Admission to the intensive care unit often has long lasting effects on patients’ further life. Not only can the reason for their admission leave several problems, but also mechanical ventilation, physical inactivity, sedation and delirium are only some of the factors that contribu
...
Admission to the intensive care unit often has long lasting effects on patients’ further life. Not only can the reason for their admission leave several problems, but also mechanical ventilation, physical inactivity, sedation and delirium are only some of the factors that contribute to the problems left after ICU stay. Over 80,000 people are annually admitted to the intensive care units of the Dutch hospitals alone and, due to technical advancements, a rising number of patients survives critical illness. Post intensive care syndrome is the overarching name that combines all the physical and mental problems related to intensive care unit stay. It has been well established that rehabilitation and early mobilisation are effective counter measures against post intensive care syndrome. It has also been shown that interactive video gaming can play a useful role in rehabilitation as an addition to conventional therapy. Evidence has shown that the use of visual feedback improves performance and adherence to the therapy in comparison to regular of physical therapy. This design study is meant to create a new interactive video gaming device that allows ICU patients that are at least semi mobile and semi cooperative, to play video games with the aim to help them leave the ICU in the best physical and cognitive state as possible. To come up with the right design, a literature study on the relevant subjects has been done. Also, expert interviews with intensive care unit care-giving staff have been conducted and experience has been gained on the intensive care unit of the Erasmus medical center Rotterdam to make sure the design is done in the right context. Based on the outcomes of this research the decision was made to aim the design to help in activities of daily living. From this aim a specific goal was formulated: The goal is to create an interactive video game controlling system that allows ICU patients, that are at least semi mobile and semi cooperative, to play video games that simultaneously helps in increasing muscle strength, delivers distraction from the daily routine in the ICU and stimulates patients cognitively. Together with physiotherapists and intensivists from the Erasmus medical center Rotterdam a list of requirements for the final designs was created. As during activities of daily living hand grip is one of the most important aspects, the decision was made to use sub-maximal grip force control as the desired training form. Because of this two different versions of grip strength trainers were proposed. The first concept uses the medium wrap grasp as input movement and the second concept uses the power-sphere grasps. These are two of the most frequently used grasp types in daily life. The concepts are designed in a way that the force exerted on the device can be used to control a video game. Internal force sensing resistors, connected to an Arduino, translate the force to a useful signal to control the game. Ten prototypes were created to get to the final designs, which were then tested with patients on the ICU. As result of testing and iterating the concepts, two final designs were delivered, fulfilling the list of requirements. Feasibility tests of these designs were done on the ICU of the Erasmus medical center Rotterdam and were promising. ICU patients participating in the tests understood the game well, were capable of performing the required movements to play the game and delivered feedback on the design and the gaming experience. This paper has lead up to a final prototype that has gone through basic testing to check for feasibility and has proven to work. Further scientific research on a larger scale should be the next step to review the clinical effects of the device.