Under and Over: Measuring experience through a randomised controlled study
The Under and Over activity consists of a plastic board and two shoe laces. The laces can be threaded or woven under and over the board to create different patterns. It was designed by, and for, people with Multiple Sclerosis (MS) as a tool and activity to improve their hand and arm function. MS can, over time, limit a person’s ability to perform activities of daily living, especially activities that require the use of their hands and arms (their upper limbs).
The upper limb is often neglected in management strategies of MS, yet research studies involving people with MS highlight the importance of upper limb function and the significant impact this might have on people who have lost lower limb function. Therefore, it is important to find new ways and rehabilitation strategies aimed to preserve, maintain and or improve upper limb function in people with MS. We explored whether repeated use of the Under & Over tool can improve upper limb function in people with MS.
One group of patients were asked to follow a set programme of patterns for 3 months, whereas another group were invited to create their own patterns using the tool. Although the tool is standardised across different people, it still enables them to convey, capture and communicate their own preferences, subjectivity and physical ability. It becomes a tool to care for their upper limb function, and for themselves.
This project was funded by Roche.
Project links: Website, Publication.
Through making the patterns, the participants are performing their patient experience. These patterns are not pre-existing and are dependent on external factors, so are created in response to the changing MS ensemble which fluctuates and changes daily.
The tool is flexible enough that people can create their own patterns or complete pre-designed patterns in any way they like, and conduct the activity where and when they like.
This project seeks to explore and take seriously external factors, paying close attention to how people with MS manage to complete a standard activity in different conditions.
We worked with The Agency of Design to develop an activity that was both engaging but also usable for people with MS.