Designing for Usability: Development and Evaluation of a Portable Minimally-Actuated Haptic Hand and Forearm Trainer for Unsupervised Stroke Rehabilitation

What fucking useless research, healthy participants! I'd fire the mentors and senior researchers that approved this! My God, the stroke medical world is hopelessly stupid!

Designing for Usability: Development and Evaluation of a Portable Minimally-Actuated Haptic Hand and Forearm Trainer for Unsupervised Stroke Rehabilitation

Raphael Rätz^{1, 2} Alexandre Ratschat^2* Nerea Cividanes-Garcia² Gerard Ribbers^{3, 4} Laura Marchal-Crespo^{2, 3, 5}

• ¹Motor Learning and Neurorehabilitation Laboratory, ARTORG Center for Biomedical Engineering Research, University of Bern, Switzerland
• ²Department of Cognitive Robotics, Delft University of Technology, Netherlands
• ³Department of Rehabilitation Medicine, Erasmus Medical Center, Netherlands
• ⁴Rijndam Rehabilitation Center, Netherlands
• ⁵Motor Learning and Neurorehabilitation Laboratory, ARTORG Center for Biomedical Engineering Research, University of Bern, Switzerland

The final, formatted version of the article will be published soon.

In stroke rehabilitation, simple robotic devices hold the potential to increase the training dosage in group therapies and to enable continued therapy at home after hospital discharge. However, we identified a lack of portable and cost-effective devices that not only focus on improving motor functions but also address sensory deficits. Thus, we designed a minimally-actuated hand training device that incorporates active grasping movements and passive pronosupination, complemented by a rehabilitative game with meaningful haptic feedback. Following a human-centred design approach, we conducted a usability study with 13 healthy participants, including three therapists.In a simulated unsupervised environment, the naive participants had to set up and use the device based on written instructions. Our mixed-methods approach included quantitative data from performance metrics, standardized questionnaires, and eye tracking, alongside qualitative feedback from semi-structured interviews. The study results highlighted the device's overall ease of setup and use, as well as its realistic haptic feedback. The eye-tracking analysis further suggested that participants felt safe during usage. Moreover, the study provided crucial insights for future improvements such as a more intuitive and comfortable wrist fixation, more natural pronosupination movements, and easier-to-follow instructions. Our research underscores the importance of continuous testing in the development process and offers significant contributions to the design of user-friendly, unsupervised neurorehabilitation technologies to improve sensorimotor stroke rehabilitation.