September 14, 2016

Some High Tech Designers Don't Get It

There is lots of news about how technology can help disabled people recover the use of their affected hand.  Here is what drives me crazy.  Watch this video of a high tech rehab device and DO MORE than look at the flashy movement on the screen and the client's happy face. 
Look at what the woman's hand is doing.

1.  Media reports and even many research articles do not explain that using technology is only the beginning.  The goal is to have a person's hand manipulate objects - not just touch objects on the screen so the computer makes objects blow up or move.  To be fair, the technology helped a woman move her arm so she could bring her hand to the location the task required.  However, photos show that using an expensive robotic arm is not the only way to show clients they have hand function when shoulder and elbow muscles are weak.  Instead of grasping objects resting on a table, clients can rest objects in their lap or stand to reduce how far weak shoulder and elbow muscles have to move the arm, which is remarkably heavy.

2.  Cherry picking high level clients to demonstrate technology is misleading.  I am suspicious when I see stroke survivors begin by using a gross grasp to hold a cylinder-shaped Wii controller and end up grasping a small object between the tips of their thumb and index finger.  Where are the videos of stroke survivors who have trouble opening their hand after they make a fist?  A meta-analysis of 44 studies done on 1362 subjects found that robot-assisted therapy improved only arm movement (1). High functioning clients benefit from the fun aspects of computer games, but I think clients who have less recovery need technology the most.

3.  Proof-of-concept videos are misleading when they have able-bodied people demonstrate the product.  Able-bodied people move at a lightening speed that many stroke survivors never regain.  Speed requires effortless control of every joint.  I can tell my hand to open or close, but I cannot simultaneously tell all the joints in my arm what to do.

The Bottom Line:   Promotional material for technology is not always honest about the ton of work that many clients must do to close the gap between what the computer is doing to objects and what clients want their hand to do. 

1. Veerbeck J, Langbroek-Amersfoort A, Wegen E, Meskers C, Kwakkei G. Effects of robot-
    assisted therapy for the upper limb after stroke.  Neurorehabilitation and Neural Repair. Sept
    5, 2016, doi,10.1177/545068316666957.

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