Konstantin Aal

ICT-based system to predict and prevent falls (iStoppFalls): study protocol for an international multicenter randomized controlled trial

BackgroundFalls are very common, especially in adults aged 65 years and older. Within the current international European Commission’s Seventh Framework Program (FP7) project ‘iStoppFalls’ an Information and Communication Technology (ICT) based system has been developed to regularly assess a person’s risk of falling in their own home and to deliver an individual and tailored home-based exercise and education program for fall prevention. The primary aims of iStoppFalls are to assess the feasibility and acceptability of the intervention program, and its effectiveness to improve balance, muscle strength and quality of life in older people.Methods/DesignThis international, multicenter study is designed as a single-blinded, two-group randomized controlled trial. A total of 160 community-dwelling older people aged 65 years and older will be recruited in Germany (n = 60), Spain (n = 40), and Australia (n = 60) between November 2013 and May 2014. Participants in the intervention group will conduct a 16-week exercise program using the iStoppFalls system through their television set at home. Participants are encouraged to exercise for a total duration of 180 minutes per week. The training program consists of a variety of balance and strength exercises in the form of video games using exergame technology. Educational material about a healthy lifestyle will be provided to each participant. Final reassessments will be conducted after 16 weeks. The assessments include physical and cognitive tests as well as questionnaires assessing health, fear of falling, quality of life and psychosocial determinants. Falls will be followed up for six months by monthly falls calendars.DiscussionWe hypothesize that the regular use of this newly developed ICT-based system for fall prevention at home is feasible for older people. By using the iStoppFalls sensor-based exercise program, older people are expected to improve in balance and strength outcomes. In addition, the exercise training may have a positive impact on quality of life by reducing the risk of falls. Taken together with expected cognitive improvements, the individual approach of the iStoppFalls program may provide an effective model for fall prevention in older people who prefer to exercise at home.Trial registrationAustralian New Zealand Clinical Trials Registry Trial ID: ACTRN12614000096651.International Standard Randomised Controlled Trial Number: ISRCTN15932647.

Come_in@palestine: adapting a german computer club concept to a palestinian refugee camp

Come_IN computer clubs are a well-established approach to foster learning, social networks and integration in German neighborhoods with a high percentage of migrant population. We have transferred this concept to a different part of the world: a Palestinian refugee camp. Similar to the German neighborhoods we deal with, refugee camps are also the result of migration moves; however, in this case - an enforced one. This paper describes the come_IN approach and investigates its adaptation to a Palestinian refugee camp. Obviously it exhibits fundamental cultural, social, and political dissimilarities from the German setting. Refugees living in camps have to deal with a number of local living and subsistence challenges, as well as having to tackle mounting critical issues related to their refugee status. Here we describe the first three years of activities and experiences.

3D Printing with Marginalized Children—An Exploration in a Palestinian Refugee Camp

We work with a multi-national network of computer clubs for families and children called come_IN. In two such clubs (located in Palestinian refugee camps in the West Bank), we worked with children on playful approaches concerning 3D modeling and 3D printing within a five-week, qualitative field study. Based on this study, we report on the achievements as well as on the difficulties of digital fabrication and of “Making” in developmental and educational contexts. The benefits are related to an overarching theme of self-expression where the main focus was on dimensions as playfulness, approachable complexity, individualization, immediacy and physicality and collaboration as well as motivation. The problematic aspects were mostly related to socio-technical limitations concerning the themes of orientation and camera control, the lack of coordination and collaboration features, usability and UX issues as well as the construction and limitations of current 3D printers. Based on those findings, we have derived implications for the design and the appropriation of future systems for digital fabrication with children, especially in developmental/educational settings, such as improvements of their collaboration support or better feedback mechanisms regarding the system status towards the end user.

