Optimization Strategies for the Design of Rehabilitation Aids for

Parkinson's Patients based on Hierarchical Analysis

Huimin Wang

a

and Tianyang Zhu

*b

Department of Art and Design Beijing University of Chemical Technology Beijing, China

Keywords: Parkinson's, Rehabilitation Assistive Devices, Hierarchical Analysis, Optimal Design.

Abstract: Objective: The Parkinson's disease has gradually increased in the elderly population in China, and the

research of rehabilitation assistive devices for patients with Parkinson's has become more and more

important. This study analyzes the existing Parkinson's rehabilitation assistive devices in the market, and

proposes an optimization strategy for the design of rehabilitation assistive devices for Parkinson's patients

according to the actual needs of patients. Methods: The existing research results of Parkinson's

rehabilitation assistive devices were sorted out by inductive method, and the tendency of patients' needs

between each level of rehabilitation products of assistive devices was extracted from functional level,

service level and emotional level based on hierarchical analysis. Conclusion: At this stage, domestic

research on the design of medical assistive devices for Parkinson's disease remains relatively scarce. The

functions of the products are mostly limited to self-care or mobility assistance under the action of external

forces; these products have problems such as insufficient targeting of functional positioning, lack of

systemic and sustainability in the use process, and lack of emotionality. The optimized solutions and design

strategies of inclusiveness and autonomy, systemic and sustainability, and emotional design are proposed to

provide reference for future product design and application of training assistive devices for Parkinson's

patients.

1 INTRODUCTION

1

Parkinson's syndrome (PD) is a neurodegenerative

disease common in middle and old age (Liu 2016),

and the number of Parkinson's patients in the world

is about 6 million (Zhuang 2017). The increase in

the number of Parkinson's patients and the

weakening capacity of home-based patient care

services have exacerbated the burden on family

finances and social health care services. With the

current scientific treatments, Parkinson's disease

cannot be cured and can only be assisted by

medication and physical rehabilitation training. It is

an urgent problem to address in rehabilitation

research on how to make patients less distressed and

restore their ability to take care of themselves (Liu

2021). In the early stage of Parkinson's symptoms,

the use of reasonable and scientific rehabilitation

assistive devices is one of the effective methods to

slow down the physical function lesions and

a

https://orcid.org/0000-0003-4398-8584

b

https://orcid.org/0000-0001-5118-8216

improve the quality of life of patients. With the

progression of Parkinson's disease, the tremor of

movement and delayed gait impairment, as well as

the psychological negativity lead to the gradual

narrowing of the patient's range of activities, and the

home becomes the patient's main place of activity.

As patients spend more time at home, the need for

physical exercise increases, which requires the

optimal design of assistive devices in terms of

autonomous exercise and emotional companionship

to provide a more effective and comfortable

home-based rehabilitation environment for

Parkinson's patients, so as to realize the need for

patients to complete autonomous exercise through

assistive devices, which enhances the sense of

self-efficacy and improves the sense of well-being.

Wang, H. and Zhu, T.

Optimization Strategies for the Design of Rehabilitation Aids for Parkinson’s Patients based on Hierarchical Analysis.

DOI: 10.5220/0011206600003438

In Proceedings of the 1st International Conference on Health Big Data and Intelligent Healthcare (ICHIH 2022), pages 25-36

ISBN: 978-989-758-596-8

Copyright

c

25

2 OVERVIEW OF

REHABILITATION ASSISTIVE

DEVICES FOR PD

Parkinson's assistive devices are assistive devices

that help patients overcome the obstacles of the

disease, alleviate the adverse effects of symptoms

such as tremor, bradykinesia and dyskinesia, and

improve the ability to care for themselves in daily

life. Through the use of medical assistive devices,

Parkinson's patients can improve the completion of

basic behavioral movements and effectively improve

their quality of life while enhancing their ability to

adapt to their environment. The improvement of

self-care ability can promote the self-efficacy of

Parkinson's patients, regulate negative psychological

emotions, and alleviate the burden and stress of

health care workers and family members.

2.1 Classification of Existing

Parkinson's Rehabilitation Assistive

Devices

In order to allow Parkinson's patients to spend their

old age peacefully, elderly care with technology and

assistive devices has gradually become the

mainstream of social development (Li 2018)

Research and analysis of existing Parkinson's

assistive devices in the market can be categorized

into whole-body assistive devices, upper limb

assistive devices, and lower limb assistive devices

based on their target limb parts, as shown in Table 1.

