Tetteroo Daniel, Timmermans Annick A A, Seelen Henk A M, Markopoulos Panos
Department of Industrial Design, Eindhoven University of Technology, Den Dolech 2, 5612 AZ, Eindhoven, the Netherlands.
J Neuroeng Rehabil. 2014 Sep 24;11:140. doi: 10.1186/1743-0003-11-140.
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. 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.
We 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.
A 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.
TagTrainer 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.
上肢训练康复技术通过针对个体患者的需求，有可能增加提供给患者的治疗量、持续时间和质量。对此类技术的实证评估侧重于临床效果；然而，对于它们在日常实践中的应用所产生的影响却知之甚少。根据患者情况定制训练内容需要治疗师的积极参与，并且需要扩展他们的角色，包括编写和修改练习。目前尚不清楚这是否可行，也尚未探索使其在实践中取得成功的社会技术要求。本研究调查了治疗师在多大程度上能够承担编写针对患者的特定训练内容的角色，以及通过共享创建的内容是否能够实现工作量的节省。
我们展示了TagTrainer：一种用于康复的交互式桌面系统，可通过操作日常实物来进行操作，以开展模拟日常生活任务的练习。TagTrainer支持治疗师创建适合个体患者需求的自定义练习、调整现有练习，并为患者制定和共同制定个性化的练习计划。四位从事中风和截瘫康复治疗的治疗师使用TagTrainer为期三周。对治疗师进行了半结构化访谈，向他们发放了问卷，并收集了观察记录和使用日志。
总共从头创建了20个练习，另外还有3个练习是作为现有练习的变体创建的。重要的是，所有这些练习都是为满足患者表达的特定需求而创建的。患者认为这些练习具有激励作用，并将这些练习纳入了他们的常规训练中。
TagTrainer可以通过增加治疗的多样性和针对性来支持手臂手部康复训练。治疗师认为TagTrainer最适合用于同时监督多名患者的小组训练。治疗师积极性很高，并且只需经过最少的培训，就能为符合个体需求和能力的患者创建和定制练习。未来的研究将考察能够鼓励治疗师贡献和共享训练内容的社会技术条件，并提供采用新技术所需的同伴支持。