Computer-Enabled Project Spaces: Connecting with Palestinian Refugees across Camp Boundaries

Come_IN computer clubs are an established approach to support inter-cultural and inter-generational learning in German neighborhoods. We explore the adaptation of the come_IN concept to the Palestinian context as a means to bridge the social and economic divide that has plagued West Bank society for a period of more than six decades. Social exclusion, political conflicts and prolonged military occupation have kept the refugee camps in a perpetual state of marginalization. In this paper we report on our work in Al Amari-- a Palestinian refugee camp adjacent to the city of Ramallah. We examine how the computer club enables the emergence of social ties among residents of the camp and university students acting as tutors. Even though the ties are small-scale and informal, they have the potential to generate new and wider opportunities for exchange that may eventually support more social integration between the camps marginalized population and the wider Palestinian population.

The effect of sensor-based exercise at home on functional performance associated with fall risk in older people - a comparison of two exergame interventions

AbstractBackgroundThere is good evidence that balance challenging exercises can reduce falls in older people. However, older people often find it difficult to incorporate such programs in their daily life. Videogame technology has been proposed to promote enjoyable, balance-challenging exercise. As part of a larger analysis, we compared feasibility and efficacy of two exergame interventions: step-mat-training (SMT) and Microsoft-Kinect® (KIN) exergames.Methods148 community-dwelling people, aged 65+ years participated in two exergame studies in Sydney, Australia (KIN: n = 57, SMT: n = 91). Both interventions were delivered as unsupervised exercise programs in participants’ homes for 16 weeks. Assessment measures included overall physiological fall risk, muscle strength, finger-press reaction time, proprioception, vision, balance and executive functioning.ResultsFor participants allocated to the intervention arms, the median time played each week was 17 min (IQR 32) for KIN and 48 min (IQR 94) for SMT. Compared to the control group, SMT participants improved their fall risk score (p = 0.036), proprioception (p = 0.015), reaction time (p = 0.003), sit-to-stand performance (p = 0.011) and executive functioning (p = 0.001), while KIN participants improved their muscle strength (p = 0.032) and vision (p = 0.010), and showed a trend towards improved fall risk scores (p = 0.057).ConclusionsThe findings suggest that it is feasible for older people to conduct an unsupervised exercise program at home using exergames. Both interventions reduced fall risk and SMT additionally improved specific cognitive functions. However, further refinement of the systems is required to improve adherence and maximise the benefits of exergames to deliver fall prevention programs in older people’s homes.Trial registrationsACTRN12613000671763 (Step Mat Training RCT) ACTRN12614000096651 (MS Kinect RCT)

Exploring user experience and technology acceptance for a fall prevention system: results from a randomized clinical trial and a living lab

BackgroundFalls are common in older adults and can result in serious injuries. Due to demographic changes, falls and related healthcare costs are likely to increase over the next years. Participation and motivation of older adults in fall prevention measures remain a challenge. The iStoppFalls project developed an information and communication technology (ICT)-based system for older adults to use at home in order to reduce common fall risk factors such as impaired balance and muscle weakness. The system aims at increasing older adults’ motivation to participate in ICT-based fall prevention measures. This article reports on usability, user-experience and user-acceptance aspects affecting the use of the iStoppFalls system by older adults.MethodsIn the course of a 16-week international multicenter study, 153 community-dwelling older adults aged 65+ participated in the iStoppFalls randomized controlled trial, of which half used the system in their home to exercise and assess their risk of falling. During the study, 60 participants completed questionnaires regarding the usability, user experience and user acceptance of the iStoppFalls system. Usability was measured with the System Usability Scale (SUS). For user experience the Physical Activity Enjoyment Scale (PACES) was applied. User acceptance was assessed with the Dynamic Acceptance Model for the Re-evaluation of Technologies (DART). To collect more detailed data on usability, user experience and user acceptance, additional qualitative interviews and observations were conducted with participants.ResultsParticipants evaluated the usability of the system with an overall score of 62 (Standard Deviation, SD 15.58) out of 100, which suggests good usability. Most users enjoyed the iStoppFalls games and assessments, as shown by the overall PACES score of 31 (SD 8.03). With a score of 0.87 (SD 0.26), user acceptance results showed that participants accepted the iStoppFalls system for use in their own home. Interview data suggested that certain factors such as motivation, complexity or graphical design were different for gender and age.ConclusionsThe results suggest that the iStoppFalls system has good usability, user experience and user acceptance. It will be important to take these along with factors such as motivation, gender and age into consideration when designing and further developing ICT-based fall prevention systems.