Whole-body assistive devices tend to act on the

whole limb of the patient for rehabilitation treatment

or data monitoring, and the main existing

whole-body assistive devices are hyperbaric oxygen

chamber, Parkinson's therapy device and physical

data monitor, etc. (Mao 2020). The effect of

cognitive training on exercise training in Parkinson's

rehabilitation was investigated by Davide Ferrazzoli

et al. It was found that cognitive training has a

crucial role in motor training and sustained

concentration is effective in accomplishing the target

movement behaviors, and that hyperbaric chamber

plays a role in improving cognitive impairment for

Parkinson's patients (Davide 2018). Parkinson's

therapeutic device is an innovative technology based

on brain pacemakers and brain rehabilitation

therapies that act on the patient's head, ears and feet

to compensate for the lack of pharmacological and

surgical treatment and improve tremor, rigidity and

bradykinesia. The data monitor is applied to the

patient's rehabilitation process to provide real-time

data detection and feedback based on the patient's

behavioral response, helping healthcare

professionals to effectively monitor the patient's

pathology and treatment effects.

Upper limb assistive devices are mainly applied

to the patient's hand, and are used for patients with

resting hand tremor to carry out rehabilitation

training or assisted movement, and to improve the

dexterity and completion of fetching movements,

including finger training inserts, finger extension

trainers, convenient fetchers and training gloves. The

finger training board is equipped with wooden sticks

of different diameters to guide patients to insert the

sticks into the holes precisely, train the flexibility of

finger joints and hand strength control ability, and

improve hand and eye coordination function. The

finger extension trainer includes grip strength ball,

elastic finger sleeve and finger presser to help

patients strengthen grip strength training and finger

flexion and extension rehabilitation in the process of

using the assistive device. The ergonomically

designed gun-shaped convenient fetcher can help

patients reduce tremor interference and provide

convenience for patients to grasp various objects of

different shapes and sizes, soft and hard.

The lower extremity aids mainly focus on the

patient's legs, alleviating gait disorders caused by

slow and rigid movement through intensive pace

training, including laser crutches, walkers, exercise

scooters, lower extremity gait exoskeletons and gait

trainers. For plantar pressure correction, Liu Yan et

al. started a ten-week training with the Lokomat

lower limb robotic gait exercise system in forty

Parkinson's patients, and the treatment confirmed

that rehabilitation training with the lower limb robot

had more significant effects than conventional

rehabilitation training (Liu 2017). The BioMot, a

lower extremity gait exoskeleton, can provide

assistance to patients with gait rehabilitation and

musculoskeletal injuries, and also allows for

seamless interaction and safe movement to

accommodate the user's intent and ability (Bacek

2017). The gait trainer can improve gait movements,

limb coordination and muscle flexibility by training

the patient's lower extremity muscles and nerve

responses to achieve a balanced gait.

ICHIH 2022 - International Conference on Health Big Data and Intelligent Healthcare

26

Table 1: Classification of Parkinson's rehabilitation assistive devices.

Targeted parts Available products for assistive devices

Whole body

Hyperbaric oxygen chamber Parkinson's therapy device Physical data monitor

Upper Extremity

Finger training board Finger extension trainer Handy picker Training gloves

Lower Extremity

Laser crutch Mobility aid Gait trainer Exercise scoote

r

2.2 Analysis of the Advantages and

Disadvantages of Existing

Parkinson's Assistive Devices

The current assistive devices for Parkinson's disease

and their peripheral services are designed to have

significant effects on patients' life assistance,

medical care and functional exercise. In terms of life

assistance, it is close to the patients' daily life, which

can alleviate their impairment of clothing, food,

housing, and transportation, improve their self-care

ability, and improve the quality of life of Parkinson's

patients. In terms of medical care, the product can

effectively monitor the patient's health index and

slow down the spread of the disease through medical

means. In terms of functional training, patients are

guided to use assistive device products for simple

game interaction, physical exercise of local lesion

areas, and enhancement of limb function. However,

the existing design of Parkinson's assistive device in

China remains in the exploration stage, and there are

deficiencies in the detailed aspects.

The prevalence of Parkinson's disease in China is

about 17%, with nearly more than 2 million

Parkinson's patients (Mina 2019). The huge group

base combined with the obvious differences in the

degree of disease staging, onset site, significant

symptoms, and changes in disease among patients,

these problems lead to the difficulty of more refined

functional positioning of Parkinson's assistive device

products for different patients. According to the

above analysis and comparison of existing assistive

device products, it can be found that although the

current assistive device has achieved a simple

division for different parts of the patient's limbs.

