User-centered practicability analysis of two identification strategies in electrode arrays for FES induced hand motion in early stroke rehabilitation.

BACKGROUND: Surface electrode arrays have become popular in the application of functional electrical stimulation (FES) on the forearm. Arrays consist of multiple, small elements, which can be activated separately or in groups, forming virtual electrodes (VEs). As technology progress yields rising numbers of possible elements, an effective search strategy for suitable VEs in electrode arrays is of increasing importance. Current methods can be time-consuming, lack user integration, and miss an evaluation regarding clinical acceptance and practicability. METHODS: Two array identification procedures with different levels of user integration-a semi-automatic and a fully automatic approach-are evaluated. The semi-automatic method allows health professionals to continuously modify VEs via a touchscreen while the stimulation intensities are automatically controlled to maintain sufficient wrist extension. The automatic approach evaluates stimulation responses of various VEs for different intensities using a cost function and joint-angles recordings. Both procedures are compared in a clinical setup with five sub-acute stroke patients with moderate hand disabilities. The task was to find suitable VEs in two arrays with 59 elements in total to generate hand opening and closing for a grasp-and-release task. Practicability and acceptance by patients and health professionals were investigated using questionnaires and interviews. RESULTS: Both identification methods yield suitable VEs for hand opening and closing in patients who could tolerate the stimulation. However, the resulting VEs differed for both approaches. The average time for a complete search was 25% faster for the semi-automatic approach (semi-automatic: 7.3min, automatic: 10.5min). User acceptance was high for both methods, while no clear preference could be identified. CONCLUSIONS: The semi-automatic approach should be preferred as the search strategy in arrays on the forearm. The observed faster search duration will further reduce when applying the system repeatedly on a patient as only small position adjustments for VEs are required. However, the setup time will significantly increase for generation of various grasp types and adaptation to different arm postures. We recommend different levels of user integration in FES systems such that the search strategy can be chosen based on the users' preferences and application scenario.

Technology for home dementia care: A prototype locating system put to the test.

INTRODUCTION: The user experience of persons with dementia and their primary caregivers with locating systems is not firmly established. METHODS: Eighteen dyads used a prototype locating system during 4 weeks. Primary outcome measures were ratings of usability, and product functions and features. Secondary outcome measures were caregiver burden, perceived self-efficacy, frequency of use, and willingness to purchase the prototype. Changes in scores between baseline (T1) and end of testing period (T2) were compared by performing independent and dependent samples correlations and descriptive statistics. RESULTS: Seventeen dyads made up the final sample. Ratings of usability and product functions and features were fair, but usability ratings were significantly reduced after 4 weeks. Although the prototype was used infrequently by majority of the participants, most caregivers would be willing to purchase the prototype, with men more willing than women. No significant change in technological willingness, caregiver burden, or perceived self-efficacy was found between T1 and T2. Perceived self-efficacy significantly negatively correlated with willingness to purchase the prototype after 4 weeks. DISCUSSION: Results highlight the importance of including end users in the research and development phase of locating systems to improve the user experience in home dementia care. Necessary indications for further research are carrying out randomized controlled trials with larger, more representative samples and developing innovative software and hardware solutions.

Let's do this together: Bi-Manu-Interact, a novel device for studying human haptic interactive behavior.

Our area of interest is robotic-based rehabilitation after stroke, and our goal is to help patients achieve optimal motor learning during high-intensity repetitive movement training through the assistance of robots. It is important, that the robotic assistance is adapted to the patients' abilities, thereby ensuring that the device is only supporting the patient as necessary ("assist-as-needed"). We hypothesize that natural and learning-effective human-machine interaction can be achieved by programming the robot's control, so that it emulates how a physiotherapist adaptively supports the patients' limb movement during stroke rehabilitation. This paper introduces the design of a novel interactive device Bi-Manu-Interact. This device is suited to be used as an experimental setup for the investigation of haptic human-human interaction and for collecting data to model therapists' haptic behavior. In this paper, we present mechanical and sensory specifications as well as tasks visualizations for future investigations. Results of a pilot clinical evaluation of the Bi-Manu-Interact with nine stroke patients are also presented in this work.

A user-centered design approach in the development of rehabilitation devices after stroke.

Involving users in iterative development processes is to be shown to increase the quality of health care devices and to prevent refusal. Successful use can only be achieved provided that the devices are accepted by its users. In this study potentials of user satisfaction surveys in the development of stroke rehabilitation devices are presented. The two arm-training devices Reha-Slide (RS) and Bi-Manu-Track (BMT) are assessed for patient satisfaction. The aim is to detect the satisfaction with the current state of certain aspects of the devices to obtain incentives for technical optimisation. Correlation analyses from the data of 18 patients show significant positive correlations between satisfaction with the introduction and the personal well-being during training with both devices, whereas no significant correlations are found between satisfaction with the introduction and the perceived safety. In the RS sample, a higher satisfaction with the training also correlates with a higher feeling of improvement. The results are used to derive improvement suggestions tailored to the systems and its users. The surveys are conducted as a method for improving the ongoing design process of innovative technical devices developed in the BMBF (Federal Ministry of Education and Research) funded project "BeMobil".

Investigating CSI: portrayals of DNA testing on a forensic crime show and their potential effects.

The popularity of forensic crime shows such as CSI has fueled debate about their potential social impact. This study considers CSI's potential effects on public understandings regarding DNA testing in the context of judicial processes, the policy debates surrounding crime laboratory procedures, and the forensic science profession, as well as an effect not discussed in previous accounts: namely, the show's potential impact on public understandings of DNA and genetics more generally. To develop a theoretical foundation for research on the "CSI effect," it draws on cultivation theory, social cognitive theory, and audience reception studies. It then uses content analysis and textual analysis to illuminate how the show depicts DNA testing. The results demonstrate that CSI tends to depict DNA testing as routine, swift, useful, and reliable and that it echoes broader discourses about genetics. At times, however, the show suggests more complex ways of thinking about DNA testing and genetics.