Proposal

Introduction

Personas

• Age: 65
• Condition: Had stroke 7 years ago, still suffering from minor hemiparesis
• Work: Carpenter, now retired
• Personality: Used to be good with his hands, very caring, patient, enthusiastic and really wants to improve his state, even at this age

Timothy - The old, enthusiastic guy.

---

Motivation

He wants to be able to hammer a nail in again while holding the nail with his weaker hand’s fingers. His ultimate goal is to build a cupboard for his six-year-old grandchild in the near future.

Familiarity with technology

He has never really been too keen about using technology and is resistant to the idea. He thinks using old techniques for rehabilitation may be more effective. Playing games that are not board games or cards is foreign to him. He doesn’t own any technology at home other than his telephone.

Scenario

He has been going to rehabilitation since his stroke and has had very slow and little improvement. He doesn’t mind asking for help when he needs it, however being independent was his identity before the stroke. He lives with his daughter’s family and gets bored at home at times - he would like some entertainment from time to time.

Anne - the forward thinker

---

Motivation

She wants to get back to her pre-stroke self as soon as she can so she can get back to her work. She has teenager children who need her support at home as well. She uses the computer constantly at work but is now having trouble typing emails she needs to tend to as soon as possible.

Familiarity with technology

Anne loves technology. She is quite advanced in her knowledge of the latest gadgets and makes sure she engages her children with her love for technology.

Scenario

The stoke was a huge surprise for Anne and her family. With her being in this new situation, she wants to recover as soon as she can and is motivated to do anything, even play games for her rehabilitation. She is a little discouraged since it’s been four months since her stroke and hasn’t seen much improvement, however she is still motivated as ever to improve the situation. She lives with her husband and children who help her with simple tasks such as buttoning her shirts and zipping her coat. Even though getting back to work is her ultimate goal, she would like to be more independent in her everyday tasks.

• Age: 45
• Condition: Had stroke four months ago, suffering from stiff muscles in fingers
• Work: Financial Advisor at Freedom 55
• Personality: Very focused woman. Loving mother, but has always been a professionally driven individual.

• Age: 75
• Condition: Had stroke one week ago, suffering from hemiparesis
• Work: School teacher, retired now
• Personality: Very shy but wise woman, loves children and games meant for children. Loves to cook, even at this age.

Ruth- the lady with no support

---

Motivation

She wants to restart cooking however, other than that, doesn’t really have much motivation. She thinks she has had a great life so far and would like to not use up resources. She doesn’t have much family and has no one to take care of her, so her motivation to resume her previous functionality is quite low.

Familiarity with technology

She never had a great interest in technology but isn’t resistant from the idea. The most technology she has ever used is her computer at home to simply browse the internet. She does love children games, especially those that give rewards and is open to playing on devices she has never been exposed to before.

Scenario

Ruth’s stroke was only a week ago and she is in full swing for recovery. However, with her low motivation, the progress is going slower than expected. She has the potential to fully recover fairly quickly and has been experiencing improvement already. She has no support other than her own low motivation to get back and resume her cooking hobby. She would like to be able to complete simple tasks such as sorting peas and peeling the skin off carrots.

Use Case Scenarios

Use Case 1: Start Running Application

Description	User as a patient starts running the application
Normal Scenario	User turns on the tablet device User finds the application ‘Wire Loop’ game application User tabs the icon to launch Main menu page of the application is displayed
Alternative Scenario	User turns on the tablet device User activates a voice recognition program built in the tablet device User says “Wire Loop” ‘Wire Loop’ game application is launched Main menu page of the application is displayed
Error Scenario	N/A

Use Case 2: Choose Game Types

Description	After initiating the application, user as a patient selects the game type. The game type is different by the number of fingers he or she will train with.
Normal Scenario	Main menu page of the application is displayed There are 5 different game types in the main menu and they are different by the number of user’s fingers involving in the game User chooses a game type The game of selected type is initiated
Alternative Scenario	N/A
Error Scenario	N/A

Use Case 3: Start The Game

Description	User as a patient begins the game of selected type by placing his or her fingers on the starting points
Normal Scenario	The game of selected type is initiated Scene of the game is displayed The scene of the game consists of a given time, path of finger, starting point of the path, and ending point of the path As soon as user places their fingers on the starting point of the path, the game is started
Alternative Scenario	N/A
Error Scenario	The game of selected type is initiated Scene of the game is displayed The scene of the game consists of a given time, path of finger, starting point of the path, and ending point of the path User does not place their fingers starting point of the path The game is not started until all starting point is touched by user’s fingers