However, the assistive device for the whole body is

only limited to the medical aspect and lacks the

function training of the limbs. The assistive devices

for upper and lower extremities only work on the

common areas of the patient's body, such as the

hands and legs, and lack attention to small areas of

the body, such as the shoulders, small arms, knees,

or feet.

Parkinson's disease is comprehensive, complex

and long-term in nature. Existing assistive device

products often only provide superficial and simple

training for conditions such as hand tremor and short

gait. If the patient's tremor amplitude deepens or

decreases during use, or if other parts of the body

other than the hands and legs are added, the single

function cannot meet the complex disease situation

Optimization Strategies for the Design of Rehabilitation Aids for Parkinson’s Patients based on Hierarchical Analysis

27

in real time, and it is difficult to achieve in-depth

and lasting support for the patient's condition and

variations. The existing Parkinson's assistive devices

have certain defects in terms of volume structure and

emotional care, in addition to basic functions. Most

medical care assistive devices such as hyperbaric

chamber, Parkinson's therapy device, gait trainer,

etc. are large and expensive, and their use is limited

to exclusive places such as hospitals and nursing

homes. Considering the individual differences in

patients' different status backgrounds, home living

environments and economic bases, many high-end

assistive device products are difficult to access. The

limitations of the existing Parkinson's assistive

devices in terms of targeted features, use sites,

system services and emotional care are all pressing

issues that need to be addressed in future designs.

3 NEEDS ANALYSIS OF

PARKINSON'S PATIENTS

3.1 Motion Extraction for Parkinson's

Patients

Standardized management of Parkinson's disease

includes standardized clinical diagnosis, disease

severity scores, and treatment decisions. Some

standardized assessment systems such as the Unified

Parkinson's Disease Rating Scale (UPDRS) score

and Hoehn and Yahr (HY) staging provide good

support for the docking of the Parkinson's

rehabilitation assistive devices (Tan 2019).

Parkinson's disease is currently classified by the

Hoehn and Yahr (HY) staging, which is medically

accepted. HY staging is divided into five stages,

where staging <3 is defined as early Parkinson's

disease, staging at 3-4 is defined as mid- to

late-stage Parkinson's disease, and staging at 5 is

defined as late-stage Parkinson's disease (Wang

2017). In the early and middle stages of Parkinson's,

the use of assistive devices can be effective in

improving patients' self-care ability and quality of

life, and the design of interventions should be

considered for the disease and actual needs of

patients at this stage. Based on the Unified

Parkinson's Disease Rating Scale (UPDRS version

3.0), the distribution of muscle pain in Parkinson's

patients in Figure 1 shows that the main lesions are

in the back, arms and hands of the upper extremities,

and the leg muscles of the lower extremities, where

the assistive device can be used for targeted

rehabilitation.

Figure 1: Distribution of muscle pain sites with

Parkinson's patients.

The assessment of the activities of daily living

and mobility check of the scale takes into account

the impact of changes in the onset and degree of

resting tremor and muscle tonus on patients' daily

behavioral movements. Combined with the analysis

of the symptom performance of patients in the early

and middle stages of PD, the key behavioral actions

of patients were extracted to set the reference of

assistive device actions and to make design guidance

for the corresponding functional services of the

Parkinson's rehabilitation assistive device, as shown

in Table 2.

Table 2: Correlation analysis based on stage symptoms of Parkinson's disease and the needs of the patients.

Staging Symptoms Mobility Summary Demands for assistive devices

Stage 1

Tremor with unilateral limb,

myotonia or bradykinesia

without significant functional

impairment or with mild

im

p

airment.

Basic fluency in daily activities.

There is no need for assistive

device intervention.

Stage 2

Resting tremor, myotonia or

bradykinesia extending to both

limbs.

Patients can still maintain normal

posture with mild impact on daily

life.

Assistive device needs exist for

basic actions in daily life, and the

efficiency of actions is improved to

some extent b

y

assistive device.

ICHIH 2022 - International Conference on Health Big Data and Intelligent Healthcare

28

Stage 3

Presence of some degree of

limitation of mobility with mild

or moderate functional

impairment.

There is some impairment in

activities such as getting up,

dressing, walking, tying

shoelaces, and writing. However,

the patient can live independently

without rel

y

in

g

on others.

The need for assistive device is

high for daily life, and the

improvement effect is more

obvious by using assistive devices.

