Adelante Centre of Expertise in Rehabilitation and Audiology, Zandbergsweg 111, 6432 CC, Hoensbroek, The Netherlands.
J Neuroeng Rehabil. 2012 Aug 2;9:52. doi: 10.1186/1743-0003-9-52.
Rehabilitation technology for upper limb training of stroke patients may play an important role as therapy tool in future, in order to meet the increasing therapy demand. Currently, implementation of this technology in the clinic remains low. This study aimed at identifying criteria and conditions that people, involved in development of such technology, should take into account to achieve a (more) successful implementation of the technology in the clinic.
A literature search was performed in PubMed and IEEE databases, and semi-structured interviews with therapists in stroke rehabilitation were held, to identify criteria and conditions technology should meet to facilitate (implementation of) technology-assisted arm-hand skills training in rehabilitation therapy of stroke patients. In addition, an implementation strategy frequently applied in general health care was used to compose a stepwise guidance to facilitate successful implementation of this technology in therapy of stroke patients. Implementation-related criteria mentioned by therapists during the interviews were integrated in this guidance.
Results indicate that, related to therapy content, technology should facilitate repetition of task-related movements, tailored to the patient and patient's goals, in a meaningful context. Variability and increasing levels of difficulty in exercises should be on offer. Regarding hardware and software design of technology, the system should facilitate quick familiarisation and be easily adjustable to individual patients during therapy by therapists (and assistants). The system should facilitate adaptation to individual patients' needs and their progression over time, should be adjustable as to various task-related variables, should be able to provide instructions and feedback, and should be able to document patient's progression. The implementation process of technology in the clinic is provided as a stepwise guidance that consists of five phases therapists have to go through. The guidance includes criteria and conditions that motivate therapists, and make it possible for them, to actually use technology in their daily clinical practice.
The reported requirements are important as guidance for people involved in the development of rehabilitation technology for arm-hand therapy of stroke patients. The stepwise guide provides a tool for facilitating successful implementation of technology in clinical practice, thus meeting future therapy demand.
康复技术可作为治疗工具，为上肢训练中风患者，以满足日益增长的治疗需求，可能发挥重要作用。目前，该技术在临床上的应用仍然较低。本研究旨在确定标准和条件，开发这样的技术，人们应考虑实现（更多）成功地将该技术应用于临床治疗。
在 PubMed 和 IEEE 数据库中进行文献检索，并与中风康复治疗师进行半结构化访谈，以确定标准和条件，技术应满足（实施）辅助手臂技能训练的技术，以促进中风患者的康复治疗。此外，还采用了一种在一般医疗保健中经常应用的实施策略，为该技术在中风患者治疗中的成功实施制定了一个循序渐进的指导方针。访谈中治疗师提到的与实施相关的标准被纳入该指南。
结果表明，与治疗内容相关，技术应促进与任务相关的运动的重复，针对患者和患者的目标，并在有意义的背景下进行。应提供运动的可变性和逐渐增加的难度。关于技术的硬件和软件设计，系统应便于治疗师（和助手）在治疗过程中快速熟悉并能轻松调整到个体患者。系统应便于适应个体患者的需求及其随时间的进展，应能根据各种与任务相关的变量进行调整，应能够提供指导和反馈，并应能够记录患者的进展。该技术在临床中的实施过程提供了一个循序渐进的指导，该指导包括激励治疗师的标准和条件，并使他们能够在日常临床实践中实际使用技术。
报告的要求是指导中风患者上肢治疗康复技术开发人员的重要依据。逐步指南提供了一个工具，以促进技术在临床实践中的成功实施，从而满足未来的治疗需求。
