During the first phase of the project, research was done. Initially, a context mapping study was done to gain insight of the context of the problem we were trying to solve for our case owner. Information about assistive technologies, co-design and participatory design, cerebral palsy and about already existing products was also researched. This page will give a short summary of the research and the most important insights will be used for the requirements.
2.1 Assistive Technologies
Assistive technologies are any product, instrument, equipment or technology that is designed to support people with disabilities or limitations in their daily life in completing tasks or participating in activities. These products are designed to improve the quality of life, independence, and functionality of individuals with physical, cognitive or sensory disability.
To be able to make an assistive technology successful multiple theories can be used. During this project the following theories will be used:
- User centered design: During the design process of the assistive technology the end user is taken into account. This ensures that the product meets the needs and preferences of the end-user.
- Human factors engineering: The design of the technology should take into account human factors. In this way, the device can be used with a minimal risk of user error.
- Human centered design: the human/user experience will be used as a central point of concern.
- Participatory design: in the design process of the assistive technology not only users should play a part in the design process, but also important stakeholders such as family members, healthcare professionals and caretakers.
The main theory that will be used is human centered design more information about this design theory will be explained in the next paragraph.
2.2 Human-Centered Design
Human-centered design(HCD) is a design strategy that approaches the design process with the human experience as its central point of concern. It aims to understand the needs of the user and create products, services, and experiences that are tailored to their needs.
One of the most important aspects of HCD is the concept of affordances. Affordances refer to the properties of an object that suggest how it can be used. As these affordances can greatly influence how products can be used. During this project it is important to take into account how the affordances of the products influence the user to act when interacting with their design.
The HCD process typically involves several stages, starting with research to understand the needs and preferences of the users. This can involve user interviews, surveys, and observation. The next stage is ideation, where designers generate ideas and solutions to the problems identified in the research stage. This is followed by prototyping, where designers create low-fidelity prototypes to test their ideas and receive feedback from users. The final stage is testing, where designers test their prototypes with users and refine their designs based on feedback.
‘Collaborative design’ – otherwise known as co-design, is a qualitative design approach where the end user is actively involved throughout the entire design process. Co-design enables designers to cultivate empathy towards the end user. This provides in-context design solutions during the development process that accommodates for their needs. This Improves the likelihood of adoption and sustained use of the product.
The first stages of co-designing a product requires designers to build empathy for the user. The structure of these workshops can be seen in Table 1 which covers all content from discovering and defining the problem, to developing and delivering the concept. Human centered design research methods are applied for designers to discover a deeper and more comprehensive understanding of potential design issues and therefore solutions.
Affinity diagrams are a great way to structure initial ideas and design problems. This works by categorizing similar ideas, and refining them down to manageable and clear design problems. Through this way of organization designers can move forward with clear goals in mind to start ideating design solutions for each category. Plotting these ideas on an achievability/ importance graph (fig 1) helps designers decide which ideas to pursue. All ideas rated above the median value for importance or achievability are taken forward.
During this project we will use participatory and design for empowerment as co-design methods.
Because of this the design will lie between participatory design and design for empowerment. Design for empowerment requires more from the co-designer than the project and the schedule of the co-designer allow. However with participatory design the co-designer would only be involved in setting the requirements and testing the prototypes. Besides that, with participatory design other stakeholders are taken in account as well, for example, her children, partner or caretakers. During the interviews it was clear that being involved with developing the design is something the co-designer is interested in, they have a lot of ideas and want to share those.
Working closely together with the co-designer will allow for following a direction in line with the social model of disability. If design is made by people who have no experience of living with disability it is hard to not try and fix what the non-disabled person would perceive as a problem. However the goal is not to make someone be able to function as what is deemed normal. The goal is to create a design that will allow the user to live their life in an easier way. What the co-designer perceives as easier might not be what is deemed normal.
Due to the vast array of issues that we have been presented with we will use achievability/ importance graphs to map out what is important and what is achievable. This is important since not everything can be done with the time span given, this will help define the best direction to go in
2.4 Cerebral Palsy
Cerebral palsy (CP) is the most common physical disability starting from childhood. It is a static neurologic condition which most often follows from brain injury before the cerebral development undergone in the womb is complete, though since the brain develops long after it is also possible for cerebral palsy to develop postnatally. Though the symptoms of cerebral palsy may vary wildly between individuals, the main complaints sufferers of CP have to face are as follows:
- Muscle stiffness and spasticity: Adults with CP may experience muscle stiffness and tightness, especially in their legs, which can make movement difficult and uncomfortable.
- Balance and coordination problems: CP can also cause difficulties with balance and coordination, making it challenging for adults to perform tasks that require precise movements.
- Chronic pain: Adults with CP may experience chronic pain, especially in the muscles and joints, as a result of the strain placed on their bodies from spasticity and movement difficulties.
- Fatigue: Because individuals with CP must use more energy and effort to move their bodies, they may experience fatigue and exhaustion more quickly than those without the condition.
