Device Design Principles in Pediatric Rehabilitation: Insights From The Dual Role of A Parent and A Rehabilitation Engineer

Abstract

<h3>Research Objectives</h3> My purpose is to discuss the technological challenges of pediatric rehabilitation from the role of both a parent and a rehabilitation engineer. <h3>Design</h3> In May 2020, my three-year-old daughter suffered a severe traumatic brain injury (TBI) from a falling tree branch. <h3>Setting</h3> We spent two weeks in the pediatric intensive care unit, followed by six weeks in physiatry, ten weeks in inpatient and since then have been discharged home. <h3>Participants</h3> I focus on the experience of my daughter from the perspective of both parent and a rehabilitation engineer. <h3>Interventions</h3> Examples of home interventions are commercial devices such as a home partial body-weight support system and eye gaze technology. We also explored custom-made devices such as a button interface for a simple video game, and a EMG biofeedback system. Each of these approaches were attempted for at least two weeks, some of them for months. <h3>Main Outcome Measures</h3> My focus is on usability, determined as the frequency of use after initial learning of the device. <h3>Results</h3> The commercial partial body weight support system has been used most often (at least once per week). This was due to its relatively quick setup time, versatility, its helpful assistance to the therapist, and its ability to be used with other technologies. Eye gaze was helpful but limited in its versatility and ability to accommodate head and eye motor impairments although still used at least once per week. The custom-made button interface was used about once every 2-3 weeks due to the need to use a computer and the longer setup time involved in that. The custom-made EMG biofeedback system was terminated due to insufficient cognitive function and poor muscle signals. <h3>Conclusions</h3> Design of rehabilitation technologies, especially in children, must account for setup time, robustness, ease of use, versatility, motivational capacity, minimizing complexity, complementing the therapist, and generating active participation among other important factors. Rehabilitation engineers are encouraged to spend time not only in the clinic but at home with the patients themselves to understand the lived experience. <h3>Author(s) Disclosures</h3> None.