Use Case 4: Complete The Game

Description	User as a patient follows the finger path and reaches to the ending point of the path within given time
Normal Scenario	Following succesful case 3, and with fingers touching the touchscreen, the user follows the path without leaving the boundary of the path User’s fingers successfully reaches to the ending point of the path within time The application gives auditory and visual feedback to the user to notify the success of training and completion of current stage. The scene of next level game is displayed As the game level increases, the finger path becomes more difficult by more complex finger path so that it can motivate the user to perform the finger movement with more precision
Alternative Scenario	N/A
Error Scenario 1	The game is started after the user touches the starting point of the path with their fingers With fingers touching the touchscreen, the user follows the finger path User’s fingers touch the boundary of the finger path The application gives auditory and visual feedback to the user to notify the failure The game is stopped and the user fails to complete the current stage of the game The game resets to the original starting scene of the current level.
Error Scenario 2	The game is started after the user touches the starting point of the path with their fingers With fingers touching the touchscreen, the user follows the finger path User's finger fail to reach the ending point of the finger path within given time The application gives auditory and visual feedback to the user to notify the failure The game is stopped and the user fails to complete the current stage of the game The game resets to the original starting scene of the current level.

Use Case 5: Adjust The Given Time

Description	User as a patient adjusts the given time of the current game stage
Normal Scenario	The game of selected type is initiated Scene of the game is displayed User adjusts the given time of current game stage The given time is set
Alternative Scenario	The game of selected type is initiated Scene of the game is displayed User’s assistant adjusts the given time of current game stage The given time is set
Error Scenario	The game of selected type is initiated User tabs the ‘Previous Level’ arrow button to see the lower level game or less complex finger path game User selects appropriate game level As soon as user places his or her fingers on the starting point of the path, the game is started

Use Case 6: Selects Level of The Game

Description	User as a patient selects level of the game or complexity of the finger path
Normal Scenario	The game of selected type is initiated User tabs the ‘Next Level’ arrow button to see the higher level game or more complex finger path game User selects appropriate game level As soon as user places his or her fingers on the starting point of the path, the game is started
Alternative Scenario	The game of selected type is initiated User tabs the ‘Previous Level’ arrow button to see the lower level game or less complex finger path game User selects appropriate game level As soon as user places his or her fingers on the starting point of the path, the game is started
Error Scenario	N/A

Use Case 7: Quit The Game

Description	User as a patient quits from the current game and goes back to main menu
Normal Scenario	Scene of the game is displayed User tabs the “Main Menu” button Main menu of the application is displayed
Alternative Scenario	N/A
Error Scenario	N/A

Use Case 8: Quit The Application

Description	User as a patient quits from the application
Normal Scenario	Scene of the game is displayed User tabs the “Main Menu” button User tabs the “Exit” button User quits from the application
Alternative Scenario	User presses the home button of a tablet device
Error Scenario	N/A

.

Extra Use Case: Adjust The Width of The Finger Path

Above are our primary goals to achieve. The primary goal focuses on the patient’s improvement on the speed and agility of finger use. If the time is allowed, our team will work on one more feature that can highly improve patient’s accuracy of finger use. The Use Case is stated below:

Description	User as a patient adjusts the width of the finger path
Normal Scenario	The game of selected type is initiated Scene of the game is displayed User adjusts the width of the finger path The width of the path is set
Alternative Scenario	The game of selected type is initiated Scene of the game is displayed User’s assistant adjusts the width of the finger path The width of the path is set
Error Scenario	The game of selected type is initiated Scene of the game is displayed User increases or decreases the width of the finger path The width reaches its pre-set maximum or minimum width User cannot increases or decreases the width any further

.

Related Products

Hand rehabilitation device for people who suffer from motor disorder after stroke is not specific but in wide range. The purpose of this device is different from device to device and it depends on the seriousness of patient’s disorder. Moreover, the method of rehabilitation is different.

Hand Mentor

The Hand Mentor from Kinetic Muscles Inc. is a hand rehabilitation device in which a patient can train his or her hand movement by playing the built-in games in this device. This device is targeting mainly the rehabilitation of arm and hand. As a patient participate in the game with assistive robotic device around his or her arm, the patient controls a game character by using the arm and hand in the device. Different types of game encourages a patient to move the arm and hand in different movement. Moreover, if the patient faces the difficulty, then the robotic device helps to move the arm and hand. Such goal-oriented device using games highly motivates a patient to train his or hand in more intensive manner.
Costs about $10,000

AMADEO

Produced by Tyromotion, the AMADEO is another hand rehabilitation device in which a patient can train his or her hand, especially fingers, either passively or actively. This device is targeting mainly the rehabilitation of fingers. A patient with very limited movement in his or her fingers, the finger muscles can be treated passively by performing the automated movement sequences. It improves motor and neurological function of fingers and hand. On the other hand, a patient can actively participate in rehabilitation by moving the fingers without any assistance of the device. The device can measure the force and movement of fingers, so it enables the progress tracking.

