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Orthopedic and Rehabilitation Engineering

Orthopedic and Rehabilitation Engineering - Poster Session E

Poster K17 - Reimagining medical device user interfaces- Tactile and visual discrimination strategies to support users with mechanosensory, visual, and auditory disabilities.

Saturday, October 26, 2024
10:00 AM - 11:00 AM EST
Location: Exhibit Hall E, F & G

Introduction:  Over 40 million people in the U.S. have a disability that involves challenges related to vision, hearing, mobility, and tactile sensing. Though the Americans with Disabilities Act and a host of other local and national laws regulate physical accessibility of public spaces, such as wheelchair access, Braille signage, and the like, there is no regulatory framework governing the accessibility of physical user interfaces employed on medical and assistive devices. We have redesigned our existing neurologic assessment device to incorporate enhanced tactile and visual discrimination strategies to support users with disabilities that cause mechanosensory, auditory, and visual dysfunction. Our multi-modal neurologic assessment and therapy prototype (MAT) is a portable device designed to assess and provide therapies for conditions that involve movement of the upper limbs. MAT has a patient-facing array of touch-sensing pads that the patient touches in a pattern chosen by the clinician for the desired assessment or therapy regimen. Touch pad signifiers, customized to the patient’s color vision, sensory needs, and style preferences allow the patient to follow the clinician’s instructions easily. These custom signifiers and a patient-facing LCD screen, eliminate the need for auditory instructions which are unsuitable for patients with auditory sensitivities. Developing accessibility strategies that are applicable to the numerous physical interfaces encountered on medical, therapeutic, and assistive devices will increase patient compliance with and enjoyment of these technologies.

Materials and

Methods:  Our multi-modal assessment and therapy prototype (MAT) has an expandable frame holding an array of patient-facing touch capacitive pads (Figures 1 and 2) integrated into a ripstop base fabric. The capacitive pads are electrically connected though the sheet to a rear array of clinician-facing conductive fasteners (Figures 3). The clinician selects an assessment or therapy regimen from the menu of programs and attaches wires connected to the mating sides of the conductive fasteners, in a manner similar to applying a 12-lead EGK to a patient. Additional signifiers and LCD instructions indicate to the patient what pads to touch in what order (Figures 1 and 4), the processor and optional LEDs display the patient’s progress. MAT offers a variety of array patterns to record lateral, crossbody, and circular upper limb motion for rotator cuff assessment and surgical recovery, stroke rehabilitation, and neurological assessments (Figure 5). Arrays are enhanced with custom signifiers to support users with auditory, visual, or mechanosensory sensitivities and disabilities, and the inexpensive textile arrays can be wiped clean or disposed of after each use. Touch capacitive fabrics, sensors, LEDs, screens, and microprocessors purchased from Adafruit Industries.

Results, Conclusions, and Discussions: Interface design, whether virtual or physical, is a challenging and multifactorial process, but designing for accessibility greatly complicates this process. Over 37 million individuals in the U.S. have hearing impairments, approximately 12 million experience challenges with color vision, and over 5 million are on the autism spectrum and face a myriad of mechanosensory challenges. Applying usability heuristics; specifically those related to visibility, matching the design to the real world, tactics to provide user control and freedom, and strategies for improving recognition can both drive innovation and inform the development of novel interface solutions. The redesign process for the user interface of our multi-modal upper limb and cognitive assessment and therapy prototype device, MAT, included using these informed customization strategies. Touch array elements on this prototype now incorporate optimal user-specific identifiers and directional elements to provide enhanced visual discrimination and minimize mechanosensory challenges related to auditory, visual, or tactile sensitivities. Incorporating the user’s taste preferences, special interests, or preferred language can further support active and enjoyable engagement. The MAT prototype currently provides game-based interaction and permits measurements of upper limb movement, and a selectable menu for assessments or concussion or TBI is underway. Future work includes expanding the height and width dimensions of MAT to accommodate users of various heights and adding attachment mechanisms so that MAT can be attached to portable medical equipment such as IV poles, in addition to being used in the tabletop mode. Interface updates are planned that include the addition of a second, clinician-facing LCD screen for data acquisition and enhancing the patient-facing screen to provide accessible text options such as increased font size and a low color vision palate.

Acknowledgements (Optional):  Research reported in this abstract was supported in part by the Institutional Development Award (IDeA) Network for Biomedical Research Excellence from the National Institute of General Medical Sciences of the National Institutes of Health under grant number P20GM103430.