60
J. Tao and S. Yu
5.1 Introduction
With the advent of aging society, China is suffering form the high incidence, mortality
and disability rates of stroke. The population over 40 years old in China who have
suffered from and have suffered from stroke is estimated to be 12.42 million and
70% of the survivors of stroke have different degrees of disability (Wang et al.
2019). Stroke and disability caused by stroke are the major contributors to “poverty
due to illness” in China.
Modern rehabilitation theories and practice have proved that rehabilitation training
can alleviate functional disability of patients, accelerate the rehabilitation process of
stroke, reduce potential nursing costs, and save social resources (Ostwald et al. 2008).
Despite of the government’s efforts on developing the nation-wide rehabilitation
delivery system, China is still struggling with the conflicts between limited resource
provision and the huge demands of rehabilitation. According to the National Survey
on Resources of Rehabilitative Medicine in 2009, there was a personnel gap of
15,000 rehabilitative specialists and 28,000 therapists based on the requirements of
personnel quota listed in the Guide on Establishing and Managing Rehabilitative
Units in General Hospitals (Chinese Association of Rehabilitation Medicine 2009).
In terms of treatment method, therapists carry out most rehabilitation treatments
manually. Therefore, therapists are often overworking and it is difficult to ensure the
recommended amount and consistent quality of rehabilitation training.
Exoskeletons are basically wearable machines providing power and/or structural
supports to human body. Given the nature of rehabilitation exoskeleton being a kind of
advanced robotic technology, it has the advantages of automation, programmability,
controllability and accuracy. Studies showed that the exoskeleton-based rehabilitation is a promising alternative to conventional manual therapy for improving motor
function of stroke patients (Norouzi-Gheidari et al. 2012), because the device is
designed to have multi-DOF to mimic various limb movements to accommodate all
types of exercises (Rahman et al. 2015). It is also suggested that exoskeletons can be
a potential solution to high quality rehabilitation training and a possible replacement
(or supplement) of therapists. Given the huge patient population and the increasing
desire for better life quality, there is huge potential for rehabilitative exoskeleton to
prevail in China. However, currently there are very few rehabilitative exoskeletons
certified for medical use and most of them are too expensive to popularize in China.
Given the encouraging policy of domestication of advanced medical devices and
technologies as well as the emergence of a Blue Sea market, rehabilitative exoskeleton
has been drawing attentions and interests of Chinese high-tech companies, universities, and research institutions [e.g. Chen et al. (2019, 2018), Zhang et al. (2019)].
However, aside from the design of rehabilitative exoskeleton hardware and software,
which is the focus of most studies in this era, the service design is also critical
if rehabilitative exoskeletons are to realize the declared social-economic benefits.
Service design may provide solutions to wider and fairer access to exoskeleton,
better affordability and satisfaction of exoskeleton-based treatments, while create
J. Tao and S. Yu
5.1 Introduction
With the advent of aging society, China is suffering form the high incidence, mortality
and disability rates of stroke. The population over 40 years old in China who have
suffered from and have suffered from stroke is estimated to be 12.42 million and
70% of the survivors of stroke have different degrees of disability (Wang et al.
2019). Stroke and disability caused by stroke are the major contributors to “poverty
due to illness” in China.
Modern rehabilitation theories and practice have proved that rehabilitation training
can alleviate functional disability of patients, accelerate the rehabilitation process of
stroke, reduce potential nursing costs, and save social resources (Ostwald et al. 2008).
Despite of the government’s efforts on developing the nation-wide rehabilitation
delivery system, China is still struggling with the conflicts between limited resource
provision and the huge demands of rehabilitation. According to the National Survey
on Resources of Rehabilitative Medicine in 2009, there was a personnel gap of
15,000 rehabilitative specialists and 28,000 therapists based on the requirements of
personnel quota listed in the Guide on Establishing and Managing Rehabilitative
Units in General Hospitals (Chinese Association of Rehabilitation Medicine 2009).
In terms of treatment method, therapists carry out most rehabilitation treatments
manually. Therefore, therapists are often overworking and it is difficult to ensure the
recommended amount and consistent quality of rehabilitation training.
Exoskeletons are basically wearable machines providing power and/or structural
supports to human body. Given the nature of rehabilitation exoskeleton being a kind of
advanced robotic technology, it has the advantages of automation, programmability,
controllability and accuracy. Studies showed that the exoskeleton-based rehabilitation is a promising alternative to conventional manual therapy for improving motor
function of stroke patients (Norouzi-Gheidari et al. 2012), because the device is
designed to have multi-DOF to mimic various limb movements to accommodate all
types of exercises (Rahman et al. 2015). It is also suggested that exoskeletons can be
a potential solution to high quality rehabilitation training and a possible replacement
(or supplement) of therapists. Given the huge patient population and the increasing
desire for better life quality, there is huge potential for rehabilitative exoskeleton to
prevail in China. However, currently there are very few rehabilitative exoskeletons
certified for medical use and most of them are too expensive to popularize in China.
Given the encouraging policy of domestication of advanced medical devices and
technologies as well as the emergence of a Blue Sea market, rehabilitative exoskeleton
has been drawing attentions and interests of Chinese high-tech companies, universities, and research institutions [e.g. Chen et al. (2019, 2018), Zhang et al. (2019)].
However, aside from the design of rehabilitative exoskeleton hardware and software,
which is the focus of most studies in this era, the service design is also critical
if rehabilitative exoskeletons are to realize the declared social-economic benefits.
Service design may provide solutions to wider and fairer access to exoskeleton,
better affordability and satisfaction of exoskeleton-based treatments, while create