Abstract

BackgroundRehabilitation technology for upper limb training can potentially increase the amount, duration, and quality of therapy offered to patients by targeting the needs of individual patients. Empirical evaluations of such technologies focus on clinical effectiveness; however, little is known regarding the implications of their implementation in daily practice. Tailoring training content to patients requires active participation by therapists, and requires an extension of their role to include authoring and modifying exercises. It is not yet known whether this is feasible, and the socio-technical requirements that will make it successful in practice have not yet been explored. The current study investigates the extent to which therapists can take the role of authoring patient-specific training content and whether effort savings can be achieved by sharing the created content.MethodWe present TagTrainer: an interactive tabletop system for rehabilitation that can be operated by manipulating every day physical objects in order to carry out exercises that simulate daily living tasks. TagTrainer supports therapists in creating their own exercises that fit individual patient needs, in adjusting existing exercises, and in putting together personalized exercise programs for and with patients. Four therapists in stroke- and paraplegia-rehabilitation have used TagTrainer for three weeks. Semi-structured interviews were conducted with the therapists, questionnaires were administered to them, and observation notes and usage logs were collected.ResultsA total of 20 exercises were created from scratch, while another three exercises were created as variations of the existing ones. Importantly, all these exercises were created to address specific needs that patients expressed. The patients found the exercises motivating and these exercises were integrated into their regular training.ConclusionsTagTrainer can support arm-hand rehabilitation training by increasing therapy variability and tailoring. Therapists consider TagTrainer most suited for group sessions where they supervise many patients at once. Therapists are motivated and are able to, with minimal training, create and tailor exercises for patients fitting individual needs and capabilities. Future research will examine the socio-technical conditions that will encourage therapists to contribute and share training content, and provide the peer support needed for the adoption of a new technology.Electronic supplementary materialThe online version of this article (doi:10.1186/1743-0003-11-140) contains supplementary material, which is available to authorized users.

Highlights

  • Rehabilitation technology for upper limb training can potentially increase the amount, duration, and quality of therapy offered to patients by targeting the needs of individual patients

  • Future research will examine the socio-technical conditions that will encourage therapists to contribute and share training content, and provide the peer support needed for the adoption of a new technology

  • This study aims to identify whether and how therapists can successfully take the role of authoring training content, tailoring exercises to individual patients, and whether effort savings can be achieved by sharing the training content they create

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Summary

Introduction

Rehabilitation technology for upper limb training can potentially increase the amount, duration, and quality of therapy offered to patients by targeting the needs of individual patients. A literature survey of research on rehabilitation technology for arm-hand training [8] shows that the majority of this work has focused on impairment-based training and is not fully aligned with state-of-the-art trends in neurorehabilitation, which requires offering patient-tailored [9,10] and task-oriented training [5,11], [12] Another important requirement is variation in training, which has been shown to contribute towards enhanced motor learning by increasing engagement and attention during learning [13], by allowing for random practice [11], and by offering a broader range of movement experiences, used in performing new skills [14]. Lack of exercise variability leads to a cessation of progress in patients because training offers no new challenges to them [15,16]

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