Abstract
The design of digital technologies that support poststroke rehabilitation at home has been a topic of research for some time. If technology is to have a large-scale impact on rehabilitation practice, then we need to understand how to create technologies that are appropriate for the domestic environment and for the needs and motivations of those living there. This paper reflects on the research conducted in the Motivating Mobility project (UK Engineering and Physical Science Research Council: EP/F00382X/1). We conducted sensitizing studies to develop a foundational understanding of the homes of stroke survivors, participatory design sessions situated in the home, and experimental deployments of prototype rehabilitation technologies. We identified four challenges specific to the homes of stroke survivors and relevant to the deployment of rehabilitation technologies: identifying a location for rehabilitation technology, negotiating social relationships present in the home, avoiding additional stress in households at risk of existential stress, and providing for patient safety. We conclude that skilled workers may be needed to enable successful technology deployment, systematizing the mapping of the home may be beneficial, and education is a viable focus for rehabilitation technologies.
Highlights
The design of interactive technologies to support rehabilitation from disability acquired through stroke has been a topic of research since 1991, when Dijkers et al [1] presented a novel robotic system that could guide a stroke patient through a series of reaching exercises, under the hypothesis that repeated use could support the rehabilitation of movement in the affected limb
If deployment work is to be done as part of health care systems, and as domestic rehabilitation technologies are a relatively new phenomenon, we might speculate that existing health care professions are, as a whole, unlikely to have the skills or knowledge required to immediately engage in effective deployment work and to negotiate all the challenging human factors identified earlier
Our work suggests the importance of considering prior usage of the home; current and anticipated or hoped for future usage of the home; changes in emotional response due to stroke; any spaces purposefully created to support the well-being of a stroke survivor; social usage of a space that might have an impact on the technology integration process; and the availability of utilities necessary to support technologies, principally power sockets but potentially access to a network
Summary
The design of interactive technologies to support rehabilitation from disability acquired through stroke has been a topic of research since 1991, when Dijkers et al [1] presented a novel robotic system that could guide a stroke patient through a series of reaching exercises, under the hypothesis that repeated use could support the rehabilitation of movement in the affected limb. Research has subsequently expanded to cover a broad range of robotic installations intended to support the rehabilitation of motor abilities [2] and to approaches such as the use of virtual reality content to motivate physical engagement with robotic installations and to ground motor skills relearning in practical examples [3,4,5]. Many of these installations have been targeted at high-throughput clinical environments where individuals might spend a relatively short period. Rehabilitation would ideally continue until maximum recovery has been achieved [7], the increasing demand for services and financial constraints typically means that service needs often cannot be met, potentially creating a situation in which outcomes for stroke survivors are suboptimal
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