Co-creation of APO: a mixed reality stroke rehabilitation application using a holistic indigenous model of health

PURPOSE: This project explores the use of mixed and augmented reality technologies in the development of a motivating stroke rehabilitation application that supports adherence and that is based on the indigenous Māori health model Te Whare Tapa Whā which incorporates taha tinana (physical health), taha wairua (spiritual health), taha whānau (family health), and taha hinengaro (mental health). METHODS: With expert stakeholder input and Māori design partners, we designed APO: a mixed reality, social, puzzle prototype application using a smartphone and tangible wooden blocks with digital photo overlays. We conducted co-creation sessions with seven people living with stroke who used the prototype and provided feedback. RESULTS: Using reflexive thematic analysis based on both APO and existing rehabilitation practices, we conceptualise three themes: creative pursuits with physical aspects encourage regular paretic limb use, social interactions around shared media represent meaningful connections with friends, family and communities, and, routines of use, particularly through spacing out activities through the week, can help balance participants' feelings of exertion. CONCLUSION: By using the insights from the co-creation study, we then refined the APO design to further support the multi-faceted aspects of rehabilitation and health for people living with stroke.