Title: Using the Microsoft 'Kinect' as a Stroke Rehabilitation tool. Re-appropriation of non-commodity electronics devices for use in facial paralysis rehabilitation
Funder: Department of Health (England)

Abstract: Framing problems with facial paralysis - Designing automated rehabilitation (Months 1-2) Four focus groups will be run to create a framework for the patient needs. New patients (acute phase) across the full spectrum of facial paralysis will be included in the groups. Participants will also comprise of members of Nottingham SRCG, a team member from NUH Occupational Therapy Dept. and the software engineering team. Data gathered will form the basis of a user oriented design. This will be tailored to build upon current rehabilitation and physiotherapy techniques, while reducing the common frustrations found by patients performing the exercises. Deliverables 1: Defining workflow Quantifying patient needs and limitations Compile formal description of relevant activities and required UI structure Design interaction framework 2. Development of an application protocol interface suitable for rehabilitation (Months 2-7) The prototype will initially focus on the creation of a tracking system for facial regions around the mouth, e.g. exaggerated recitation of the vowels, and puckering of lips. The Kinect has an Application Protocol Interface (API) which allows a programmer to design for facial recognition, but in its current form it is insufficient for this proposed type of therapy. A required expansion on the Kinects ‘primitive surface feature distribution’ system would allow for the detection of asymmetries occurring at specified fiducial points on a patients face. Primary regions of interest would be the Zygomatic (cheek) muscles, Orbicularis Oris (mouth) and Orbicularis Oculi (eye). Detecting and quantifying these asymmetries would be a significant initial milestone. Deliverables 2: Creation of functional algorithms for detecting corresponding points on an asymmetric face 3. Cyclical testing and iterative Software Development (Months 8-10) The choice of fiducial markers on the face will be decided from analysis of best occupational therapy practise. Matching corresponding regions of interest between sides will pose significant challenges as the general ‘surface features’ used in facial recognition - ridges, saddles, convexes and concaves - will not be as expected. The severity of the paralysis will vary from patient to patient, and this would be taken into account. Iterative design shall be performed early within this stage - weekly testing sessions involving a group of facial paralysis sufferers and a clinician. Deliverables 3: Program to work with varying levels of paralysis Software Optimisation through testing with patients 4. Creation rehabilitation Exercises (Months 10-14) Phase 4 involves building models of the desired exercises requiring the team’s close liaison with clinicians to ensure data being gathered by the system is relevant for diagnosis and treatment. Deliverables 4: Creating models of idealised ‘standard’ exercises Correlating ‘live’ users to idealised standards 5. User Centred Design and cyclical testing (Months 12-18) Phase 5 builds a system that collects and analyses valid and relevant data. This will require a user interface to be developed. This will involve best methods of user experience (UX), to impart details of measured data back to the user (and clinician) in an understandable and succinct form. The interface should give experiential, affective and meaningful interaction with the system, imparting a sense of ownership of the program. This makes the physiotherapeutic exercises engaging and fun to perform regularly. The manner in which feedback is conveyed should maintain patient motivation and on-going engagement with the technology. Appropriate feedback will allow the patient see a tangible improvement, thus maximising benefit. Testing will be done throughout this phase, and feedback from 9 patients (3 prototypes for 2 months each) would form the basis for any changes. Deliverables 5: Creating an engaging user interface and experience Testing validity of program methodology with regard to real world behaviour Iterative testing, bringing the system to a working prototype.


Research activity codes: 7.1 INDIVIDUAL CARE NEEDS
Health categories: STROKE