Motivation, Usability, and Credibility of an Intelligent Activity-Based Client-Centred Training System to Improve Functional Performance in Neurological Rehabilitation: An Exploratory Cohort Study

Abstract

(1) Background: technology-based training systems are increasingly integrated in neurorehabilitation but are rarely combined with a client-centred task-oriented approach. To provide a low-cost client-centred task-oriented system, the intelligent activity-based client-centred task-oriented training (i-ACT) was developed. The objective was to evaluate the usability, credibility and treatment expectancy of i-ACT, and the motivation towards i-ACT use in rehabilitation over time. Additionally, this study will evaluate the upper limb treatment effects after training with i-ACT. (2) Methods: a mixed-method study was performed in four rehabilitation centres. Training with i-ACT was provided during six weeks, three times per week, forty-five minutes per day, additional to conventional care. (3) Results: seventeen persons with central nervous system diseases were included. High scores were seen in the system usability scale (score ≥ 73.8/100), credibility (score ≥ 22.0/27.0)/expectancy (score ≥ 15.8/27.0) questionnaire, and intrinsic motivation inventory (score ≥ 5.2/7.0), except the subscale pressure (score ≤ 2.0/7.0). Results from the interviews corroborate these findings and showed that clients and therapists believe in the i-ACT system as an additional training support system. Upper limb functional ability improved significantly (p < 0.05) over time on the Wolf motor function test. (4) Conclusion: i-ACT is a client-centred task-oriented usable and motivational system which has the potential to enhance upper limb functional training in persons with neurological diseases.

Efficacy of a technology-based client-centred training system in neurological rehabilitation: a randomised controlled trial

“…In this study, we found a very high adherence towards i-ACT training despite voluntary participation, i.e. 97.92%, which confirms the results from our cohort study [ 24 ]. This percentage might have been even higher because the reasons to miss an i-ACT therapy session were doctor appointments, hospital visits and family-related activities (i.e.…”

“…amount of practice), amount of repetitions (amount of practice), number of targets reached (from which a therapist can derive the level of difficulty), and the percentage of compensational movements (from which a therapist can derive the level of difficulty). i-ACT also has the potential to increase therapy dosage without major financial burden and negative side events as no adverse events or increase of fatigue were reported towards the additional use of i-ACT, no interference of additional i-ACT training to conventional care is found, and i-ACT is considered a low-cost system [ 24 ]. Also, during the COVID-19 pandemic, a secured online platform is developed so all results can be consulted by therapists from a distance which creates opportunities for the independent use of i-ACT in rehabilitation or even implementation in the person’s home environment.…”

“…Although these systems are not developed to meet rehabilitation goals, we explored the skeleton tracking feature of Microsoft Kinect in earlier research and developed an intelligent activity-based client-centred training (i-ACT) system using Microsoft Kinect sensor and software development kit [ 22 ]. i-ACT allows persons with CNS deficits to train more explicit on individual goals and the usability of i-ACT and persons’ motivation, credibility and expectancy towards using i-ACT for rehabilitation purposes, was established [ 23 ]. Results of that cohort study showed an increase over time regarding upper limb functional ability and perceived performance, but no comparison was made with a control group [ 24 ].…”

“…i-ACT allows persons with CNS deficits to train more explicit on individual goals and the usability of i-ACT and persons’ motivation, credibility and expectancy towards using i-ACT for rehabilitation purposes, was established [ 23 ]. Results of that cohort study showed an increase over time regarding upper limb functional ability and perceived performance, but no comparison was made with a control group [ 24 ]. The purpose of this trial was to investigate the effect of additional i-ACT training on functional ability, occupational performance, quality of life (QoL), fatigue, trunk movement, and shoulder active range of motion (AROM) compared to conventional therapy alone.…”

Immersion Therapy with Head-Mounted Display for Rehabilitation of the Upper Limb after Stroke—Review

“…This shows that neurological rehabilitation needs to be varied. Therapy with modern technologies increases the motivation of patients [26][27][28][29]. Several elements can help to increase motivation: game mechanics (including scoring), results feedback (including leveling up), and game fun [18].…”