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Collaborative design approach for stroke upper limb rehabilitation using Virtual Reality and Brain Computer Interface
| Name: | Description: | Size: | Format: | |
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| 3.42 MB | Adobe PDF |
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Abstract(s)
Introdução: A disfunção do membro superior é uma causa comum de incapacidade após Acidente Vascular Cerebral (AVC), deixando 60% dos pacientes com uma mão não-funcional. Intervenções de Interface Cérebro-Computador (ICC) mostraram ser um acréscimo eficaz à reabilitação convencional e podem ser bastante benéficas para pacientes com défice motor severo. No entanto, as intervenções de ICC mostraram muita variabilidade e não existindo ainda princípios orientadores para estas intervenções. Objetivos: Desenvolver princípios orientadores para futuras intervenções de ICC que utilizem realidade virtual para a reabilitação de pacientes com défice motor severo, recolhendo o conhecimento tácito e raciocínio clínico de peritos de reabilitação e também a experiência pessoal de pacientes. Metodologia: Estudo qualitativo com múltiplas perspetivas que utilizou workshops para o desenho colaborativo, baseando-se na revisão da literatura. Foi utilizada análise temática indutiva. Resultados: Foram realizados quatro workshops online síncronos com dez peritos de reabilitação e oito pacientes de AVC. Os dois temas identificados foram “Seleção da tarefa” (incluindo os subtemas: Características da tarefa, Variabilidade da tarefa e Princípios para progressão da tarefa) e “Considerações relacionadas com o paciente” (com os subtemas: Avaliação inicial do utente, Considerações para a
configuração e Fatores de personalização). Dentro destes subtemas, vários tópicos foram abordados: simplicidade da tarefa, familiaridade da tarefa, inclusão de pacientes, forma e momento para a progressão, considerações para a representação visual, traços clínicos de cada paciente, entre outros. Conclusão: Algumas recomendações podem ser retiradas deste estudo. A personalização é crucial para a inclusão de pacientes e acomodar as suas características clínicas. A significância, variabilidade e progressão da tarefa são de
elevada importância para a atividade cerebral e adesão dos pacientes. Adicionalmente, são preferenciais as tarefas unilaterais e assimétricas. A intervenção deve permitir que os profissionais de saúde personalizem o plano de treino e cada sessão, tendo em consideração a opinião do paciente
Introduction: Upper limb impairment is a common disability after stroke, leading to a non-functional hand on 60% of patients. Brain Computer Interface (BCI) interventions have showed to be an effective complement to conventional rehabilitation and could be highly valuable in patients with severe motor impairments. However, there is high variability in the intervention and there is a lack of guiding principles for BCI interventions. Objectives: To develop recommendations for future BCI interventions using virtual reality with stroke patients with severe upper limb impairment, by gathering tacit knowledge and clinical reasoning from clinical experts and adding patients’ firsthand experience. Methods: A multi-perspective qualitative study was conducted using workshops to support collaborative design, based on a literature review. Inductive thematic analysis was used. Results: Four online synchronous workshop sessions were carried out with ten rehabilitation experts and eight stroke patients. Two main themes were identified: “Task selection” (with subthemes: Characteristics of tasks, Variability of tasks and Principles to task progression) and “User related considerations” (with the subthemes, Initial patient assessment, Set-up considerations and Features of personalization). Within these subthemes, numerous topics were approached: simplicity of tasks, familiarity of tasks, patient inclusivity, timing and approach for progression, considerations for visual representation, clinical traits of each patient, among others. Conclusion: Some recommendations can be drawn from this study. Personalization is crucial for patient inclusivity and accommodation of their clinical features. Task meaningfulness, variety and task progression are of great importance for brain activity and patient engagement. Additionally, unilateral, and asymmetric tasks should be preferred. The intervention should allow for the health professionals to personalize the training plan and each session, while including the patients’ input.
Introduction: Upper limb impairment is a common disability after stroke, leading to a non-functional hand on 60% of patients. Brain Computer Interface (BCI) interventions have showed to be an effective complement to conventional rehabilitation and could be highly valuable in patients with severe motor impairments. However, there is high variability in the intervention and there is a lack of guiding principles for BCI interventions. Objectives: To develop recommendations for future BCI interventions using virtual reality with stroke patients with severe upper limb impairment, by gathering tacit knowledge and clinical reasoning from clinical experts and adding patients’ firsthand experience. Methods: A multi-perspective qualitative study was conducted using workshops to support collaborative design, based on a literature review. Inductive thematic analysis was used. Results: Four online synchronous workshop sessions were carried out with ten rehabilitation experts and eight stroke patients. Two main themes were identified: “Task selection” (with subthemes: Characteristics of tasks, Variability of tasks and Principles to task progression) and “User related considerations” (with the subthemes, Initial patient assessment, Set-up considerations and Features of personalization). Within these subthemes, numerous topics were approached: simplicity of tasks, familiarity of tasks, patient inclusivity, timing and approach for progression, considerations for visual representation, clinical traits of each patient, among others. Conclusion: Some recommendations can be drawn from this study. Personalization is crucial for patient inclusivity and accommodation of their clinical features. Task meaningfulness, variety and task progression are of great importance for brain activity and patient engagement. Additionally, unilateral, and asymmetric tasks should be preferred. The intervention should allow for the health professionals to personalize the training plan and each session, while including the patients’ input.
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Keywords
Reabilitação AVC Imaginética Membro Superior Realidade Virtual Stroke Rehabilitation Motor Imagery Upper Extremity Virtual Reality Participatory design