Stage 4

People with more severe tremor,

myotonia, bradykinesia, and

dyskinesia have difficulty taking

care of themselves and require

caregiver assistance for some

b

ehaviors

The impairment in activities such

as getting up, dressing, walking,

tying shoelaces, writing, etc. is

relatively severe, and the patient

can still manage to stand or walk

without support.

The need for assistive devices is

high, and the functions and services

need to be enhanced for mobility

assistance, medical care, and

emotional care for co-occurring

p

sychological problems.

Stage 5

The symptoms of the disease are

so severe that they cannot take

care of themselves and require a

caregiver to accompany them

throu

g

hout their lives.

Unable to stand and confined to

bed or wheelchair without

assistance.

Patients have difficulty operating

the assistive device on their own

and have limited needs.

3.2 User Role Establishment and Its

Requirements

In the context of social medical technology

development and family economic conditions

improvement, more families with Parkinson's

disease are beginning to value the use of assistive

medical products, and can afford more to improve

self-efficacy and quality of life for their patients and

enhance their sense of well-being. Most Parkinson's

patients tend to be senior citizens, with an average

age of onset of about 60 years old. The material and

spiritual life needs of elderly Parkinson's patients are

characterized by their age, diversity, differences,

emotions and stages (Huang 2020). Therefore, the

above characteristics put forward new requirements

for the design of paramedical products, and the

functional focus of the study was extended from a

single improvement in quality of life to helping

patients to exercise themselves to alleviate the

progression of the disease, with a more advanced

goal of achieving patient self-efficacy. In this study,

we selected elderly Parkinson's patients aged 60-75

years old as the target users, collected the impact of

patients' different symptoms on their daily actions

through Kano questionnaire, and summarized the

functional requirements of Parkinson's assistive

devices in order to optimize the experience of using

them, enhance their physical functions and improve

their quality of life. The purpose of the study is to

optimize the experience of using the assistive

device, enhance the physical function of patients and

improve the quality of life. Through the basic

research of Parkinson's patients, the user

representatives were selected to make a typical

target user portrait, see Figure 2.

Figure 2: Typical target user profile

A list of 18 basic functional needs of Parkinson's

patients for assistive devices based on their motor

behaviors such as tremor, bradykinesia or

dyskinesia, and psychological behavioral

characteristics such as depression, anxiety and

dependence, combined with action extraction of

symptom performance and typical target user

portrait analysis. Among them, the material life

perspective includes the basic ability needs of

patients in daily life; the rehabilitation medical

perspective includes the needs of patients' physical

function status and mental health; the

mental-emotional perspective includes patients' own

emotional development and the overall

communication with family and society. Through the

information feedback from the Kano questionnaire,

the scatter diagram of basic functional needs of

Parkinson's rehabilitation assistive devices was

drawn according to the priority level of the 18

functional needs of the patients under investigation,

which were classified as charismatic needs,

expectation needs, undifferentiated needs and

essential needs, as shown in Figure 3

Optimization Strategies for the Design of Rehabilitation Aids for Parkinson’s Patients based on Hierarchical Analysis

29

Figure 3: Scatter diagram of basic functional needs for Parkinson's rehabilitation assistive devices.

Through the user feedback of Parkinson's

assistive device on the Internet, 18 basic functional

requirements were sorted and summarized based on

three levels: physical life, medical rehabilitation, and

spiritual and emotional life, as shown in Figure 4.

Combined with the data from the research

questionnaire, the functional demand points of

Parkinson's assistive devices that appear more

frequently in the user experience and expectation

feedback were summarized.

Figure 4: Summary of functional requirement points for Parkinson's assistive devices

4 HIERARCHICAL ANALYSIS

OF FUNCTIONAL ELEMENTS

OF PARKINSON 'S ASSISTIVE

DEVICES

4.1 Functional Element Hierarchy

Analytic Hierarchy Process (AHP) refers to the

hierarchy of complex decision-making systems,

transforming multi-element decisions into

multi-level single-element problems, and helping to

analyze the weights or priorities among the elements

at different levels (Wang 2021). To address the issue

of the basic functions of rehabilitation assistive

devices for Parkinson's patients, it is necessary to

analyze the structural appearance, operational

processes, functional services, emotional care and

other design elements of rehabilitation assistive

devices, taking into account the different identity

backgrounds, generational relationships, life

socialization, goal preferences, behavioral habits and

health status of patients and other relevant factors.

