Upper Extremity Rehabilitation Equipment for Stroke Patients in Taiwan: Usage Problems and Improvement Needs

Abstract

The purpose of this study was to survey occupational therapists for the usage problems and for their improvement needs for upper extremity rehabilitation equipment (UERE). A questionnaire was given to experienced occupational therapists from 113 hospitals that provide occupational therapy services with three or more professional full-time therapists. A total of 48 hospitals sent back questionnaires, and 184 valid questionnaires were received. Most of the UERE had two major problems: The base of the equipment was unstable, and the equipment was uninteresting to use. The therapists reported that three major needs for design improvement in the UERE were adjustability of functions, exchangeability of components and recording of movement data. Some therapists had suggestions for designing new types of UERE, such as manual dexterity training equipment, activities of daily living oriented equipment, sensory re-education equipment, arm supination and pronation training equipment, and wrist extension training equipment. These findings reveal the genuine user needs of upper extremity devices and provide useful applications to the development and re-design of these devices. However, obtaining opinions primarily from experienced occupational therapists may pose a methodological limitation of this study. In future research, it is advised to include patients' opinions and also investigate whether a clinician's years of experience would affect his or her viewpoint of usage problems and improvement needs of the UERE.

Design and control of system for elbow rehabilitation: Preliminary findings

“…-facilitating a variety of arm movements; -being usable in a seated position; -giving feedback to clients; -including virtual activities specific to daily living; -being useful at home; -having adjustable resistance, and -costing less than 6000 USD. 18,21 To sum up, based on the classification proposed by Maciejasz et al, 19 we proposed a novel exoskeleton for upper limb rehabilitation purposes in low-and middle-income countries, with the following features: -application field: supporting basic activities of daily living (ADL), neurological rehabilitation and orthopedic rehabilitation; -target group: patients with severe neurological deficits, including post-stroke patients, those with traumatic brain injury (TBI) or spinal cord injury (SCI), geriatric patients with neurodegenerative disorders, and people who need similar solutions for functional support during recovery only (e.g., for avoiding physical effort after cardiopulmonary diseases); -type of assistance: active device and elbow strength assistance; -mechanical design: exoskeleton-based arm with a single one-degree-of-freedom (SDOF) stepper motor and control system; -control strategy: a mix of kinematic and dynamic; and -clinical evaluation: experimental study, further research and a randomized controlled trial. The most common symptoms in elbow functional deficits are weakness, loss of joint control, excessive muscle contraction, spastic co-contraction, and pathological synergies.…”

Effectiveness of Augmented Reality in Stroke Rehabilitation: A Meta-Analysis

“…The rehabilitation systems should have repetitive, challenging, motivating, and intensive exercises to enhance the efficacy of neural plasticity for the patients. Traditional rehabilitation methods are often performed with external instruments such as treadmill ambulation using harness suspension and manual assistance by physical therapists, and arm skating onboard which supports the movement of the hand for upper limb rehabilitation [9,10]. Majority of the traditional systems presented to improve activities of daily living performance and increase patients' independence [11,12].…”

The industrial design of a robotic device for upper-limb stroke rehabilitation

“…Previous literature outlines how the primary manifestations of acceptability barriers to rehabilitative devices are usability issues, stigma, and a lack of user consideration (Huang, Lee, Hsieh, & Chen, 2013;Liu et al, 2015;Skogsrød, 2014).…”

“…"Device usability refers to the aspects of a product that make a consumer prefer, select, and use one product instead of another" (Lane, Usiak, Stone, & Scherer, 1997, p. 131), and is a significant influencer of perceived ease of use, one of the primary determinants of acceptability (Story, 2012;Venkatesh, 2000;Wu et al, 2014). High levels of usability facilitate conditions where users experience greater control, reduced anxiety, increased openness of environment, and a positive user-interaction (Huang et al, 2013;Venkatesh et al, 2003). Brooke (2006) defines usability as the appropriateness to a purpose.…”

“…Key usability issues experienced during rehabilitative device use include instability of both devices and user securing mechanisms; difficulty of installation of both the device and the user into the device; a lack of adjustability of both device ergonomics and difficulty, and an uninteresting user interaction (Huang et al, 2013).…”