Comparing direct and indirect interaction in stroke rehabilitation

Maryam Khademi,Lucy Dodakian,Cristina Videira Lopes,Hossein Mousavi Hondori,Alison Mckenzie,Steven C Cramer

doi:10.1145/2559206.2581192

Abstract

We explore the differences of direct (DI) vs. indirect (IDI) interaction in stroke rehabilitation. Direct interaction is when the patients move their arms in reaction to changes in the augmented physical environment; indirect interaction is when the patients move their arms in reaction to changes on a computer screen. We developed a rehabilitation game in both settings evaluated by a within-subject study with 10 patients with chronic stroke, aiming to answer 2 major questions: (i) do the game scores in either of the two interaction modes correlate with clinical assessment scores' and (ii) whether performance is different using direct versus indirect interaction in patients with stroke. Our experimental results confirm higher performance in use of DI over IDI. They also suggest better correlation of DI and clinical scores. Our study provides evidence for the benefits of direct interaction therapies vs. indirect computer-assisted therapies in stroke rehabilitation.

Highlights

Stroke is a leading cause of serious long-term disability in adults
Abstract1 We explore the differences of direct (DI) vs. indirect (IDI) interaction in stroke rehabilitation
We developed a rehabilitation game in both settings evaluated by a within-subject study with 10 patients with chronic stroke, aiming to answer 2 major questions: (i) do the game scores in either of the two interaction modes correlate with clinical assessment scores? and (ii) whether performance is different using direct versus indirect interaction in patients with stroke

Summary

Introduction

Stroke is a leading cause of serious long-term disability in adults. More than 795,000 people in the United States suffer from a stroke each year [1]; this costs the country an estimated $38.6 billion that includes the cost of healthcare services and missed days of work. Studies in Stroke Rehabilitation Prior HCI research in stroke rehabilitation ranges from behavior change through design and persuasive technology to developing systems for compensation control and upper extremity rehabilitation. Balaam et al [3] reported on their experiences with building systems that keep patients with stroke motivated to engage in upper limb rehabilitation exercise. Digital box and blocks [5] was built as an in-home assessment apparatus for individuals with stroke. This is an example of rehab games that leverage indirect interaction, i.e., patients need to manipulate the blocks in real-world while the effect of their action can be monitored indirectly in a screen. Comparing our work to the above research, we investigate which interaction technique is most appropriate within the practical domain of stroke rehabilitation

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