There is a new book out, by Mrs Shani Shamah. Shani shares her experience of living with stroke here.
Our latest article describing the results from SCRIPT project is now online on JNER (open access, here)
Here is a copy of the abstract:
Assistive and robotic training devices are increasingly used for rehabilitation of the hemiparetic arm after stroke, although applications for the wrist and hand are trailing behind. Furthermore, applying a training device in domestic settings may enable an increased training dose of functional arm and hand training. The objective of this study was to assess the feasibility and potential clinical changes associated with a technology-supported arm and hand training system at home for patients with chronic stroke.
A dynamic wrist and hand orthosis was combined with a remotely monitored user interface with motivational gaming environment for self-administered training at home. Twenty-four chronic stroke patients with impaired arm/hand function were recruited to use the training system at home for six weeks. Evaluation of feasibility involved training duration, usability and motivation. Clinical outcomes on arm/hand function, activity and participation were assessed before and after six weeks of training and at two-month follow-up.
Mean System Usability Scale score was 69 % (SD 17 %), mean Intrinsic Motivation Inventory score was 5.2 (SD 0.9) points, and mean training duration per week was 105 (SD 66) minutes. Median Fugl-Meyer score improved from 37 (IQR 30) pre-training to 41 (IQR 32) post-training and was sustained at two-month follow-up (40 (IQR 32)). The Stroke Impact Scale improved from 56.3 (SD 13.2) pre-training to 60.0 (SD 13.9) post-training, with a trend at follow-up (59.8 (SD 15.2)). No significant improvements were found on the Action Research Arm Test and Motor Activity Log.
Remotely monitored post-stroke training at home applying gaming exercises while physically supporting the wrist and hand showed to be feasible: participants were able and motivated to use the training system independently at home. Usability shows potential, although several usability issues need further attention. Upper extremity function and quality of life improved after training, although dexterity did not. These findings indicate that home-based arm and hand training with physical support from a dynamic orthosis is a feasible tool to enable self-administered practice at home. Such an approach enables practice without dependence on therapist availability, allowing an increase in training dose with respect to treatment in supervised settings.
This study has been registered at the Netherlands Trial Registry (NTR): NTR3669.
The experience of living with stroke and using technology: opportunities to engage and co-design with end users
Purpose: We drew on an interdisciplinary research design to examine stroke survivors’ experiences of living with stroke and with technology in order to provide technology developers with insight into values, thoughts and feelings of the potential users of a to-be-designed robotic technology for home-based rehabilitation of the hand and wrist. Method: Ten stroke survivors and their family carers were purposefully selected. On the first home visit, they were introduced to cultural probe. On the second visit, the content of the probe packs were used as prompt to conduct one-to-one interviews with them. The data generated was analysed using thematic analysis. A third home visit was conducted to evaluate the early prototype. Results: User requirements were categorised into their network of relationships, their attitude towards technology, their skills, their goals and motivations. The user requirements were used to envision the requirements of the system including providing feedback on performance, motivational aspects and usability of the system. Participants’ views on the system requirements were obtained during a participatory evaluation. Conclusion: This study showed that prior to the development of technology, it is important to engage with potential users to identify user requirements and subsequently envision system requirements based on users’ views.Implications for Rehabilitation
An understanding of how stroke survivors make sense of their experiences of living with stroke is needed to design home-based rehabilitation technologies.
Linking stroke survivors’ goals, motivations, behaviour, feelings and attitude to user requirements prior to technology development has a significant impact on improving the design.
I am just back from the HSI2013, the 6th International Conference on Human System Interaction, where our paper received the Best Paper Award in the area of “Technologies Enhancing well-being for older people”. This was a joint paper with the Accompany consortia (http://accompanyproject.eu). Well done to all co-authors.
The paper will be shortly listed on IEEE Xplore but here is the bibliographical entry:
Amirabdollahian, F. et al., “Accompany: Acceptable robotiCs COMPanions for AgeiNg Years – Multidimensional Aspects of Human-System Interactions”, 6th International IEEE Conference on Human System Interaction, Sopot, Poland, 06-08 June 2013.
Our paper, Amirabdollahian and Johnson, titled “Analysis of the results from use of haptic peg-in-hole task for assessment in neurorehabilitation” is now published in the Journal of Applied Bionics and Biomechanics. It can be found under volume 8, issue 1, pages 1-11, and with the DOI: 10.3233/ABB-2011-0017. Further information can be found here.