Post-stroke reahabilitation through functional electrostimulation: patient experience as the focus of design process

In Italy a stroke event represents the third cause of death and the first cause of a severe physical disability that leads to a series of impairments. Those who have had a stroke can obtain various benefits through rehabilitation, namely the treatment that is undertaken in the hospital and that continues until measurable improvements occur. Rehabilitation aims to restore the maximum possible independence to the patient, and at favouring the improvement of physical functions and more. Thus, discharged patients start a phase of home rehabilitation that very often is not adequate for the type of deficit they have developed. It is therefore necessary to think of a project thanks to which the patient continues with constancy and perseverance the motor rehabilitation in such a way as to acquire mastery in the functions lost due to the stroke. This paper presents the final work of a Product Design student developed within the IUAV University of Venice, relating to the topic of home post-stroke rehabilitation enhanced by FES (functional electrostimulation) wearable technology. The project proposes an innovative solution to rehabilitate the upper limb being compromised due to an ictal episode. The device is wearable to ensure an adequate electric shock for rehabilitation without compromising arm movements. The development process of the new rehabilitation device has began with in-depth research in various fields. The disease was first studied on a clinical level through a literature review; then proceeded with a visit to the IRCCS San Camillo hospital located in the Lido of Venice where the student was able to see closely how rehabilitation therapy is dealt with and how doctors approach patients. In particular, the rehabilitation that is dealt with in that facility is robotic, through the use of technology also applied to the patient's body. During the first visit to the hospital, the student was able to test some machines on herself. This has implemented the knowledge of the different technologies and the possibility of applying it directly on the users' body without contraindications. The design process also included a phase that involved users, patients and doctors, through questionnaires and semi-structured interviews in order to assess the impact of rehabilitation during hospitalization and after discharge. The development of the design solution has involved a prototyping phase in order to detect the most suitable shape for gripping with the disabled arm. This approach offers to the designer the opportunity to verify the adaptability of the object. Furthermore, this phase allowed the designer to broaden his empathic and communicative knowledge with people who have suffered a trauma, going beyond theory. One of relative importance for design purposes was the exchange of information and experiences between specialists in the sector (doctors), end users and designers. Sharing of results obtained during the development of the project with the final users has contributed to the growth of the work, as it has made it possible to identify criticalities and strengths of the technology currently used for clinical rehabilitation in order to be able to exploit it also within end-user homes.