The demand for rehabilitation assistive device use

by Parkinson's patients is diversified and

differentiated, and there is no obvious demand

hierarchy and structural division of demand

direction yet, so it is suitable to use hierarchical

analysis to summarize and analyze the

interrelationship and importance degree among

different elements.

According to the complex basic need points of

Parkinson's patients, it can be seen that the patients

have high needs for basic life at home in terms of

ICHIH 2022 - International Conference on Health Big Data and Intelligent Healthcare

30

clothing, food, transportation, medical rehabilitation

effects of the disease and emotional spiritual

companionship. To meet these needs, the functional

design of assistive devices should focus on whether

the structure of the product is lightweight,

convenient, easy to operate, and suitable for patients

with mobility impairments to use at home. The

design of assistive devices should also consider

whether the services can meet the needs of patients

to establish contact with their families and

healthcare professionals, whether the efficacy of the

devices can meet the needs of patients to improve

their self-care ability and medical rehabilitation, and

whether they can provide emotional care to patients'

psychological, emotional and attitudinal preferences.

Following a generalization of the above needs

analysis, five basic requirements for Parkinson's

assistive devices to meet the needs were derived:

appearance structure, operation process, service

level, functional effectiveness, and emotional care,

which constitutes the hierarchical analysis model

shown in Figure 5.

Figure 5: Analysis of functional elements of Parkinson's

rehabilitation assistive devices.

The functional aspects include the basic

functions that an assistive device should have for

Parkinson's rehabilitation. According to user analysis

and research, for patients suffering from resting

tremor, myotonia and dyskinesia or bradykinesia,

their basic needs for assistive devices should include

the ability to improve their mobility skills in daily

life, such as dressing, dining, cleaning, walking, etc.,

and to improve their self-care ability. The assistive

device can be used for simple movement training

and scientific medical interventions to improve

physical functions, monitor the feedback of the

disease and alleviate the extent of the disease to a

certain extent. The design of Parkinson's assistive

devices should include diverse functional designs for

patients with different differences, combining

elements such as the user's background, physical

health condition and the environment in which the

product is used, to meet the patient's needs for

self-care and medical rehabilitation in daily life.

The service dimension mainly refers to the

service design of the Parkinson's rehabilitation

assistive devices. The service of the rehabilitation

assistive devices not only includes the service for the

patients themselves, but also needs to consider the

connection between the patients' families,

communities and medical care, and build a

multi-point and related service system. For the

patients themselves, the services of rehabilitation

assistive device products cannot be limited to a

certain stage and a certain problem. The long onset

cycle of Parkinson's disease requires that assistive

device products should extend the time span of

services, deepen the patients' memory of using them,

and strengthen the service effect and user

experience. For the patient's peripheral relationships,

it is necessary to strengthen the connectivity

between each relationship for integrated services.

The Parkinson's rehabilitation assistive device

should be a more "people-oriented" product, and the

product design should incorporate emotional care for

patients. Parkinson's disease is a common

degenerative disease of the nervous system, caused

by lesions in certain functional areas of the brain. If

the lesions in these areas involve functional areas

that control mood and emotion, it will affect the

patient's psychological mood, and its nonmotor

symptoms are mainly manifested in psychological

behavior as depression, anxiety and dependence.

Patients with PD suffer from the disease and are

often in a closed environment due to limited

mobility and lack of communication with the outside

world, and are prone to persistent depression,

difficulty concentrating, lack of interest in life and

work, and other depressive moods. The confusion

and uncertainty about the future and the dependence

on medical staff and family members due to the

inability to take care of themselves are emotional

factors that need to be considered and taken care of

in the design of the Parkinson's rehabilitation

assistive device. The design of rehabilitation

assistive devices can enhance the emotional care of

patients in terms of needs such as fun games, music

videos, emotional de-escalation and color healing.

4.2 Integration of Functional Elements

From the summary of the demand points of

Parkinson's patients, it can be concluded that the

main expectation of users for assistive devices is to

effectively alleviate the degree of their own lesions,

reduce the impact of symptoms such as limb tremors

Optimization Strategies for the Design of Rehabilitation Aids for Parkinson’s Patients based on Hierarchical Analysis

31

and muscle stiffness on behavioral movements,

improve movement flexibility, and restore normal

body posture. Therefore, functional rehabilitation

training is the primary function, and the peripheral

design can be enriched on this basis. In addition, the

target users of assistive devices should target the

elderly Parkinson's group and its surrounding

relationship network, and systematic services

between patients and their families, communities

and medical care should be established. Considering

that the place of use of the product is suitable for

home use, the product can be designed to be more

convenient for carrying and storage. In recent years,

wearable devices are widely used in the medical

field and have an important role in health

monitoring, efficacy measurement, and disease

discovery, etc. Applying them to the medical field

has become a hot topic for medical device

innovation, and the products are gradually applied to

clinical practice (Hu 2018).