- Difficulty with fine motor skills: CP can also affect fine motor skills, such as the ability to write, type, or manipulate small objects with the hands.
- Speech difficulties: Some adults with CP may have difficulty with speech, including slurred or unclear speech.
- Swallowing difficulties: In more severe cases, CP can affect the muscles used in swallowing, making it difficult to eat and drink safely.
While there currently is no way to treat cerebral palsy, a management plan can help alleviate the symptoms somewhat. The main goals of CP treatment is to alleviate complaints and pain, improve health, cognitive development and independence. Neurodevelopmental treatment and physiotherapy are two vital aspects of this treatment. Sometimes it can be decided to make use of botox (Botulinum toxin) to relax cramped muscles.
External aids such as electric shock therapy have proven to be somewhat useful as well in the treatment of CP, though various studies are not as enthusiastic about this treatment as others. Braces however have proven to be a very practical and useful solution. In developing children, the legs can be supported in such a way to limit the deformation of the limbs.
During this project the case owner has most difficulties with the symptoms of muscle stiffness, muscle spasticity, balance and coordinate problems. More information on how this affects her lifestyle will be explained in the problem definition.
2.5 Market Research
In the existing market there are some products that can be used as an assistive product/technology for people with cerebral Palsy. Assistive devices to help with everyday activities include:
- Adaptive dressing aids
- Long handle bath sponges and brushes
- Adaptive bath benches
- Raised or lowered toilet seats
- Safety grab bars in rooms
- Weighted silverware, cups, bowls and plates
- Adapted scissors
- Reaching aids
- Manual house key turners
- Non-slip mats
- Pull-out tables next to bed, couch, chairs
- Bed positioning aids and pillow
These products can be used to learn from. However to design the product for our case owner her problem needs to be taken into account. The main problem is the accessibility in the kitchen, in special accessibility in high places more in depth information is explained in the problem definiton. Because the problem acknowledges more research about products that help our case owner reach the desired product easily in the above cabinets can be researched.
In this category are already products that have partially solved our problem. Although these products deliver a solution to our problem none of them will fully fulfill the needs of our user. Therefore the products can be used to take inspiration from and distinct features can be used to combine.
- Borg, J., Larsson, S., & Östergren, P.-O. (2011). The right to assistive technology: for whom, for what, and by whom? Disability & Society, 26(2), 151–167. https://doi.org/10.1080/09687599.2011.543862
- Saborowski, M., & Kollak, I. (2015). “How do you care for technology?” – Care professionals’ experiences with assistive technology in care of the elderly. Technological Forecasting and Social Change, 93, 133–140. https://doi.org/10.1016/j.techfore.2014.05.006
- Jacobson, R. (2000). Information Design. In Google Books. MIT Press. https://books.google.nl/books?hl=nl&lr=&id=vnax4nN4Ws4C&oi=fnd&pg=PA59&dq=human+centered+design&ots=PbK7Y1juDd&sig=v_cBigIaBjxq6bPT7id2Kwmc3EU&redir_esc=y#v=onepage&q=human%20centered%20design&f=false
- Daveler, B., Salatin, B., Grindle, G. G., Candiotti, J., Wang, H., & Cooper, R. A. (2015). Participatory design and validation of mobility enhancement robotic wheelchair. Journal of Rehabilitation Research and Development, 52(6), 739–750. https://doi.org/10.1682/JRRD.2014.11.0278
- Fortune, J., Burke, J., Dillon, C., Dillon, S., O’Toole, S., Enright, A., Flynn, A., Manikandan, M., Kroll, T., Lavelle, G., & Ryan, J. M. (2022). Co-designing resources to support the transition from child to adult health services for young people with cerebral palsy: A design thinking approach. Frontiers in Rehabilitation Sciences, 3, 976580. https://doi.org/10.3389/fresc.2022.976580
- Tochetto, J., Guimarães, C., Maranho, A. L., & Tartari, A. L. (2016). Design with me: I have special needs! The case for cerebral palsy. In Lecture Notes in Computer Science (pp. 214–222). Springer International Publishing.
- Verschuren, O., Peterson, M. D., Balemans, A. C. J., & Hurvitz, E. A. (2016). Exercise and physical activity recommendations for people with cerebral palsy. Developmental Medicine & Child Neurology, 58(8), 798–808. https://doi.org/10.1111/dmcn.13053
- Hombergen, S. P., Huisstede, B. M., Streur, M. F., Stam, H. J., Slaman, J., Bussmann, J. B., & van den Berg-Emons, R. J. (2012). Impact of Cerebral Palsy on Health-Related Physical Fitness in Adults: Systematic Review. Archives of Physical Medicine and Rehabilitation, 93(5), 871–881. https://doi.org/10.1016/j.apmr.2011.11.032
- Krigger, K. W. (2006). Cerebral Palsy: An Overview. American Family Physician, 73(1), 91–100. https://www.aafp.org/pubs/afp/issues/2006/0101/p91.html