This project was in collaboration with a startup company, Pratikara. The brief was to design a solution to aid stroke patients during post-stroke rehabilitation. Here's how I took the project from research to a working prototype.​
Research: Understanding Stroke Rehabilitation
I began by thoroughly researching stroke—its causes, types (like ischaemic strokes, particularly MCA strokes), treatment methods, and the rehabilitation timeline. Stroke patients, especially during post-stroke rehabilitation, face various challenges like reduced body awareness, motor control issues, and sensory deficits. To ground the design in real user needs, I conducted extensive user, task, and market analysis by engaging with stroke patients, caregivers, physical therapists, and neurologists.
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Key Insights from Research
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The patients may not feel when they are being touched or know where the touch is.
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The patients don’t know where their body is and how it is moving.
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The patient may experience right neglect or left neglect.
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They may not be able to focus to complete a task, even when it is something they wish to do.
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The patient may have problem finding an object that was put down in front of them.
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The patient may have changes in vision like losing part of their field of vision in one or both eyes. Or, having double vision.
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Stroke survivors may have dramatically shortened attention spans or may experience deficits in short-term memory.
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Individuals also may lose their ability to make plans, comprehend meaning, learn new tasks, or engage in other complex mental activities.
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Repetition is key to Stroke Rehabilitation
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It is hard to convince stroke patients to do a particular activity.
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Tools such as Goniometers (measurement of ROM), Manual muscle testing dynamometer (measure muscle strength), Reflex hammer (to check the reflexes) are tools that are used manually by the therapists.
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The upper limb includes shoulder, arm, elbow, wrist, hand and fingers. Some patients lose independent control of selected muscle groups, resulting in abnormal synergy. To avoid this, they have to practice right movement during the sessions.
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The patients hold their breath during their activity training.
While doing any therapy with their paretic limb, they use a lot of energy which makes them hold their breath.
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The patients responds to touch, pressure, vibration and sound.
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Most of the patients face issues with shoulder during post stroke rehabilitation. Shoulder subluxation is one of the major complications experienced among stroke survivors. It was observed that approximately 84% of stroke survivors will have Shoulder subluxation and related shoulder pain. Stroke patients who have their arm unsupported and/or handled inappropriately (pulling on the arm) are at a higher risk for traction nueropathy and injury.
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Patients who have a seriously weakened or paralyzed arm commonly experience moderate to severe pain that radiates outward from the shoulder.
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Stroke patients require intensive as well as early physiotherapy to enhance recovery, which require high amount of cost for the treatment.
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Some caregivers in India are not well aware of the technology domain.The caregivers are the ones who help the patients start off with the product.
Redefined Brief:
To design a wearable device for the upper limb keeping in mind the physical, cognitive, and behavioural dysfunctions that are associated with stroke patients affected in the MCA, and also aid the clinicians during post stroke rehabilitation.
Key Design Parameters
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Focus on correct movements of the shoulder, arm, elbow, wrist, hand, and fingers.
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Provide real-time feedback to guide proper limb positioning and movement.
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Prevent shoulder subluxation.
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Make therapy engaging and repetitive but not boring.
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Incorporate audiovisual feedback for better comprehension.
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Use light, affordable materials and simple technology for ease of use by both patients and caregivers.
Gunasekaran, Acute stroke
Impact: Body paralysis
Inhouse treatment
Gunasekaran had Ischaemic stroke twice. The first time, he had paralysis on his right side. Post the second stroke, he has both his sides paralysed and has his muscles contracted. Due to which he lost mobility in both his limbs. Lack of timely rehabilitation exercise has brought him to this condition.
Eshwaran, Mild stroke
Impact: Body weakness
In House Treatment
Eshwaran, was affected by stroke while he was working in his shop. Post stroke, his right side got paralysed. His upper limb is severely affected. He has very poor attention span and prefers to lie down most of the time. The physiotherapist helps him with the rehabilitation exercises.
Kanmani, Acute ischaemic stroke
Impact: Left side paralysis, Body weakness
Inhouse treatment
Kanmani had Ischaemic stroke. Post stroke, she is experiencing Complex regional pain syndrome (CRPS) on her shoulder. She also lost strength in both her limbs. Poor strength has inhibited her mobility in both her upper as well as lower limbs.
Jayashree, Acute stroke
Impact: Body weakness, right side paralysis and recurring fever
In house treatment
Jayashree, in her early 60s experienced acute stroke. A very active lady, since then started being by herself most of the time. Her right side paralysis has made her weak and dependent on the physiotherapists as well as all her caregivers.
