scholarly journals A Game Controller for Stroke Rehabilitation

2021 ◽  
Author(s):  
◽  
William Duncan
Keyword(s):  
Design Process ◽  
Neural Plasticity ◽  
Lower Limb ◽  
Stroke Rehabilitation ◽  
Essential Elements ◽  
User Centered Design ◽  
Functional Requirements ◽  
Stroke Patients ◽  
Game Controller ◽  
Task Training

<p>Successful stroke rehabilitation relies on early, long-term, repetitive and intensive treatment. Repetitions conducted during clinical rehabilitation are significantly lower than that suggested by physiotherapeutic literature to relearn lost motor capabilities. This leaves patients to achieve this quantity in their home environment. Exercises can be monotonous and repetitive, making it difficult to maintain patient motivation. Exergames have been promoted for use in the home to make rehabilitation entertaining, increasing patients engagement with their therapy. Marketed exergaming systems for lower limb rehabilitation are hard to find, and none as of yet, facilitate Strength for Task Training (STT), a novel physiotherapeutic method for lower limb stroke rehabilitation. Strength for Task Training involves performing brief but intensive strength training (priming) prior to task-specic training to promote neural plasticity and maximise the gains in locomotor ability.  This research investigates how the design of a game controller for lower limb stroke rehabilitation can facilitate unsupervised STT to compliment clinical contact time.  The game controller was developed as part of a complete exergaming system designed to specifically facilitate STT. This involved working closely with co-researcher Scott Brebner who designed the exergame media. A user centered design approach was followed to include clinicians and stroke patients in the design process. This ensured the design aligned with the functional requirements of STT and the contextual needs of the patient. Workshops with stroke clinicians and neurophysiologists pointed to the specific areas of STT that a designed system could address. An iterative design process was used to develop, compare and improve concepts through testing with participants and clinicians. User testing involved participants using the game controller to interact with the digital game.  The final output was a prototype pair of smart shoes with an attachable weighted sole. The design used removable sensors to translate lower limb movement into ingame interactions. The design of the shoes and weighted sole provided a simple and safe way to engage in unsupervised STT. Research findings suggest that while not all of the STT therapy can be incorporated in an unsupervised and home-based exergame system, there are some essential elements that can. Adaptable hardware was found to be integral to facilitating intensive priming. Barriers to use can be reduced through considering the diverse physiological and cognitive abilities of stroke patients and aesthetic consideration can help create a meaningful game controller that promotes its use in the home.</p>

scholarly journals A Game Controller for Stroke Rehabilitation

2021 ◽  
Author(s):  
◽  
William Duncan
Keyword(s):  
Design Process ◽  
Neural Plasticity ◽  
Lower Limb ◽  
Stroke Rehabilitation ◽  
Essential Elements ◽  
User Centered Design ◽  
Functional Requirements ◽  
Stroke Patients ◽  
Game Controller ◽  
Task Training

<p>Successful stroke rehabilitation relies on early, long-term, repetitive and intensive treatment. Repetitions conducted during clinical rehabilitation are significantly lower than that suggested by physiotherapeutic literature to relearn lost motor capabilities. This leaves patients to achieve this quantity in their home environment. Exercises can be monotonous and repetitive, making it difficult to maintain patient motivation. Exergames have been promoted for use in the home to make rehabilitation entertaining, increasing patients engagement with their therapy. Marketed exergaming systems for lower limb rehabilitation are hard to find, and none as of yet, facilitate Strength for Task Training (STT), a novel physiotherapeutic method for lower limb stroke rehabilitation. Strength for Task Training involves performing brief but intensive strength training (priming) prior to task-specic training to promote neural plasticity and maximise the gains in locomotor ability.  This research investigates how the design of a game controller for lower limb stroke rehabilitation can facilitate unsupervised STT to compliment clinical contact time.  The game controller was developed as part of a complete exergaming system designed to specifically facilitate STT. This involved working closely with co-researcher Scott Brebner who designed the exergame media. A user centered design approach was followed to include clinicians and stroke patients in the design process. This ensured the design aligned with the functional requirements of STT and the contextual needs of the patient. Workshops with stroke clinicians and neurophysiologists pointed to the specific areas of STT that a designed system could address. An iterative design process was used to develop, compare and improve concepts through testing with participants and clinicians. User testing involved participants using the game controller to interact with the digital game.  The final output was a prototype pair of smart shoes with an attachable weighted sole. The design used removable sensors to translate lower limb movement into ingame interactions. The design of the shoes and weighted sole provided a simple and safe way to engage in unsupervised STT. Research findings suggest that while not all of the STT therapy can be incorporated in an unsupervised and home-based exergame system, there are some essential elements that can. Adaptable hardware was found to be integral to facilitating intensive priming. Barriers to use can be reduced through considering the diverse physiological and cognitive abilities of stroke patients and aesthetic consideration can help create a meaningful game controller that promotes its use in the home.</p>

scholarly journals Exergaming for Lower Limb Stroke Rehabilitation: A Game Controller for Lower Limb Stroke Rehabilitation

2021 ◽  
Author(s):  
◽  
RuiFeng Yeo
Keyword(s):  
Lower Limb ◽  
Stroke Rehabilitation ◽  
Weight Lifting ◽  
Ease Of Use ◽  
Neural Pathways ◽  
Game Controller ◽  
Research Findings ◽  
The Media ◽  
Task Training ◽  
At Home

<p><b>The success of stroke rehabilitation requires the patient engage in early, long-term high repetitions and intensive treatment. When comparing clinical and literature statistics, it is confirmed that clinical rehabilitation is not achieving required repetitions and intensity for effective rehabilitation of basic motor skills as prescribed in physiotherapy literature. It is then the patient’s responsibility to carry out the rehabilitation at home without supervision. These exercises can also be very mundane and repetitive, which reduces the patient’s motivation to exercise. Exergames have been found (Alankus et al., 2010, p. 21130, (King, Hijmans, Sampson, Satherley, & Hale, 2012 Deutsch et al., 2009), (Mortazavi et al., 2014), (Shirzad et al., 2015).to improve patients’ engagement with their therapies at home.</b></p> <p>Currently there are systems to facilitate lower limb stroke rehabilitation,but none includes Strength for Task Training (STT). STT is a novel physiotherapeutic method for lower limb rehabilitation and comprises of two main phases: first being the strength training (priming) and second being the task training. Priming is brief weight lifting to excite the neural pathways (neuroplasticity) in the affected region, which primes the brain for learning; this is then promptly followed by task training to maximise gains in the locomotor ability.</p> <p>This project builds up on the research and development of a game controller by Duncan (2016) for lower limb stroke rehabilitation to facilitate STT. This project is a collaboration with Regan Petrie who designed the media aspect of the exergame system.</p> <p>A game controller was developed and this was part of a complete exergaming system which was designed to specifically facilitate STT. This project compiles more research findings together with feedback from the user and the clinicians to help improve the system. This was to ensure that the design is aligned to the specific requirements of functional STT rehabilitation and contextual needs of the patient.</p> <p>The final output is a pair of prototype shoes which included a sensor to measure movement, a pair of weighted sleeve and a pair of balance sole. The weighted sleeve has removable weights and facilitates the strength part of the training. The shoes are the adaptors which allow the user to the balance soles which is used to constantly challenge the user’s balance. The sensors translate limb movement and are for the user to interact with the game. This system provides a simple and safe method to engage in unsupervised STT.</p> <p>Feedback from clinicians indicates that the shoes can facilitate the strength part of the exercise, the sensors the task part of the training, and the balance sole is useful for challenging and improving balance. User testing sessions offer information about: the usability of the system, including ease of use and intuitive design; the aesthetics of the physical objects and whether the system is engaging patients in their therapies.</p>

scholarly journals Exergaming for Lower Limb Stroke Rehabilitation: A Game Controller for Lower Limb Stroke Rehabilitation

2021 ◽  
Author(s):  
◽  
RuiFeng Yeo
Keyword(s):  
Lower Limb ◽  
Stroke Rehabilitation ◽  
Weight Lifting ◽  
Ease Of Use ◽  
Neural Pathways ◽  
Game Controller ◽  
Research Findings ◽  
The Media ◽  
Task Training ◽  
At Home

<p><b>The success of stroke rehabilitation requires the patient engage in early, long-term high repetitions and intensive treatment. When comparing clinical and literature statistics, it is confirmed that clinical rehabilitation is not achieving required repetitions and intensity for effective rehabilitation of basic motor skills as prescribed in physiotherapy literature. It is then the patient’s responsibility to carry out the rehabilitation at home without supervision. These exercises can also be very mundane and repetitive, which reduces the patient’s motivation to exercise. Exergames have been found (Alankus et al., 2010, p. 21130, (King, Hijmans, Sampson, Satherley, & Hale, 2012 Deutsch et al., 2009), (Mortazavi et al., 2014), (Shirzad et al., 2015).to improve patients’ engagement with their therapies at home.</b></p> <p>Currently there are systems to facilitate lower limb stroke rehabilitation,but none includes Strength for Task Training (STT). STT is a novel physiotherapeutic method for lower limb rehabilitation and comprises of two main phases: first being the strength training (priming) and second being the task training. Priming is brief weight lifting to excite the neural pathways (neuroplasticity) in the affected region, which primes the brain for learning; this is then promptly followed by task training to maximise gains in the locomotor ability.</p> <p>This project builds up on the research and development of a game controller by Duncan (2016) for lower limb stroke rehabilitation to facilitate STT. This project is a collaboration with Regan Petrie who designed the media aspect of the exergame system.</p> <p>A game controller was developed and this was part of a complete exergaming system which was designed to specifically facilitate STT. This project compiles more research findings together with feedback from the user and the clinicians to help improve the system. This was to ensure that the design is aligned to the specific requirements of functional STT rehabilitation and contextual needs of the patient.</p> <p>The final output is a pair of prototype shoes which included a sensor to measure movement, a pair of weighted sleeve and a pair of balance sole. The weighted sleeve has removable weights and facilitates the strength part of the training. The shoes are the adaptors which allow the user to the balance soles which is used to constantly challenge the user’s balance. The sensors translate limb movement and are for the user to interact with the game. This system provides a simple and safe method to engage in unsupervised STT.</p> <p>Feedback from clinicians indicates that the shoes can facilitate the strength part of the exercise, the sensors the task part of the training, and the balance sole is useful for challenging and improving balance. User testing sessions offer information about: the usability of the system, including ease of use and intuitive design; the aesthetics of the physical objects and whether the system is engaging patients in their therapies.</p>

Designing the Armadillo Orthosis: User experience design for a wearable upper limb stroke therapy device.

2021 ◽  
Author(s):  
◽  
Jessica Saul
Keyword(s):  
Design Process ◽  
User Experience ◽  
Upper Limb ◽  
Stroke Rehabilitation ◽  
Robotic Device ◽  
Stroke Therapy ◽  
User Testing ◽  
Stroke Patients ◽  
Research Through Design ◽  
Human Centred Design

<p>Stroke is a medical condition causing disability worldwide (Feigin et al., 2014; Murray et al., 2012; National Heart Lung and Blood institute, 2016). It can leave people with physical and cognitive deficits. The individual’s function in everyday activities following a stroke depends on the severity of the stroke and the amount of therapy available to them. Rehabilitation for the physical impairments, such as upper limb deficits, can promote recovery and is delivered by physiotherapists and occupational therapists. Therapy takes place predominantly in the clinical environment. It is manual, task based, delivered one on one, and can be time intensive. Self-management methods for patients’ stroke rehabilitation are gaining attention from healthcare professionals (Taylor, Monsanto, Kilgour, Smith, & Hale, 2019). Rehabilitation that can be done at home has benefits for the individual, the family or caregiver, the therapist and the healthcare system. Independent rehabilitation at home reduces pressure on healthcare resources and can be beneficial for stroke patients recovery. So, medical interventions and products are shifting from clinical to community and home environments.   The use of robotics for rehabilitation has the potential to support recovery of function and assist with everyday tasks in a variety of ways. This paper explores the design of a robotic device for the hand. By involving stroke patients, clinicians and carers in the design process, this research aims to improve the user experiences of a robotic device for hand rehabilitation. Designing for the user experience has the potential to improve the engagement and acceptance of the robotic device for independent home therapy.   A combination of methods have been used to include users in the design process and gather qualitative data to inform the design. The methodologies include research through design and human-centred design. Research through design includes methods such as a literature review, using and adapting design criteria, prototyping, iteration, user-testing, and thematic analysis. Human-centred design is about involving users in the development process and include methods such as surveys, semi-structured interviews, observations, and user testing. There were four clinicians and seven stroke patients that met inclusion criteria and participated in the testing. Three patients and three clinician participants were involved in the interviews. Personas were used to understand user wants and needs, and to inform criteria for the design process.  By using these methods we gain a better understanding of the users’ needs in order to improve the design of the pre-existing robotic upper limb stroke rehabilitation device. The purpose of the design is to meet the needs of the stroke patient in his or her own home. This design study focuses on developing the user experience by addressing usability. Interactions considered during the iterative design process are putting on and taking off the device. It is found through testing and iterations that comfort, cleaning and safety were necessary for this wearable robotic upper limb stroke therapy device to be easily worn and used in the home.</p>

Technological Advances in Stroke Rehabilitation—High Tech Marries High Touch

US Neurology ◽  
2010 ◽  
Vol 06 (02) ◽  
pp. 102 ◽  
Author(s):  
Richard C Senelick ◽  
Keyword(s):  
Neural Plasticity ◽  
Stroke Rehabilitation ◽  
Repair Process ◽  
High Tech ◽  
Functional Abilities ◽  
Stroke Patients ◽  
Neural Repair ◽  
Technological Advances ◽  
Improved Outcomes ◽  
The Brain

Until recently, the rehabilitation of stroke patients relied heavily on treatment that focused on teaching them how to compensate for their physical deficits. However, the latest neurorehabilitation studies show that the concept of neural plasticity (the ability of the brain to repair itself) can be applied effectively to the rehabilitation regimen of such patients, leading to improved outcomes and enhanced functional abilities. Stroke patients with limited voluntary movement could now benefit from technologies such as functional electrical stimulation (FES) combined with necessary repetition of functional tasks (use-dependent plasticity) to enhance the neural repair process and improve outcomes, thus enabling them to begin to overcome their previous limitations and to improve their physical capabilities.

Designing the Armadillo Orthosis: User experience design for a wearable upper limb stroke therapy device.

2021 ◽  
Author(s):  
◽  
Jessica Saul
Keyword(s):  
Design Process ◽  
User Experience ◽  
Upper Limb ◽  
Stroke Rehabilitation ◽  
Robotic Device ◽  
Stroke Therapy ◽  
User Testing ◽  
Stroke Patients ◽  
Research Through Design ◽  
Human Centred Design

