Posts Tagged User centered design
[ARTICLE] User-centered design of a patient’s work station for haptic robot-based telerehabilitation after stroke – Full Text
Robotic therapy devices have been an important part of clinical neurological rehabilitation for several years. Until now such devices are only available for patients receiving therapy inside rehabilitation hospitals. Since patients should continue rehabilitation training after hospital discharge at home, intelligent robotic rehab devices could help to achieve this goal. This paper presents therapeutic requirements and early phases of the user-centered design process of the patient’s work station as part of a novel robot-based system for motor telerehabilitation.
Stroke is one of the dominant causes of acquired disability  and it is the second leading cause of death worldwide . The high incidence of the disease and the current demographic developments are likely to increase the number of stroke patients in the future. Most of the survivors have physical, cognitive and functional limitations and require intensive rehabilitation in order to resume independent everyday life . Therefore, the main goal of motor rehabilitation is relearning of voluntary movement capability, a process which takes at least several months, some improvement can occur even after years. In the rehabilitation clinic, patients usually receive a daily intensive therapy program. However, for further improvement of motor abilities, severely affected patients are required to continue their rehabilitation training outside the rehabilitation settings, after being discharged from the rehabilitation clinic. Langhammer and Stanghelle  found that a lack of follow-up rehabilitation treatment at home leads to deterioration of activities of daily living (ADL) and to motor functions in general. A possible solution is an individualized and motivating telerehabilitation system in the patient’s domestic environment. Some studies ,  have confirmed the advantage of home rehabilitation after stroke and showed that telerehabilitation received high acceptance and satisfaction, both from patients, as well as from health professionals . Most of the existing telesystems ,  are based on audio-visual conferencing or on virtual environments and contain rather simple software for monitoring patients’ condition. However, in neurological rehabilitation the sensorimotor loop needs to be activated by provision of physiological haptic feedback (touch and proprioception) .
Robot-based rehabilitation is currently one of the most prevalent therapeutic approaches. It is often applied in hospitals alongside conventional therapy and is beneficial for motor recovery . Rehabilitation training including a haptic-therapy device may therefore be even more promising for home environments than non-haptic telerehabilitation. Several telerehabilitation systems, which include not only audio and visual, but also haptic modality, already exist ,  . Most of these solutions use low-cost commercial haptic devices (e.g. joysticks) for therapy training, with the goal of cost minimization and providing procurable technology. Nonetheless, devices specifically developed for stroke rehabilitation, which are already established in clinical settings, may have greater impact on motor relearning and could therefore also be more effective at home, compared with existing home rehabilitation devices.
In a previous paper , we presented a concept and design overview of a haptic robot-based telerehabilitation system for upper extremities which is currently under development. In the present work, we describe therapeutic requirements, user-centred development  and implementation of the patient’s station of the telesystem.
[Abstract] Interfacing brain with computer to improve communication and rehabilitation after brain damage.
Communication and control of the external environment can be provided via brain–computer interfaces (BCIs) to replace a lost function in persons with severe diseases and little or no chance of recovery of motor abilities (ie, amyotrophic lateral sclerosis, brainstem stroke).
BCIs allow to intentionally modulate brain activity, to train specific brain functions, and to control prosthetic devices, and thus, this technology can also improve the outcome of rehabilitation programs in persons who have suffered from a central nervous system injury (ie, stroke leading to motor or cognitive impairment).
Overall, the BCI researcher is challenged to interact with people with severe disabilities and professionals in the field of neurorehabilitation. This implies a deep understanding of the disabled condition on the one hand, and it requires extensive knowledge on the physiology and function of the human brain on the other.
For these reasons, a multidisciplinary approach and the continuous involvement of BCI users in the design, development, and testing of new systems are desirable. In this chapter, we will focus on noninvasive EEG-based systems and their clinical applications, highlighting crucial issues to foster BCI translation outside laboratories to eventually become a technology usable in real-life realm.
[ARTICLE] Usability test of a hand exoskeleton for activities of daily living: an example of user-centered design
Purpose: (1) To assess a robotic device (Handexos) during the design process with regard to usability, end user satisfaction and safety, (2) to determine whether Handexos can improve the activities of daily living (ADLs) of spinal cord injury (SCI) patients and stroke patients with upper-limb dysfunction.
Methods: During a 2-year development stage of the device, a total of 37 participants (aged 22–68), 28 clinicians (experts) and nine patients with SCI or stroke (end users) were included in a user-centered design process featuring usability tests. They performed five grasps wearing the device. The assessments were obtained at the end of the session by filling out a questionnaire and making suggestions.
Results: The experts’ opinion was that the modified device was an improvement over the preliminary version, although this was not reflected in the scores. Whereas end user scores for comfort, grasp, performance and safety were above the sufficiency threshold, the scores for year 2 were lower than those for year 1.
Conclusions: The findings demonstrate that although Handexos meets the initial functional requirements and underlines the potential for assisting SCI and post-stroke subjects in ADLs, several aspects such as mechanical complexity and low adaptability to different hand sizes need to be further addressed.
Implications for Rehabilitation
Wearable robotics devices could improve the activities of daily living in patients with spinal cord injury or stroke.They could be a tool for rehabilitation of the upper limb.Further usability tests to improve this type of tools are recommended
Source: Taylor & Francis Online