Karthik, Mild stroke
Impact: Right side paralysis
In house treatment
Karthik, a young man in his 30s, finds it hard to move his right upper as well as the lower limb. The physiotherapist has been visiting him thrice a week to help him out with the exercises. Due to the encouragement by his caregivers and physiotherapist, he is able to make fast recovery.
Joslin, Mild stroke
Impact: Body weakness
St. John’s Medical College Hospital
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Joslin, a young woman in her 30s, finds it hard to do any activity due to her body weakness.
Post stroke, her body has become weak and her cognitive thinking has been badly affected. Anju, the physiotherapist helps her out with the exercises
Anitha, Acute stroke
Impact: Upper limb paralysis
St. John’s Medical College Hospital
Anitha, finds it hard to move her hand due to paralysis on her right side. Post stroke, her right side had paralysed. Post rehabilitation in the hospital, she is able to make some movements. The physiotherapist helps her out with the exercises
Madhu, Acute stroke stroke
Impact: Right side paralysis
St. John’s Medical College Hospital
Madhu, finds it hard to move his right side of the body on his own. He takes support to move his body parts.
Post stroke, he has become bed ridden due to the paralysis.
The physiotherapist helps him out with the exercises
Concept Exploration and Final Design​
Through multiple concept iterations, I arrived at a final design—
a wearable glove extending from the hand to the shoulder.
Key Features:
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Colour-changing strips: As the patient moves the affected limb, the strips change colour—green for the correct position and red for the wrong position. This provides immediate visual feedback, allowing patients to adjust their movements and train their muscles to follow the right patterns.
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Data-driven movement correction: The therapy begins by having the patient wear the glove on the non-affected limb to perform various tasks. The movements are recorded, providing a baseline for correct positioning. When the glove is then worn on the affected limb, the recorded data guides the patient, helping them mimic proper movements to overcome abnormal synergy.
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Audio feedback: In addition to visual cues, the glove provides audio feedback through a beep when the correct position is achieved. This auditory response reinforces movement awareness and helps patients focus on completing tasks accurately.
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Progress tracking and motivation: The system records the patient's performance data during each session, which can be accessed through a connected app. A graph visually displays progress over time, motivating patients by showing how their efforts lead to tangible improvements.
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Shoulder support to prevent subluxation: One of the major concerns for stroke patients is shoulder subluxation due to unsupported or improper handling of the arm. The glove includes a shoulder support that is part of a belt mechanism, wrapping around the chest and back to provide stability. This ensures the shoulder is protected from unnecessary strain or injury during rehabilitation.
By integrating movement correction, feedback, and support into a single wearable, this glove promotes proper rehabilitation while maintaining patient engagement and preventing common complications such as shoulder subluxation.
Prototyping and Technical Components
I created paper mockups and fabric mockups. After a detailed material study, chose a cotton and spandex blend material with a mesh pattern to ensure comfort and flexibility.
I developed a working prototype using Arduino, LED lighting for color feedback, and flex sensors to monitor joint movements.
Usability Testing and Refinements
Testing the glove provided valuable feedback. The glove was well-received for its simplicity and ease of use, although some improvements were suggested, such as enhancing the feedback response time and improving the comfort of the shoulder support.
Expanding the Product: Game-based Therapy
To further enhance engagement, I explored a game-based therapy concept. Using Unity3D and Arduino, I worked out a concept for a game that combined upper limb movements with fun, goal-oriented tasks like gardening, cooking etc. This approach would make therapy more enjoyable, while keeping it challenging enough to maintain long-term engagement.
User Group
Usability Factor
Proposed Outcomes
• Stroke Patients
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• Meaningful play
• Challenge
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• Increased motivation & enjoyment
• Continuous enjoyment
• Physiatrists
• Physiotherapists
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• Information acquisition
• Meaningful prescription​
• Get information on patient's progress
• Enable right diagnosis for patient's symptom
• Occupational therapists
• Caregivers
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• Ease of use
• Challenge
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• Easy configuration to start game
• Easy to control challenge while playing
This project was an enriching experience, teaching me the importance of empathy and user-centered design in healthcare solutions. With further development, the wearable glove and game-based therapy can become an effective, low-cost tool for stroke rehabilitation, enhancing both patient outcomes and clinical practice.
