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Impact case study

Using Interaction Technologies to Help People Tackle the Effects of Stroke and Other Impairments

Unit(s) of assessment: Computer Science and Informatics

School: School of Science and Technology


Health impacts

The Interactive Systems Research Group (ISRG) has developed serious games and related technology for stroke patients to use as part of their rehabilitation. In serious games, education rather than entertainment is the primary goal and here, researchers have developed serious games to help people overcome the effects of a stroke on their upper limbs. The game and related technologies were tested with patients after stroke as part of a feasibility randomised control trial. Results showed that those who used the intervention according to the recommended guidelines experienced a significant increase in their grip strength. One participant reported: "I was able to regain a lot of my manual dexterity in my left hand... the knock on effect to self-esteem and general wellbeing is enormous".

The user experience and involvement in the research is enhanced by the user-sensitive design methods that the group is using at Oak Field School and Sports College, a school for children with disabilities. "The involvement of people with intellectual disabilities in research has improved the quality of outcomes and impact on learners." There has also been a positive impact on the families of students with disabilities: "The impact on self-esteem, expectations and hope has been immeasurable."

Impact on public policy and services

The ISRG was a partner on the EU-funded project AEGIS, which studied the interactions between knowledge, economic growth and social wellbeing. It acted as testing partner for all AEGIS prototypes, extending existing and widely used open standards. The team worked on the web accessibility initiative, which looked at defining ways to make web content and web applications more accessible to people with disabilities.

The group's approach to developing technology changed education practice. "Working with the team at NTU had allowed us to bring about changes in educational and pedagogical practices in school… influenced the adoption of serious games in the school... work on virtual reality, then in its infancy, is now part of everyday teaching… more recently work on robotics is generating a lot of interest amongst teachers and is likely to have a big impact moving forward."

Economic impacts

ISRG's research on the AEGIS project contributed to:

  • the production of accessible open source results to ensure widespread adoption of the software
  • increasing the ability of people with disabilities to be a part of the workforce
  • dramatically reducing the burden on developers to make applications and services accessible.

The ISRG was also a partner on the GOAL project, funded by the EU, which aimed to find solutions to the transport needs of an ageing society. The immediate beneficiaries of the project were two people who got a job as a direct result of using the project's games to develop their employment skills. Adoption of the team's methodologies in user-sensitive design has led to the sustained employment of five people in GHI.

Impacts on society, culture and creativity

The development of user-sensitive design has improved the ability of user groups to make informed decisions by engaging them in the research process. In the GOAL project, it was possible for 1,542 people to be involved in the research as a result of its user-sensitive design.

The team has engaged with a range of people and organisations to help disseminate the research findings, including:

  • Oak Field School's international network of special education schools
  • EU SchoolNet, via a keynote address in 2013
  • Lab talks (including University Minister David Willetts, Sir John Savill Chief Executive of MRC and Professor Eric Thomas, former president of Universities UK).

Impacts on practitioners and professional services

Research into developing serious games to improve the employment skills of people with disabilities has influenced the way practitioners conduct their own vocational training. The team had an impact on 9,862 professionals and 1,542 trainees on the GOAL project. Their work then influenced a further 7,585 professionals and trainees on the EU-funded GOET project. The project was devised to support people with learning disabilities in getting and keeping a job.

Research background

One of the barriers to the adoption of new technologies such as virtual environments, serious games, assistive technologies and robotics is the lack of evidence of their usefulness and accessibility. The ISRG research has attempted to develop products that evidence the positive effects of using such new technologies in educational and clinical settings. To achieve this, the group has focused on user-sensitive inclusive design of new technological interventions, and on evaluating the designs with users and beneficiaries. Studies have demonstrated significant improvements in users' cognitive and physical functioning after repeated use of the intervention.

The team is committed to using open source development in order to reach the largest numbers of people and so help ensure maximum impact.

1996 Demonstrated the potential of using virtual environments with people with intellectual disabilities (ID).

Began working on a user-sensitive design process with people with ID.

1999 First major ESRC award to investigate how human tutors can assist people with ID in using virtual environments.

2001 First major EPSRC award to investigate the design of more appropriate interaction devices for virtual environments for use by people with ID.

2005 Demonstrated the impact of virtual environments on the developmental abilities of people with ID including categorising the help human tutors needed to give these students (ESRC study); their successful use in promoting self-directed activity; in improving choice making and in defining more effective interaction devices.

2006-2012 Nine major EU awards to develop serious games to teach functional and navigational skills to people with disabilities, to change attitudes towards migrant workers and refugees, and to develop and evaluate open source and accessible assistive technologies.

2009 Demonstrated the positive beneficial effect serious games can have on the choice reaction times, decision making, working memory and maths skills of people with ID.

2011 Began to describe how serious games can be combined with location-based systems for route learning applications for people with disabilities.

2011 Showed how popular, pervasive and cheap games controllers can be as effective as established assistive technology devices for use by students with a range of disabilities.

2012 Developed two games-technology-based systems for stroke rehabilitation. These included using Nintendo's Wiimote technology and the Microsoft Kinect Sensor to track hand movements and identify hand gestures. Funded by NIHR and CLAHRC, the first system has been evaluated in a large clinical trial involving 29 patients (18-85 years), with the intervention group using a specifically-designed rehabilitation glove and a series of rehabilitation games developed in XNA to facilitate highly intensive, task-specific upper limb exercises.

2012 Demonstrated, through Framework 7 funding, the effectiveness of user interaction modelling that analyses users' characteristics and does not simply focus on their disability or limitations.

2013 Research showed that engagement of children with profound learning disabilities can be improved using programmable humanoid robots.


  • Final Report to the EU of the GOAL project.
  • Final Report to the EU of the GOET project.
  • Final Report to EU of the RECALL project.
  • Final Report to the EU of the AEGIS project.
  • Testimony from Oak Field School to support claims about research in virtual environments, serious games and robotics for students with learning disabilities, and how it had a major influence on changing their educational and pedagogical practice.
  • Testimony from Social Enterprise GHI to support claims about the contribution to the sustainability of their organisation via the adoption of our participatory design approaches, and on improving the experience of people with disability and those at risk of exclusion by adopting these approaches.
  • Testimony from a person recovering from a stroke who was a participant in the home-based feasibility trial, who explains how participation affected the recovery of their motor skills and self-esteem.

The outputs of this research resulted in numerous invitations for invited papers, talks and keynotes to present the results nationally, and internationally, including:

  • Multidisciplinary approaches to designing and evaluating assistive technologies for use by children. ESRC Assistive Technology seminar series, Kings College London, 22 June, 2010
  • Using games technologies for cognitive and functional rehabilitation. Swedish National Rehabilitation Conference, Keynote Lecture, Gothenburg, Sweden, September 2011
  • Special needs and games: State of the art. European SchoolNet, Brussels, 13 June 2012.

Related Groups and Centres

The ISRG have recently worked with the following partners: