Abstract Details

Title Human-centered Design of a Privacy-preserving Mixed-reality Exercise Program for Stroke

Topic Neuro-rehabilitation

Presentation(s) P5 - Poster Session 5 (11:45 AM-12:45 PM)

Poster/Presentation
Number 14-006

Objective Develop a proof-of-concept, privacy-preserving, mixed-reality exercise program for stroke rehabilitation using a multidisciplinary and stakeholder-driven approach.

Background Post-stroke rehabilitation is essential for functional recovery, but many patients have limited access to care. Telerehabilitation (TR) connects patients and providers remotely, and mixed-reality (MR) integrates virtual objects into real-world environments via headsets. TR and MR can make rehabilitation broadly accessible. This study’s interdisciplinary team designed a novel MR exercise program incorporating feedback from people with stroke-related lived experience.

Design/Methods The exercise program was designed and tested in 3 phases: 1) cross-domain knowledge sharing, 2) program development, and 3) workshop sessions. During Phase 1, clinicians (neurologists, therapists) and computer science researchers met weekly to exchange expertise regarding rehabilitation, cyber-physical systems, and a team-developed MR program (ScenicMR). Phase 2 comprised exercise protocol development and integration into ScenicMR (ScenicMR-Recovery and Rehabilitation, or ScenicRnR). Phase 3 comprised consented participants recruited into two study cohorts: 1) individuals with ongoing stroke-related impairments (“Patient”), and 2) individuals recovered from stroke or healthy volunteers related to individuals recovering from stroke (“Recovered/HV”). Both cohorts tested and evaluated ScenicRnR.

Results Phases 1 and 2 yielded MR-based exercises with physical and virtual objects, targeting domains including upper extremity activity and balance. Multi-layer privacy-preserving algorithms were developed to identify sensitive environmental information with options for user-directed privacy shielding. In Phase 3, “Patient” (n=4) characteristics ranges were age 49-66 years, 50% female, NIH Stroke Scale 4-5, modified Rankin Scale 2 (all), chronicity 15-247 months. “Recovered/HV” (n=4) characteristics ranges were age 50-70 years, 25% female. All participants expressed interest in TR with ScenicRnR and recommended gamifying exercises. Most (n=6 strongly agreed, 2 no response) anticipated comfort with caregiver-supported home use, though differing perspectives regarding role of caregiver involvement emerged.

Conclusions A human-centered design approach yielded a prototype MR stroke exercise program. Determining feasibility of remote deployment for TR is underway.

Authors/Disclosures
Gina Gwiazda (University of California, San Francisco) PRESENTER	Ms. Gwiazda has nothing to disclose.
Alison Scheid, PT	Dr. Scheid has nothing to disclose.
Myoung Kim, PhD	Ms. Kim has received personal compensation for serving as an employee of Annexon Biosciences.
Cheol Jun Cho, PhD	Mr. Cho has nothing to disclose.
Jeremy Fischer	Mr. Fischer has nothing to disclose.
Xiaodong Li, MD	Dr. Li has nothing to disclose.
Mahmoud Elfar, PhD	Dr. Elfar has nothing to disclose.
Erik Nelson	Erik Nelson has nothing to disclose.
Hyungjong Park, MD	Dr. Park has nothing to disclose.
Yuchen Zeng	Miss Zeng has nothing to disclose.
Kamesh Krishnamurthy, MD, PhD (UC San Francisco)	Dr. Krishnamurthy has nothing to disclose.
Jessica Mok, OT	Ms. Mok has nothing to disclose.
Yasser Shoukry, PhD	The institution of Prof. Shoukry has received research support from National Science Foundation.
Bjoern Hartmann, PhD	The institution of Prof. Hartmann has received research support from Apple. The institution of Prof. Hartmann has received research support from Google. The institution of Prof. Hartmann has received research support from National Science Foundation. The institution of Prof. Hartmann has received research support from Accenture. The institution of Prof. Hartmann has received research support from UC Noyce Initiative. The institution of Prof. Hartmann has received research support from DARPA.
Sanjit Seshia (UC Berkeley)	The institution of Sanjit Seshia has received research support from National Science Foundation. The institution of Sanjit Seshia has received research support from DARPA. The institution of Sanjit Seshia has received research support from UC Noyce Initiative. The institution of Sanjit Seshia has received research support from Intel Corporation. The institution of Sanjit Seshia has received research support from Toyota Motor Corporation. The institution of Sanjit Seshia has received research support from Nissan. The institution of Sanjit Seshia has received research support from Google.
Cathra Halabi, MD (UCSF Department of Neurology)	The institution of Dr. Halabi has received research support from UC Noyce Initiative. The institution of Dr. Halabi has received research support from Weill Institute for Neurosciences Neurohub. The institution of Dr. Halabi has received research support from NIH/NIDCD. The institution of Dr. Halabi has received research support from NIH/StrokeNet. Dr. Halabi has a non-compensated relationship as a Working Group Member with National Academies of Sciences, Engineering, and Medicine Action Collaborative on TBI Care that is relevant to AAN interests or activities. Dr. Halabi has a non-compensated relationship as a Working Group Member with NIH/StrokeNet Recovery and Rehabilitation Working Group that is relevant to AAN interests or activities.

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