A Game Controller for Stroke Rehabilitation
Successful stroke rehabilitation relies on early, long-term, repetitive and intensive treatment. Repetitions conducted during clinical rehabilitation are significantly lower than that suggested by physiotherapeutic literature to relearn lost motor capabilities. This leaves patients to achieve this quantity in their home environment. Exercises can be monotonous and repetitive, making it difficult to maintain patient motivation. Exergames have been promoted for use in the home to make rehabilitation entertaining, increasing patients engagement with their therapy. Marketed exergaming systems for lower limb rehabilitation are hard to find, and none as of yet, facilitate Strength for Task Training (STT), a novel physiotherapeutic method for lower limb stroke rehabilitation. Strength for Task Training involves performing brief but intensive strength training (priming) prior to task-specic training to promote neural plasticity and maximise the gains in locomotor ability. This research investigates how the design of a game controller for lower limb stroke rehabilitation can facilitate unsupervised STT to compliment clinical contact time. The game controller was developed as part of a complete exergaming system designed to specifically facilitate STT. This involved working closely with co-researcher Scott Brebner who designed the exergame media. A user centered design approach was followed to include clinicians and stroke patients in the design process. This ensured the design aligned with the functional requirements of STT and the contextual needs of the patient. Workshops with stroke clinicians and neurophysiologists pointed to the specific areas of STT that a designed system could address. An iterative design process was used to develop, compare and improve concepts through testing with participants and clinicians. User testing involved participants using the game controller to interact with the digital game. The final output was a prototype pair of smart shoes with an attachable weighted sole. The design used removable sensors to translate lower limb movement into ingame interactions. The design of the shoes and weighted sole provided a simple and safe way to engage in unsupervised STT. Research findings suggest that while not all of the STT therapy can be incorporated in an unsupervised and home-based exergame system, there are some essential elements that can. Adaptable hardware was found to be integral to facilitating intensive priming. Barriers to use can be reduced through considering the diverse physiological and cognitive abilities of stroke patients and aesthetic consideration can help create a meaningful game controller that promotes its use in the home.