conventional therapy, allowing to provide increased dose with the available resources, and establish a continuum of care that progressively increases therapy lead of the patient from the clinic to the home.

Individual finger synchronized robot-assisted hand rehabilitation in subacute to chronic stroke: a prospective randomized clinical trial of efficacy

2012 ◽  
Vol 26 (8) ◽  
pp. 696-704 ◽  
Author(s):  
Chang Ho Hwang ◽  
Jin Wan Seong ◽  
Dae-Sik Son
Keyword(s):  
Clinical Trial ◽  
Hand Function ◽  
Intervention Group ◽  
Chronic Stroke ◽  
Sensory Loss ◽  
Hand Rehabilitation ◽  
Stroke Patients ◽  
Robot Assisted ◽  
Individual Finger ◽  
Taylor Test

Objective: To evaluate individual finger synchronized robot-assisted hand rehabilitation in stroke patients. Design: Prospective parallel group randomized controlled clinical trial. Subjects: The study recruited patients who were ≥18 years old, more than three months post stroke, showed limited index finger movement and had weakened and impaired hand function. Patients with severe sensory loss, spasticity, apraxia, aphasia, disabling hand disease, impaired consciousness or depression were excluded. Interventions: Patients received either four weeks (20 sessions) of active robot-assisted intervention (the FTI (full-term intervention) group, 9 patients) or two weeks (10 sessions) of early passive therapy followed by two weeks (10 sessions) of active robot-assisted intervention (the HTI (half-term intervention) group, 8 patients). Patients underwent arm function assessments prior to therapy (baseline), and at 2, 4 and 8 weeks after starting therapy. Results: Compared to baseline, both the FTI and HTI groups showed improved results for the Jebsen Taylor test, the wrist and hand subportion of the Fugl-Meyer arm motor scale, active movement of the 2nd metacarpophalangeal joint, grasping, and pinching power ( P < 0.05 for all) at each time point (2, 4 and 8 weeks), with a greater degree of improvement for the FTI compared to the HTI group ( P < 0.05); for example, in Jebsen Taylor test (65.9 ± 36.5 vs. 46.4 ± 37.4) and wrist and hand subportion of the Fugl-Meyer arm motor scale (4.3 ± 1.9 vs. 3.4 ± 2.5) after eight weeks. Conclusions: A four-week rehabilitation using a novel robot that provides individual finger synchronization resulted in a dose-dependent improvement in hand function in subacute to chronic stroke patients.

scholarly journals A Plug-and-Train Robot (PLUTO) for Hand Rehabilitation: Design and Preliminary Evaluation

2020 ◽  
Author(s):  
Aravind Nehrujee ◽  
Hallel Andrew ◽  
Ann Patricia ◽  
ReethaJannetSurekha ◽  
SamuelKamaleshKumar Selvaraj ◽  
...  
Keyword(s):  
Computer Games ◽  
Preliminary Evaluation ◽  
Wrist Flexion ◽  
Single Session ◽  
Hand Rehabilitation ◽  
System Usability Scale ◽  
Flexion Extension ◽  
Minimally Supervised ◽  
Experience Questionnaire ◽  
Hand Opening

Abstract Hand neurorehabilitation involves the training of movements at various joints of the forearm, wrist, fingers, and thumb. Assisted training of all these joints either requires either one complex multiple degree-of-freedom (DOF) robot or a set of simple robots with one or two DOF. Both of these are not economically or clinically viable solutions. The paper presents work that addresses this problem with a single DOF robot that can train multiple joints one at a time – the plug and train robot (PLUTO). PLUTO has a single actuator with a set of passive attachments/mechanisms that can be easily attached/detached to train for wrist flexion-extension, wrist ulnar-radial deviation, forearm pronation-supination, and gross hand opening-closings. The robot can provide training in active and assisted regimes. PLUTO is linked to performance adaptive computer games to provide feedback to the patients and motivate them during training. As the first step toward clinical validation, the device's usability was evaluated in 45 potential stakeholders/end-users of the device, including 15 patients, 15 caregivers, and 15 clinicians with standardized questionnaires: System Usability Scale (SUS) and User Experience Questionnaire (UEQ). Patients and caregivers were administered the questionnaire after a two-session training. Clinicians, on the other hand, had a single session demo after which feedback was obtained. The total SUS score obtained from the patients, clinicians, and healthy subjects was 73.3 ± 14.6 (n = 45), indicating good usability. The UEQ score was rated positively in all subscales by both the patients and clinicians, indicating that the features of PLUTO match their expectations. The positive response from the preliminary testing and the feedback from the stakeholders indicates that with additional passive mechanisms, assessment features, and optimized ergonomics, PLUTO will be a versatile, affordable, and useful system for routine use in clinics and also patients’ homes for delivering minimally supervised hand therapy.

scholarly journals Hand Rehabilitation Programs Used for Second to Fifth Metacarpal Fractures: A Systematic Literature Review Protocol

2020 ◽  
Author(s):  
Monique Marie Keller ◽  
Roline Y Barnes ◽  
Corlia Brandt
Keyword(s):  
Quality Of Life ◽  
Meta Analysis ◽  
Hand Function ◽  
Health Related Quality ◽  
Hand Rehabilitation ◽  
Metacarpal Fractures ◽  
Rehabilitation Programs ◽  
Related Quality ◽  
Health Related