At present, there are few independently

developed wearable device products in China, and

they are generally bulky and heavy and not easy to

wear (Chen 2017). However, this could contribute to

the design of assistive devices for Parkinson's

rehabilitation, and the design of assistive devices as

wearable is considered from the perspective of

usage, and the structure of more lightweight and

handy wearable assistive devices is studied. In view

of the psychological and emotional characteristics of

patients, the functions and services should also be

integrated into the corresponding emotional care.

The basic needs of Parkinson's patients for the

rehabilitation assistive devices and the functional

elements that the assistive devices should have are

clarified through the preliminary research, based on

which the logical relationship between the two is

further combined, the integration of functional

elements shown in Figure 6 is carried out to find the

inner connection between patients' needs and the

functional embodiment of the assistive devices, so as

to guide the optimal design of the product.

Figure 6: Integration of functional elements of Parkinson's

assistive devices.

5 OPTIMIZATION STRATEGY

FOR ASSISTIVE DEVICE

DESIGN FOR PARKINSON 'S

REHABILITATION

The design of assistive devices for Parkinson's

rehabilitation requires comprehensive consideration

of the product's structural appearance, functional

services, and user experience. Combining the above

research and analysis results, the design of assistive

devices for Parkinson's rehabilitation can be

optimized at three levels: functional, service, and

emotional. At the functional level, assistive devices

for Parkinson's rehabilitation should be designed to

meet the basic needs of users for self-care, taking

into account the differences in the specific parts of

the patient's body and the degree of the disease. At

the service level, assistive devices for PD should pay

more attention to the systematic connection between

patients and their families, medical and nursing staff

and social relationships, and meet the actual

changing needs of patients with a comprehensive

developmental perspective, and be able to provide

sustainable assistance as the patients' own conditions

change. At the emotional aspect, assistive device

products should include emotional design to give

users respect and care, so that they can feel warmth

and companionship during their use experience.

5.1 Implanting Diverse Linkage Design

The functional dimension of assistive devices for

Parkinson's rehabilitation considers the concept of

inclusion in functional design. Inclusive design

means that designers, product manufacturers, and

suppliers ensure that their products and services

meet the needs of the widest possible audience,

regardless of age, their own abilities, or special

circumstances, so that more people have equal

access to the products. Based on the concept of

inclusive design, the design of training assistive

devices for Parkinson's patients should take more

into account the diverse needs of different patients,

fully consider the individual differences of the

audience, and make targeted designs for the

functions, services and use environment of the

products. The rehabilitation pressure and

psychological conditions of Parkinson's patients

require that the design of assistive devices should

avoid labels such as "sick", "disabled" and "disable".

It is important to put aside narrow assumptions

about patients, to maintain and respect the

self-esteem of the audience as much as possible, to

ICHIH 2022 - International Conference on Health Big Data and Intelligent Healthcare

32

enable patients with different degrees of illness to

feel the corresponding reasonable care, and to meet

the specific needs of patients rather than deepen the

psychological burden of rehabilitation. Patients with

PD have different needs based on their background,

family environment, health care services and

economic level. Therefore, it is necessary to conduct

a comprehensive research on the users, to make a

reasonable and accurate positioning of the product

according to the actual needs, and to meet the

personalized training assistive device needs of the

patients. The focus of the design of assistive devices

for Parkinson's patients can be shifted from large

and expensive specialized medical assistive devices

to compact and universal home portable training

assistive devices with more diverse functions to

strengthen the wide applicability of the products.

Parkinson's patients have reduced independent

living ability due to resting tremor, bradykinesia and

dyskinesia, and many of them need personal

accompaniment to dress and eat, wash and clean,

and even travel. The design of assistive devices for

these patients should take into account the patients'

behavioral needs, be in line with ergonomics, and be

more suitable for the patients' diseased limbs in

terms of structure and function. The wearable

rehabilitative assistive devices are lightweight and

portable, and more flexible in terms of place and

mode of use. This paper proposes a conceptual

drawing and design reference of the product, which

can be used for targeted rehabilitation training from

the past single non-linkage product to multi-point

linkage design for different lesion sites and degrees

of lesions of patients.

