Integrating a gait analysis test in hospital rehabilitation: A service design approach.

Abstract

BackgroundGait analysis with motion capture (MoCap) during rehabilitation can provide objective information to facilitate treatment decision making. However, designing a test to be integrated into healthcare services requires considering multiple design factors. The difficulty of integrating a 'micro-service' (gait test) within a 'macro-service' (healthcare service) has received little attention in the gait analysis literature. It is a challenge that goes beyond the gait analysis case study because service design methods commonly focus on the entire service design (macro-level).ObjectiveThis study aims to extract design considerations and generate guidelines to integrate MoCap technology for gait analysis in the hospital rehabilitation setting. Specifically, the aim is to design a gait test to assess the response of the applied treatments through pre- and post-measurement sessions.MethodsWe focused on patients with spasticity who received botulinum toxin treatment. A qualitative research design was used to investigate the integration of a gait analysis system based on inertial measurement units in a rehabilitation service at a reference hospital. The methodological approach was based on contrasted methodologies from the service design field, which materialise through observation techniques (during system use), semi-structured interviews, and workshops with healthcare professionals (13 patients, 10 'proxies', and 6 doctors).ResultsThe analysis resulted in six themes: (1) patients' understanding, (2) guiding the gait tests, (3) which professionals guide the gait tests, (4) gait test reports, (5) requesting gait tests (doctors and test guide communication), and the (6) conceptual design of the service with the gait test.ConclusionsThe extracted design considerations and guidelines increase the applicability and usefulness of the gait analysis technology, improving the link between technologists and healthcare professionals. The proposed methodological approach can also be useful for service design teams that deal with the integration of one service into another.