ICT-Based Fall Prevention System for Older Adults: Qualitative Results from a Long-Term Field Study

Falls and their consequences are arguably most important events for transition from independent living to institutional care for older adults. Information and communication technology (ICT)-based support of fall prevention and fall risk assessment under the control of the user has a tremendous potential to, over time, prevent falls and reduce associated harm and costs. Our research uses participative design and a persuasive health approach to allow for seamless integration of an ICT-based fall prevention system into older adults’ everyday life. Based on a 6-month field study with 12 participants, we present qualitative results regarding the system use and provide insights into attitudes and practices of older adults concerning fall prevention and ICT-supported self-management of health. Our study demonstrates how it can lead to positive aspects of embodiment and health literacy through continuous monitoring of personal results, improved technical confidence, and quality of life. Implications are provided for designing similar systems.

Analysis of effects and usage indicators for a ICT-based fall prevention system in community dwelling older adults

Falls are a serious problem in aging societies. A sedentary life style and low levels of physical activity are major factors aggravating older adults’ fall risk. Information and communication technology (ICT)-based fall prevention interventions are a promising approach to counteract the fall risk of this target group. For some time now, fall prevention interventions have put emphasize to video game based solutions, as video games have become more popular and accepted among older adults. Studies show that such ICT-based fall prevention interventions significantly reduce fall risk in older adults. Nevertheless, the population of older adults is fairly heterogeneous, and factors like gender, age, fitness, sociability, and so on may influence the use of such systems. Therefore, the analysis of subgroups is a common procedure to investigate the affects of various factors on the effectiveness of ICT-based systems. Many of these studies analyze the effectiveness of the system with quantitative measures only. However, the effectiveness of ICT-based fall prevention systems always depends on the sustainable system use by the target group. Qualitative analyses is generally the prime selection to identify determining usage indicators for system usage. Therefore, it seems likely that combined quantitative and qualitative investigations will generate detailed information about system effectiveness and relevant usage indicators for respective target groups. Here, we analyze the ICT-based fall prevention system, iStoppFalls, incorporating exergames and a mobility monitor as well, targeting three aims, (1) is the system effective for different subgroups of older adults, (2) what are the factors influencing fall risk reduction in older adults using the system and are there combined effects of exergaming and activity monitoring on fall risk reduction, and (3) which usage indicators explain the usage of such a system by older adults. This paper will provide a better understanding of the effectiveness of ICT-based fall prevention for different subgroups and the indicators that determine the use of such technologies by older adults.

Challenges of CI Initiatives in a Political Unstable Situation - Case Study of a Computer Club in a Refugee Camp

This poster describes the research around computer clubs in Palestinian refugee camps and the various lessons learned during the establishment of this intervention such the importance of the physical infrastructure (e.g. clean room, working hardware), soft technologies (e.g. knowledge transfer through workshops), social infrastructure (e.g. reliable partners in the refugee camp, partner from the university) and social capital (e.g. shared vision and values of all stakeholders). These important insights can be transferred on other interventions in similar unstable environments.

Out of Syria: Mobile Media in Use at the Time of Civil War

ABSTRACT Social media usage during the recent uprisings in Arab countries has gained increasing attention in human–computer interaction research. This study adds to these insights by providing some findings on the use of information and communications technology (ICT), specifically mobile media, by opposition forces and political activists during the Syrian civil war. The presented study is based on 17 interviews with Syrian FSA fighters, activists, and refugees. A first analysis showed evidence for some very specific use patterns during wartime (compared to media usage of political activists under less anomic conditions). The study also describes a fragmented telecom infrastructure in Syria: government-controlled regions offer fairly intact infrastructures while rebel-controlled regions have been cut off from telephone and Internet. Moreover, the central and very critical role of mobile video for documenting, mobilization, and propaganda is discussed.