Abstract
BackgroundStroke is a leading cause of disability worldwide, with upper limb deficits affecting an estimated 30% to 60% of survivors. The effectiveness of upper limb rehabilitation relies on numerous factors, particularly patient compliance to home programs and exercises set by therapists. However, therapists lack objective information about their patients’ adherence to rehabilitation exercises as well as other uses of the affected arm and hand in everyday life outside the clinic. We developed a system that consists of wearable sensor technology to monitor a patient’s arm movement and a Web-based dashboard to visualize this information for therapists.ObjectiveThe aim of our study was to evaluate how therapists use upper limb movement information visualized on a dashboard to support the rehabilitation process.MethodsAn interactive dashboard prototype with simulated movement information was created and evaluated through a user-centered design process with therapists (N=8) at a rehabilitation clinic. Data were collected through observations of therapists interacting with an interactive dashboard prototype, think-aloud data, and interviews. Data were analyzed qualitatively through thematic analysis.ResultsTherapists use visualizations of upper limb information in the following ways: (1) to obtain objective data of patients’ activity levels, exercise, and neglect outside the clinic, (2) to engage patients in the rehabilitation process through education, motivation, and discussion of experiences with activities of daily living, and (3) to engage with other clinicians and researchers based on objective data. A major limitation is the lack of contextual data, which is needed by therapists to discern how movement data visualized on the dashboard relate to activities of daily living.ConclusionsUpper limb information captured through wearable devices provides novel insights for therapists and helps to engage patients and other clinicians in therapy. Consideration needs to be given to the collection and visualization of contextual information to provide meaningful insights into patient engagement in activities of daily living. These findings open the door for further work to develop a fully functioning system and to trial it with patients and clinicians during therapy.
Highlights
A major limitation is the lack of contextual data, which is needed by therapists to discern how movement data visualized on the dashboard relate to activities of daily living
Upper limb information captured through wearable devices provides novel insights for therapists and helps to engage patients and other clinicians in therapy
Consideration needs to be given to the collection and visualization of contextual information to provide meaningful insights into patient engagement in activities of daily living
Summary
Stroke is the leading cause of acquired adult disability in high-income countries [1], with upper limb deficits affecting an estimated 30% to 60% of survivors [2,3]. Stroke causes damage within the brain that, when affecting somatosensory circuitry, lead to difficulties sensing and controlling movement of the body’s contralateral side. Due to these limitations, stroke patients tend to reduce the utilization of the affected limb, which may cause muscle shortening and weakness, further compromising arm functionality [4]. Training is often task-specific and involves practicing tasks relevant to daily life Along with this training, therapists employ a variety of techniques to support rehabilitation, such as mirror therapy, muscle electrical stimulation, strength training, stretching and positioning, mental practice, robotics, and virtual reality applications [4,6-8]. Stroke is a leading cause of disability worldwide, with upper limb deficits affecting an estimated 30% to 60% of survivors. We developed a system that consists of wearable sensor technology to monitor a patient’s arm movement and a Web-based dashboard to visualize this information for therapists
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