Abstract BackgroundMetacarpal fractures have an incidence rate of 13.6 per 100000, affects males more than females and accounts for 33% of all hand fractures. No evidence-based rehabilitation program exists for second to fifth metacarpal fractures potentially causing poor health related quality of life, decrease hand function and disability.MethodsExperimental study designs, quasi-experimental, cohort studies and case control studies for the last ten years from January 2008 to September 2018 with English as a language restriction will be included. Sources investigating hand rehabilitation, immobilization, splinting and home programs after surgical and conservative management for second to fifth metacarpal fractures, will be included. MEDLINE, Academic Search Ultimate, CINAHL, CAB Abstracts, Health Source - Consumer Edition, Health Source: Nursing/Academic Edition, SPORTDiscus, Africa-Wide Information, MasterFILE Premier, Google Scholar and other grey literature will be searched. Two independent reviewers will independently conduct the study selection, methodology quality assessment and extraction of data. Findings will be pooled, meta-analysis performed, Summary of Findings provided according to Preferred Reporting Items for Systematic Reviews and Meta-Analysis if deemed appropriate.DiscussionIt is imperative to implement effective rehabilitation to prevent poor health related quality of life, decrease hand function and disability. In this systematic literature review, we will determine the existing evidence on hand rehabilitation programs used after post-surgical and conservative management for 20 to 59-year-old humans who sustained a single or multiple second to fifth metacarpal fracture.

Online Learning for the Real World

2003 ◽  
pp. 159-176
Author(s):  
Bridget Khursheed
Keyword(s):  
Continuing Education ◽  
Real World ◽  
Evaluation Process ◽  
Virtual Classroom ◽  
Usability Evaluation ◽  
Online Course ◽  
Course Development ◽  
The Real ◽  
University Of Oxford ◽  
The University

This chapter examines usability evaluation in the context of the Diploma in Computing via the Internet offered by the University of Oxford Department for Continuing Education and, to some extent, its on-site course partner. This ongoing online course is aimed at adult non-university (the “real world” of the chapter title) students. The chapter follows the usability evaluation process through the life cycle of course development, delivery and maintenance, analysing the requirements and actions of each stage and how they were implemented in the course. It also discusses how pedagogical evaluation must be considered as part of this process, as well as the more obvious software considerations, and how this was achieved within the course. Finally it draws some conclusions concerning the enhancements to course usability of the virtual classroom and how this atypical evaluation material can and should be integrated into an overall usability evaluation picture.

814 Do Patients Receive Reliable Outpatient Occupational Therapy After Hand Burns

2020 ◽  
Vol 41 (Supplement_1) ◽  
pp. S246-S246
Author(s):  
Katherine J Choi ◽  
Christopher H Pham ◽  
Zachary J Collier ◽  
John Carney ◽  
Dawn Kurakazu ◽  
...  
Keyword(s):  
Occupational Therapy ◽  
Psychiatric Illness ◽  
Hand Function ◽  
Hand Rehabilitation ◽  
Outpatient Therapy ◽  
Living Situation ◽  
Limited Range Of Motion ◽  
Hand Burns ◽  
Lost To Follow Up

Abstract Introduction Hands are the most commonly burned body part, and are prone to developing limited range of motion and scar contractures, which benefit from aggressive occupational therapy (OT). Many burn survivors are vulnerable with limited resources and poor follow up. The purpose of this study is to determine outpatient OT referral and compliance rates in our patient population. Methods All patients with hand burns admitted to a single ABA verified burn center from January 2015 to May 2016 were reviewed. Demographics (living situation, substance use, psychiatric illness), TBSA, interventions (type/number of surgeries), outcomes (length of stay [LOS]), and OT outcomes (inpatient and outpatient treatment, reason for discontinuation) were evaluated. Results Sixty-one patients met inclusion criteria. Mean age was 33±18 years. In terms of living situation, 17% (n=10) were homeless, and 3% (n=2) were incarcerated. A documented history of alcohol abuse was present in 13% (n=8), 23% (n=14) had positive urine toxicology screens, and 15% (n=9) had diagnosed psychiatric illness. Mean TBSA was 10%±6. Half (N=30, 51%) were managed non-operatively. At discharge, 30% (n=18) had normal hand function and did not meet criteria for outpatient hand therapy. Over 70% (n=43) received outpatient referrals, but only 44% (n=19) of those referred reliably returned for outpatient OT. Despite having outpatient OT referrals, 33% (n=14) did not present to outpatient therapy after repeats attempts of contact, and 67% (n=29) of those with referrals only came to one visit. Of those that did not complete therapy, most (n=14, 58%) were lost to follow up and unable to be contacted. Other reasons for not completing therapy within our system were out-of-network insurances requiring follow-up outside our hospital (36%) and incarceration (6%). Conclusions At our center, nearly 1 in 3 patients with hand burns had excellent function upon discharge and did not require outpatient therapy. However, when patients are referred for outpatient therapy, many do not show up or maintain reliable compliance. Many patients are simply lost to follow up. Applicability of Research to Practice While occupational therapy remains an effective and viable option for hand rehabilitation, further efforts must be aimed at providing patients mechanisms and education for achieving reliable outpatient follow up.

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