User-centred development of a portable training device using an active resistor for adaptive and passive movement control to tailor the intensity of rehabilitative walking exercise (Preprint)

Abstract

BACKGROUND Patients with reduced fitness after acute illness often cannot adhere to the prescribed exercises regarding volume and intensity. Early aerobic exercise training, however, can enhance cardiopulmonary fitness and functional recovery. Nordic walking was suggested to be implemented in rehabilitation, but to be effective, a relatively high walking speed is required. The existing ToneFit belt induces a similar movement pattern to Nordic walking, but was designed for the use in the field of recreational sport providing a higher training intensity. OBJECTIVE The purpose of the described project was to develop a new version of the ToneFit belt aimed at improved cardiovascular functioning to meet the demands of neuro-orthopaedic rehabilitation. METHODS (a) In a first project phase, therapists evaluated the original version to determine clinical requirements for a modified version. Further, a prototype of was developed in a user-centred, iterative process with repeated consultations with the therapists. (b) It was biomechanically tested with a specific patient population for a potential impact on gait stability compared to walking without the device, and (c) evaluated for usability by 9 patients in a 3-4 week training programme. RESULTS (a) The evaluation of the original version of the fitness belt revealed a limited usability but necessary improvements could be defined. Several adjustments were made during the implementation phase, i.e., an adaptable intensity and a user interface for training recommendation and monitoring within a smartphone application. (b) The biomechanical analysis could show that walking with the device does not alter the gait pattern. (c) The usability of the prototype was rated as high by patients. CONCLUSIONS The project could show that this portable training device can be used well in the rehabilitation process. Final modifications regarding the software of the smartphone app and the design of the device should be made prior to a controlled study.