Usability evaluation of a kinematics focused Kinect therapy program for individuals with stroke.

BACKGROUND: Continued and frequent use of the affected arm can result in increased function after stroke. However, long-term access to therapy is often limited, and home exercise compliance is low. While rehabilitation gaming is becoming increasingly prevalent, concerns about therapeutic method, safety, and usability for independent home use remain largely unaddressed. OBJECTIVE: The following paper presents usability evaluation of a game based home therapy program called Home Arm Movement Stroke Training Environment (HAMSTER), which is focused on retraining normal arm kinematics and preventing compensation strategies that limit recovery. METHODS: Kinect games were created with special consideration for the stroke population and retraining normal movement kinematics. Ten individuals with stroke evaluated the games in focused interviews and one individual with chronic stroke completed one month of independent HAMSTER use in the home. RESULTS: The focused interviews showed the need for motivational upper extremity home interventions. Usability evaluation showed the ability for individuals with stroke to interact with the kinematics focused Kinect games after a short exposure time. The single participant evaluation of home use showed good compliance and improvement on all of the clinical outcome measures after the one month of HAMSTER use. CONCLUSIONS: These positive results merit further evaluation of kinematic-focused home gaming interventions like HAMSTER to reduce the use of compensation strategies during home exercise and provide a supplement to conventional care to improve exercise compliance and upper extremity function after stroke.