Appendix D: Secondary Research

Overview

To begin our research, we started with background information topics mentioned by our client Courtney Celian, an OT at ShirleyRyan AbilityLab: stroke and its effects on the brain and body, and proprioception deficits experienced by stroke patients. For more research topics, we looked to our user and project. We are working with the Shirley Ryan AbilityLab to aid our user Gregory, who is a stroke patient who has proprioception deficits and paralysis on the left side of his body. Based on our user and project, we will also research current solutions for Gregory’s measuring problem while cooking, parallel solutions regarding other assistive technology in the kitchen, and how partial paralysis affects cooking abilities.

Cause and Effects of a Stroke

A stroke occurs when a certain part of the brain is obstructed from receiving oxygen and other nutrients it requires. As a result, brain cells in that area eventually completely die out and function in that part of the brain ceases. The two main causes of stroke are blocked arteries, called ischemic strokes, and burst blood vessels, called ​​hemorrhagic strokes. A stroke can lead to complications such as paralysis, loss of muscle movement, memory loss, and thinking difficulties [8].

As referenced in the project description (Appendix X), stroke also causes a deficit in spatial awareness for many individuals. A decreased ability to judge distance, size, position, rate of movement, and limb position relative to the body makes every day tasks, such as picking up and placing objects, exceedingly difficult.

Figure X illustrates the two main types of stroke, ischemic and hemorrhagic.

Stroke as the Cause for Proprioception Deficits

Harvard Health Publishing defines proprioception as “the ability to sense the position of one’s body in space, in relation to other objects” [9]. Abled individuals have this ability naturally, but when an individual becomes disabled as a result of a stroke, this ability is often lost. The amount of individuals who have experienced a stroke and proprioceptive deficits as a result “has been reported to range between 30 to 48%” [10]. The loss of proprioception makes motor skills increasingly difficult, which “can cause insurmountable problems in the struggle to regain independence” [11]. The loss of this ability can increase the length of the rehabilitation process, and it requires the stroke survivor to rely heavily on a caretaker for assistance with daily tasks. When combined with partial paralysis and limited mobility in the upper extremities, the loss of proprioception becomes even harder to overcome [10]. This often results in a loss of independence in which a caretaker steps in. Specifically in the kitchen, many stroke patients need help from their caregivers to make meals for them, monitor their safety and assist while they make meals, or help set up meal services like Meals on Wheels [13].

Parallel Solutions for Assistive Cooking

There are multiple different assistive devices available for use in the kitchen that were researched.

These include:

• Safe swallowing cups which regulate liquid control, allowing for different speeds of liquid release.

• Adjustable straws for patients with decreased arm function, such that the straw can be a longer length if the person is unable to lift the drink.

• Hand grips that allow the person to hold objects with decreased hand function, such that the object will be connected to the hand through a grip.

• AI cabinet system that uses spoken commands to access objects in the cabinet.

• Drink holder that grips cups placed with an adaptive coaster, allows for easy location of the cups.

• Boiling water aid, a disk that rattles when the water is boiling, indicating the temperature to the person.

None of these parallel solutions quite solve the specific problem outlined by our user and stakeholder. Many of these solutions involve the use of other senses such as sound or touch since visibility is often affected by stroke. Other devices include grips to hold things down, which is useful for stroke patients who have experienced partial paralysis and can only use one hand in the kitchen.

References

[1] “Adapted Drinking Aids,” Accessed on: Sep. 22, 2021. [Online].

Available: https://www.caregiverproducts.com/cups-mugs-straws.html

[2][3] “Adapted Drinking Straws & Holders,” Accessed on: Sep. 22, 2021. [Online].

Available: https://www.caregiverproducts.com/adapted-drinking-straws-holders.html

[4] “Hand Clip Cup and Phone Holder,” Accessed on: Sep. 22, 2021. [Online].

Available: https://www.caregiverproducts.com/hand-clip-cup-and-phone-holder.html

[5] M. Ficocelli and G. Nejat, “The Design of an Interactive Assistant Kitchen System,” Taylor & Francis Online, pp. 246-258, Sep. 27, 2012. Accessed on: Sep. 22, 2021. [Online].

Available: https://www.tandfonline.com/doi/full/10.1080/10400435.2012.659834?scroll=top&needAccess=true

[6] “Stress Less Drink Holder,” Accessed on: Sep. 22, 2021. [Online]. Available: https://edithbishelcenter.org/products/aids.html

[7] “Pot Minder--Prevent Pots from Boiling Over,” Accessed on: Sep. 22, 2021. [Online].

Available: https://vision-forward.org/product/pot-minder/

[8] “Stroke,” Accessed on: Sep. 22, 2021. [Online]. Available: https://www.mayoclinic.org/diseases-conditions/stroke/symptoms-causes/syc-20350113

[9] “Medical Dictionary of Health Terms,” Harvard Health Publishing, Harvard Medical School. Accessed on: Oct. 3, 2021. [Online]. Available: https://www.health.harvard.edu/j-through-p#P-terms

[10] D. Rand, “Proprioception deficits in chronic stroke—Upper extremity function and daily living,” PLoS One, vol. 13, no. 3, Mar. 30, 2018. Accessed on: Oct. 3, 2021. [Online]. Available doi: 10.1371/journal.pone.0195043

[11] D. Smith, A. Akhtar, W. Garraway, “Proprioception and Spatial Neglect After Stroke,” Age and Ageing, vol. 12, no. 1, pp 63–69, Feb. 1, 1983. Accessed on: Oct. 3, 2021. [Online]. Available: https://doi.org/10.1093/ageing/12.1.63

[12] “Understanding Stroke,” Accessed on: Oct. 3, 2021. [Online]. Available:

https://www.ohsu.edu/brain-institute/understanding-stroke

[13] “Let’s Talk About Being a Stroke Family Caregiver,” American Stroke Association, Accessed on: Oct. 3, 2021. [Online]. Available: https://www.stroke.org/-/media/stroke-files/lets-talk-about-stroke/caregivers/lta-the-stroke-family-caregiver-ucm_474396.pdf?la=en