Figure 7: Concept diagram of wearable rehabilitation

assistive device for PD.

As shown in Figure 7, the design of wearable

elastic back belt is adopted for the patient's low

back, which is combined with the exoskeleton to

strengthen the support effect and correct the patient's

flexion posture. For the upper limb area, a spring

glove design is adopted to strengthen the resistance

of the small arm and hand muscles. For the lower

limbs, the acupuncture point electrotherapy knee

brace and pace standardizer are designed to

stimulate the muscle strength of the lower limbs and

give the patient standardized pace parameters to

relieve short gait through stride training. Compared

with high-end medical devices, the operation process

setting of assistive devices should be more

simplified to improve the fault tolerance and meet

the needs that patients can achieve independent

training as users. Through scientific and effective

training, the patient can improve the completion of

basic movements required for life, strengthen his or

her self-care ability, and thus obtain a higher sense

of self-efficacy, while reducing the burden of care on

the family and health care personnel.

5.2 Establishing a Systematic Service

Network

The service aspect for designing assistive devices for

Parkinson's rehabilitation should place more

emphasis on systemic and sustainability to improve

the service quality of the product. Systematic design

requires that the users of the product are not only the

users themselves, but also the surrounding

relationships of the users, and establishes a

systematic connection for the user groups involved

in the use and service process of the whole product.

The service design of assistive devices for

Parkinson's training can integrate the functional

characteristics of smart home and the background of

the era of smart IOT to build a service system for

patients and families, communities and hospitals to

care for the rehabilitation process of Parkinson's

patients to provide systematic services and improve

the overall environment for the use of assistive

devices. A cell phone APP can be designed for the

training assistive devices, see Figure 8.

The app can provide sub-functions such as

assistive device operation, data feedback, interactive

training and communication community. Users can

use the rehabilitation assistive device app to learn

how to use the device, learn how to wear it, and

learn how to use it. The user's account is linked to

family members, doctors and caregivers, and the

patient's use of the assistive device is uploaded to the

network in real time. The feedback on the changes in

physical data generated by the use of the assistive

device helps medical and family members to better

grasp the actual situation of the patient and take

corresponding medical and caregiving measures.

The interactive training in the app can improve

patients' training enthusiasm and participation

through a game-like approach, and help patients

improve their physical functions in the training

process. The communication community can set up

patient

associations and physician consultation to

Optimization Strategies for the Design of Rehabilitation Aids for Parkinson’s Patients based on Hierarchical Analysis

33

Figure 8: User-side interface design of assistive device APP for Parkinson's rehabilitation.

strengthen the systematic connection between users

and build a diversified service chain.

The concept of sustainability is applied to the

design of assisttive devices for Parkinson's training,

which is reflected in the product's functional service

focusing on the overall long-term process of the

patient's condition. The Parkinson's syndrome is an

irreversible degenerative disease that cannot be

cured by the current level of medical research. The

assistive devices can be designed to intervene in the

degenerative process of the patient's physical

function, and the products cover different degrees of

degenerative corresponding training functions to

meet the user's continuous auxiliary training needs.

For patients with early stage PD, training assistive

devices can provide simple limb exercises for

unilateral limbs with mild symptoms, improve

muscle flexibility, reduce resting tremor, and delay

muscle stiffness and tonicity. For patients with

middle and advanced Parkinson's disease, we can

provide comprehensive functional training and

assisted living services to improve patients' ability to

take care of themselves and their quality of life on

the basis of continuous muscle exercise. The service

process will be sustainable and the service life of the

assistive device will be extended.

5.3 Deepen the Emotional User

Experience

The special psychological attitude of Parkinson's

patients determines that the design of the relevant

training assistive devices should pay attention to the

user's reflective emotions during the usage, taking

into account the patient's expectation of respect, the

desire for disease relief, the need for companionship

and emotional relief and other instinctive needs. This

instinctive layer of emotion transcends the logical

judgment of thinking and it is reflected in the

appearance of the assistive device product, which

can attract the patient's attention from the shape and

color matching in the first place, thus creating the

impulse to understand and use. Excellent design on

instinctive level emotion can reasonably avoid the

rejection of assistive device products by some

patients with low self-esteem and bigotry.

Training assistive device products for PD need to

consider avoiding the label of "aging", reducing the

use of cold metal and minimalist industrial style in

the design, and adopting more rounded and youthful

design to reduce the emotional stimulation and

psychological pressure of patients for rehabilitation

training and improve the acceptance of the product.