<p>Stroke is a medical condition causing disability worldwide (Feigin et al., 2014; Murray et al., 2012; National Heart Lung and Blood institute, 2016). It can leave people with physical and cognitive deficits. The individual’s function in everyday activities following a stroke depends on the severity of the stroke and the amount of therapy available to them. Rehabilitation for the physical impairments, such as upper limb deficits, can promote recovery and is delivered by physiotherapists and occupational therapists. Therapy takes place predominantly in the clinical environment. It is manual, task based, delivered one on one, and can be time intensive. Self-management methods for patients’ stroke rehabilitation are gaining attention from healthcare professionals (Taylor, Monsanto, Kilgour, Smith, & Hale, 2019). Rehabilitation that can be done at home has benefits for the individual, the family or caregiver, the therapist and the healthcare system. Independent rehabilitation at home reduces pressure on healthcare resources and can be beneficial for stroke patients recovery. So, medical interventions and products are shifting from clinical to community and home environments.   The use of robotics for rehabilitation has the potential to support recovery of function and assist with everyday tasks in a variety of ways. This paper explores the design of a robotic device for the hand. By involving stroke patients, clinicians and carers in the design process, this research aims to improve the user experiences of a robotic device for hand rehabilitation. Designing for the user experience has the potential to improve the engagement and acceptance of the robotic device for independent home therapy.   A combination of methods have been used to include users in the design process and gather qualitative data to inform the design. The methodologies include research through design and human-centred design. Research through design includes methods such as a literature review, using and adapting design criteria, prototyping, iteration, user-testing, and thematic analysis. Human-centred design is about involving users in the development process and include methods such as surveys, semi-structured interviews, observations, and user testing. There were four clinicians and seven stroke patients that met inclusion criteria and participated in the testing. Three patients and three clinician participants were involved in the interviews. Personas were used to understand user wants and needs, and to inform criteria for the design process.  By using these methods we gain a better understanding of the users’ needs in order to improve the design of the pre-existing robotic upper limb stroke rehabilitation device. The purpose of the design is to meet the needs of the stroke patient in his or her own home. This design study focuses on developing the user experience by addressing usability. Interactions considered during the iterative design process are putting on and taking off the device. It is found through testing and iterations that comfort, cleaning and safety were necessary for this wearable robotic upper limb stroke therapy device to be easily worn and used in the home.</p>

scholarly journals Impact of Multidisciplinary Stroke Post-Acute Care on Cost and Functional Status: A Prospective Study Based on Propensity Score Matching

2021 ◽  
Vol 11 (2) ◽  
pp. 161
Author(s):  
Chong-Chi Chiu ◽  
Jhi-Joung Wang ◽  
Chao-Ming Hung ◽  
Hsiu-Fen Lin ◽  
Hong-Hsi Hsien ◽  
...  
Keyword(s):  
Propensity Score ◽  
Functional Status ◽  
Propensity Score Matching ◽  
Acute Care ◽  
Medical Cost ◽  
Economic Burden ◽  
Stroke Rehabilitation ◽  
Stroke Patients ◽  
The Impact ◽  
Post Acute Care

Few papers discuss how the economic burden of patients with stroke receiving rehabilitation courses is related to post-acute care (PAC) programs. This is the first study to explore the economic burden of stroke patients receiving PAC rehabilitation and to evaluate the impact of multidisciplinary PAC programs on cost and functional status simultaneously. A total of 910 patients with stroke between March 2014 and October 2018 were separated into a PAC group (at two medical centers) and a non-PAC group (at three regional hospitals and one district hospital) by using propensity score matching (1:1). A cost–illness approach was employed to identify the cost categories for analysis in this study according to various perspectives. Total direct medical cost in the per-diem-based PAC cohort was statistically lower than that in the fee-for-service-based non-PAC cohort (p < 0.001) and annual per-patient economic burden of stroke patients receiving PAC rehabilitation is approximately US $354.3 million (in 2019, NT $30.5 = US $1). Additionally, the PAC cohort had statistical improvement in functional status vis-à-vis the non-PAC cohort and total score of each functional status before rehabilitation and was also statistically significant with its total score after one-year rehabilitation training (p < 0.001). Early stroke rehabilitation is important for restoring health, confidence, and safe-care abilities in these patients. Compared to the current stroke rehabilitation system, PAC rehabilitation shortened the waiting time for transfer to the rehabilitation ward and it was indicated as an efficient policy for treatment of stroke in saving medical cost and improving functional status.

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