Making Movement Sonification Usable in Clinical Gait Rehabilitation: A User-Centered Study

Sound-assisted movement rehabilitation is one of the most interesting and socially relevant applications of sonic interaction research, and existing research shows the potential of movement sonification to enhance patient motivation and movement re-learning. However, this technology is not routinely adopted in practice due to fragmented evidence of clinical effectiveness, feasibility, and usability. A key but little-explored challenge is that of designing and developing sonification systems that can readily be set up, configured, and applied by physiotherapists in a manner compatible with clinical practices and tailorable to individual patient needs and capacities, as well as training goals. In this work, we carried out an iterative user-centered design process to develop a sonification system for clinical gait rehabilitation of hemiparetic patients. This yielded a fully functional system that integrated wireless wearable inertial sensors with a laptop-based software interface for physiotherapists to configure and adjust the feedback on the fly. The feedback was ecologically based (naturalistic wading sounds) and highly individualizable through patient-specific adjustments. The system was evaluated in a real-life clinical feasibility study involving four physiotherapists and seven hemiparetic patients (4M,3F, mean age 56.14 ± 15.45). Overall, the physiotherapists found the system easy to set up and seamless to use during training, although they expressed a need for more system portability, a set of additional feedback configuration functions, and extra training / practice with using the more advanced feedback adjustment controls. While future work should address these findings and systematically explore clinical effectiveness in terms of motor learning outcomes, we believe that this work can serve to guide the design of clinically usable movement sonification systems targeting a breadth of rehabilitative applications.