In order to alleviate patients' negative psychology

such as depressed mood and anxiety and depression,

the choice of color of assistive devices can be

combined with the medical concept of color healing

therapy. Scientific studies have shown that warm

colors, such as yellow and orange, can alleviate

depression and pessimism, while cool colors, such as

blue and green, can soothe boredom and anxiety.

Exposing Parkinson's patients to a scientific color

palette in the color selection of assistive devices can

effectively alleviate the psycho-emotional symptoms

of non-motor disorders in Parkinson's patients.

The color matching design of the Parkinson's

rehabilitation assistive device was based on the color

healing method. As shown in Figure 9, for patients

whose psycho-emotional expression of non-motor

symptoms is low and pessimistic, warm colors are

considered as the main color scheme, retaining 20%

of the gray degree joint connection as well as 20%

of the cold color decoration reflecting the

technological sense of the product and enhancing the

conviction of the medical product. For patients

whose psychological mood manifests as boredom

and anxiety, color matching makes cold and warm

contrasts, and on the basis of soothing boredom

through cold colors, warm color decorations are

used to alleviate the excessive mechanization caused

by cold tones bringing psychological pressure to

patients.

ICHIH 2022 - International Conference on Health Big Data and Intelligent Healthcare

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Figure 9: Color matching scheme of assistive devices for

Parkinson's rehabilitation.

Further behaviors are guided by instinctive

emotions. The behavioral level of training of the

assistive device is designed to correlate with the

patient's experience of using the assistive device.

The level of behavior that governs daily behavior

and brain activity is reflected by the experience of

using the assistive device. The design for the

patient's behavioral level should take into account

the efficiency and enjoyment of using the training

assistive device product. Due to the aging of the

patient group with Parkinson's disease and the

special characteristics of action behavior and mental

behavior, the functional design requires the

operation process of assistive device to be simple

and easy to understand, with a simple and clear

command interface and a certain degree of fault

tolerance, so that patients can quickly accumulate

operating experience and enhance the efficiency of

using the product. Games are not only an aid to

conventional rehabilitation, but also an alternative

therapy(Meijer 2017). In the overall use process of

the product, human-computer interaction can be

enhanced through simple games, such as setting

levels and sending simple instructions to guide

patients to complete the corresponding training, and

matching encouraging points and reward exchange

mechanisms. Game-like behavioral design facilitates

the user to have fun and regulate their emotions

while increasing their motivation to use the device.

Through the optimal design of instinctive and

behavioral aspects, we can enhance the meaningful

value of the product and realize the emotionality of

the reflective aspect. Training assistive devices for

Parkinson's patients should fully understand the

users' own psychological aspirations and meet their

diverse emotional needs. Adhering to the

people-oriented principle and creating a design that

truly impresses people can increase patients'

satisfaction with the use, establish a two-way

connection and emotional bond between the user and

the product, establish the centrality of this training

assistive device product, and deepen patients'

awareness and loyalty to the training assistive device

product.

6 CONCLUSIONS

The increasing prevalence of Parkinson's disease and

the diverse treatment needs of a large group of

patients have raised higher requirements for the

corresponding training assistive devices. The

optimal design of training assistive devices for

Parkinson's patients should be based on a thorough

research of the patient population and a

comprehensive understanding of the patient's

background, degree of disease, behavior, family

environment, social relationships, and the medical

treatment received. It should meet the actual needs

of the users and establish a multifaceted connection

of "patient-family-community-medical care" to form

an integrated product service system. It should

analyze the strengths and weaknesses of various

assistive device products in the market, such as life

support, medical care, and functional exercise, and

propose corresponding optimization solutions. The

future design of Parkinson's training assistive

devices should pay more attention to the

inclusiveness and autonomy of the products, so that

each patient can use the training assistive device

equally and with dignity, and enhance the user's

self-care ability. The process of using the product

should place more emphasis on the systemic nature

of the service and the sustainability of the use of

long-term effects. The systemic service should

strengthen multiple connections and enhance the

patient's self-efficacy through long-term

accompanying treatment. The design also needs to

integrate the emotional care for patients, adhere to

the "people-oriented" emotional design. The social

background of PD determines that the training

assistive devices for the patient group have a broad

market development prospect, and we should

actively promote the innovative design of training

assistive devices for PD to provide better services

for more people with the disease, increase the sense

of well-being, and relieve the pressure and burden of

the patient's family and social health care.

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