A participatory model for cocreating accessible rehabilitation technology for stroke survivors : user-centered design approach

Kerr, Andrew and Grealy, Madeleine and Slachetka, Milena and Wodu, Chioma Obinuchi and Sweeney, Gillian and Boyd, Fiona and Colville, David and Rowe, Philip (2024) A participatory model for cocreating accessible rehabilitation technology for stroke survivors : user-centered design approach. JMIR Rehabilitation and Assistive Technologies, 11. e57227. ISSN 2369-2529 (https://doi.org/10.2196/57227)

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Abstract

Background: Globally, one in three people live with health conditions that could be improved with rehabilitation. Ideally this is provided by trained professionals delivering evidence based levels of dose, intensity and content, for optimal recovery. The inability of healthcare providers to deliver this, creates an opportunity for technological innovation. Design processes that lack close consideration of users’ needs and healthcare budgets, however, mean that many rehabilitation technologies are neither useful, nor used. Objective: To develop a model for designing accessible rehabilitation technology using a co-creation approach that is informed by users who have completed, or are completing, an eight-week technology based rehabilitation programme. Methods: To address this problem our multi-disciplinary research group established a co-creation centre for rehabilitation technology that places the user at the centre of the innovation process. The core of this model is an eight-week holistic rehabilitation programme delivered exclusively through commercial and prototype technology so that users are able to provide truly informed feedback on technologies under development, as well as creating an observatory to better understand how patients interact with rehabilitation technologies. The process is supported by focus groups for product development and a translation group advising on broader issues of adoption. As the leading cause of global adult disability, the target population for the centre has been stroke, however the principles can be applied to any clinical population. Results: Our model has been active for more than two years with 80/86 individuals completing the programme. Five new devices have emerged from the process with further ideas logged for future development. In addition, it has led to accessibility modifications to existing technology, including modifications to hand grips and the structure of rehabilitation games. Critically it has also produced a set of co-created protocols for technology enriched rehabilitation that has allowed us to replicate the model on an acute stroke ward. Conclusions: Sub-optimal rehabilitation limits recovery from health conditions. Technology offers support to increase access to intensive and enriched rehabilitation, but needs to be designed to suit users and not just their impairment. Our co-creation model, built around participation in an intensive, technology-based programme, has produced new accessible technology and demonstrated the feasibility of our overall approach to providing the rehabilitation that people need, for as long as needed.

ORCID iDs

Kerr, Andrew ORCID logoORCID: https://orcid.org/0000-0002-7666-9283, Grealy, Madeleine ORCID logoORCID: https://orcid.org/0000-0002-2823-8841, Slachetka, Milena ORCID logoORCID: https://orcid.org/0000-0003-1453-0419, Wodu, Chioma Obinuchi ORCID logoORCID: https://orcid.org/0000-0002-4128-1051, Sweeney, Gillian, Boyd, Fiona, Colville, David and Rowe, Philip ORCID logoORCID: https://orcid.org/0000-0002-4877-8466;