User-Centered Design of Auditory Feedback for Hemiparetic Gait Rehabilitation

Auditory biofeedback has been increasingly explored as a tool to enhance motor learning during gait rehabilitation by augmenting patient self-awareness of their kinematics [3]. Hemiparetic patients (e.g. after stroke or traumatic brain injury) exhibit considerable intra-group variability in terms of impairment types and mobility level. Therefore, it is important for assistive technological systems to be patient-tailored and flexible in order to cater to the inherent diversity of individual therapy needs [2]. To achieve this, it has long been recommended that patients and professionals be systematically and meaningfully involved in the development process, which typically involves several iterations of design and testing with the ultimate goal of increasing usability and user acceptance [1]. However, this type of methodology is not the norm due to time/budget constraints and challenges in working with interdisciplinary groups [1,2]. We have, together with physiotherapists and hemiparetic patients, developed and tested a range of novel auditory feedback paradigms targeting hemiparetic gait using a novel technological system. We explored specific use-cases in which real-time feedback was provided on stance and swing phase kinematic characteristics such as limb and joint rotation, sometimes in combination with rhythmic cueing. The feedback stimuli have been designed to be goal-oriented, ecologically meaningful, and aesthetically acceptable to patients. Feasibility tests have been conducted with relevant patients. We showcase a hand-picked set of feedback types to demonstrate the devised use-cases and feedback design philosophy. We believe that this work is an important step in the realization of clinically usable auditory feedback systems for hemiparetic gait rehabilitation.


References

Dabbs, A. D. V., Myers, B. A., Mc Curry, K. R., Dunbar-Jacob, J., Hawkins, R. P., Begey, A., & Dew, M. A. (2009). User-centered design and interactive health technologies for patients. Computers, informatics, nursing: CIN, 27(3), 175.

Lesaffre, M. (2018). Investigating embodied music cognition for health and well-being. Springer handbook of systematic musicology, 779-791.

Linnhoff, D., Alizadeh, S., Schaffert, N., & Mattes, K. (2020). Use of acoustic feedback to change gait patterns: Implementation and transfer to motor learning theory—A scoping review. Journal of Motor Learning and Development, 8(3), 598-618.