Electrical Stimulation

BaroMedical clinic developed a device in which electrical currents activate the muscle contractions and nerve conduction. The purpose of this device is to enable functional movement of limb by stimulating the nerve of patient who lost the control of the muscle and, moreover, to elicit the voluntary movement of limb. The application of this electrical stimulation device on arm and hand allows a patient to open the clenched hand voluntarily. Repetitive electrical stimulation therapy for long time allows more voluntary movement with less assistance.

Through the research on the currently possible solution for patient with motor disorder, specifically in hand, we have found several factors:

• The goal-oriented product greatly motivates the patient to be more engaged in the rehab activity for longer period
• Highly sophisticated rehab device with mechanical equipments involved that tends to be more effective in recovery is enormously expensive and bulky in size and weight
• Most of the rehab devices are available only in clinic or in hospital
• The target users of each rehab device are specific.

Product Comparison

By doing the research on currently available hand rehab product, we have realized that there is not much of rehab product with game feature. There are some goal-oriented products, like HandMentor, but they are significantly expensive and large in size, so they are mostly available only in clinics or hospital. Also, those rehab devices with game feature mainly focus on training bigger muscles, like arm and wrist, but not the smaller muscles, like finger, where it requires the delicacy of control.
Therefore, our product focuses on low-cost, portability, game feature, and training delicate movement of finger muscles.

Considering all, our proposed solution is a game application on the tablet device that focuses on the patient who needs to train the finger. Firstly, since it is application development, development cost would be significantly low and the low-cost rehab game application is possible. Also, the game application in today’s prevalent tablet device is greatly portable and allows more patients to involve in the rehab activity. Next, as mentioned above, we decided to develop game as rehab method rather than simple repetitive exercise so that the patient would be more motivated to participate and concentrate on the rehab activity. Moreover, different level of game with different complexity of this game application forces the patients to actively use their hand and fingers with various poses in different movement, so the patients can train their finger in more delicate way.

High Level Design

Figure 1, High-Level design of Wire Loop

The abstracted high level approach follows the following procedure:

1. Sensory touch data is recieved through device APIs
2. The data is processed to determine the location of the digit relative to the rendered 2D graphic elements on the screen
3. With the location determined, graphics are updated to visualy indicate progress, sucess or failure
4. An audible response is coupled with the visual elements to provide a more accessible and immersive experience

Feasibility Justification

With the availability of iPad of Apple company, all three teammates will develop the iOS game application in objective-C of XCode or in Javascript. Although we do not have experience in the application development, everyone has been exposed to coding in C and Java, so everyone will be comfortable in using objective-C or Javascript in couple of weeks, and also we will receive some help from open source codes.

Once all the team members get used to the language, the first phase of our project will be the development of a game interface. Majorly, we will make quite an effort to find optimal design of main gaming feature, like the position of the finger path, width of the finger path, and position and size of starting point and ending point of the finger path, where the patients will train their fingers. After that, the non-functional requirement features, like setting buttons, will be considered. In this step, the team will try to optimize the size and position of buttons, such as main menu button, given time controlling button, etc. to ensure those non-functional requirement feature does not obstruct the patient’s rehab activity. For this phase, the low fidelity prototype will be necessary to find the optimal and user-friendly design of game interface design.

Next, our team will focus on developing the human-computer interaction features. This phase, certainly, will be the most demanding part of the project, so the extra efforts from each team member are expected and all of us will try to receive help from the open sources. The order of steps would be ‘multi-finger touch recognition feature’ that the application recognizes the patient’s finger touching the touchscreen, ‘path boundary sensitive feature’ that will indicate the failure of the game when the patient touches the boundary of finger path, ‘game time feature’ that will give patient the given time of the game, and ‘auditory and visual feedback feature’. Once the all theses essential game interacting features are implemented, the usability testing with a volunteer will be very crucial in improving our product.
Thus, this will be iterative process to develop our product far better.

Very lastly, we will finalize our product development by implementing the main page design, and creating different game types (game types are different by the number of the fingers the patient wants to train with, as mentioned above) and different level of game (different complexity of the finger path). This phase is expected to be simple and short.

* If the time is allowed, our team will work on the one more feature, ‘adjusting width of finger path’, that allows an user to adjust the width of the finger path so that our product can give more rehab activity feature for the patient to train with.

Summary of Contributions