Stephen Uzor

Investigating the long-term use of exergames in the home with elderly fallers

Rehabilitation has been shown to significantly reduce the risk of falling in older adults. However, low adherence to rehabilitation exercises in the home means that seniors often do not get the therapy that they require. We propose that the use of tailored exergames could encourage adherence to falls rehabilitation in the home, as exergames have proved successful in clinical settings. We describe the results from the first known study to investigate the long-term (12 weeks) use of exergames, designed in close collaboration with elderly users, for falls rehabilitation in the home. Our findings suggest that there is an untapped potential of exergames for home rehabilitation use, as our findings show that there was better adherence to exercise in participants who used the exergames, versus those who used standard care. Finally, we make recommendations for designers, on the design of exergames for the rehabilitation of seniors.

Exploring & designing tools to enhance falls rehabilitation in the home

Falls are the leading cause of accidental injury-related deaths in the elderly; a fall can lead to a loss of independence, and a fear of falling. Rehabilitation programmes involving exercise have proved the most successful way to reduce the risk of falls. However, the limitations of standard care (e.g. booklets) could prevent home users from receiving the full therapeutic benefit that rehabilitation offers. Having consulted users and health experts, we developed games, and visualizations for falls rehabilitation that we believe could potentially overcome the main barriers to effective rehabilitation in the home. In this paper, we describe user studies that we carried out with older adults to evaluate the use of these visual tools versus standard care, both in the laboratory and in the home. Our main findings show that our visualizations and games were able to overcome the major limitations of standard care, and that they were usable and acceptable to the end users.

Capturing the response of players to a location-based game

Location-based games offer opportunities for us to learn more about people’s interactions and feelings towards the environment they are in as well as to understand more about the mental models and locations associated with known environments, e.g. a university campus with its associations of learning. In our study, we wanted to manipulate the activities in a game to take advantage of certain locations in the hope of producing certain emotional reactions. However, it is not enough to simply produce these reactions; one must also have a way of capturing any emotions produced whether these are the ones expected or not. The objective of this paper, therefore, was to trial a new methodology for location-based games that aims at capturing the players’ emotional reactions to the activities in a game whilst in certain locations. In order to test the methodology, we designed a location-based game that can be played on any Bluetooth-enabled mobile phone that has an accelerometer. The game has been designed to interweave with a persons’ normal activity. As a result, there is little distinction between gaming time and non-gaming time.

Developing visualisation software for rehabilitation: Investigating the requirements of patients, therapists and the rehabilitation process

This article describes the ongoing process of engaging with users in the development and evaluation of prototype visualisation software, which aims to assist in the understanding and improvement of appropriate movements during rehabilitation. The value of the process is illustrated in the article with a discussion of the key findings of pre-pilot focus groups with stroke survivors and therapists. The article describes how the design of the visualisation software is being adapted to meet the emerging understanding of the needs of patients and professionals, and of the rehabilitation process.

Time to exercise!: an aide-memoire stroke app for post-stroke arm rehabilitation

A majority of Stroke survivors have an arm impairment (up to 80%), which persists over the long term (>12 months). Physiotherapy experts believe that a rehabilitation Aide-Memoire could help these patients [25]. Hence, we designed, with the input of physiotherapists, Stroke experts and former Stroke patients, the Aide-Memoire Stroke (AIMS) App to help them remember to exercise more frequently. We evaluated its use in a controlled field evaluation on a smartphone, tablet and smartwatch. Since one of the main features of the app is to remind Stroke survivors to exercise we also investigated reminder modalities (i.e., visual, vibrate, audio, speech). One key finding is that Stroke survivors opted for a combination of modalities to remind them to conduct their exercises. Also, Stroke survivors seem to prefer smartphones compared to other mobile devices due to their ease of use, usability, familiarity and being easier to handle with one arm.

Identifying barriers to effective user interaction with rehabilitation tools in the home

This paper presents the results from a user workshop that was undertaken to investigate the relationship between the nature of current home rehabilitation tools and the motivation to exercise. We also present a method of visual feedback which we hope will be an effective tool for informing users regarding important clinical measures associated with their recovery. Older adults over the age of 60 were involved in the study. The findings from the user workshop suggest that the relatively passive nature of current rehabilitation materials is less than ideal for sustaining motivation to exercise. Furthermore, our results suggest that visual feedback and more interactive methods can play an important role in engaging users in home rehabilitation.

The Development and Evaluation of an Interactive System for Age Related Musculoskeletal Rehabilitation in the Home

This paper describes a series of user studies carried out to investigate the usability, significance, and acceptance of two visualization tools designed to improve the quality of, and adherence to home-based exercise programmes for musculoskeletal rehabilitation. The core functionality of these visualization tools enabled the users to observe the optimal way to perform their exercises via a mannequin, and receive feedback on their own movements through the use of body worn sensors. Before full deployment in the home, two user studies were carried out in the laboratory, and then two in the home with seniors who had recently undergone musculoskeletal rehabilitation using a standard care paper based booklet in the home. Our key findings suggest that by using the visualization tools the participants were able to overcome the major limitations of standard care; and that these tools were considered by the users to be useful in encouraging participation in home exercise.

An investigation of user responses to specifically designed activities in a multimodal location based game

Location-based games offer opportunities for us to learn more about what different types of interactions are appropriate in certain settings. In our study we designed several different types of activity (i.e. from standard key presses, to very physical lunges, to speech cues) that required the players to use different modalities in certain locations. Since the players could play the game whenever they wanted over the course of several days and the game space covered a wide area, i.e. the whole of the university campus, we needed a way to capture any of the activities, emotions and interactions whether these were the ones expected or not. The objective of this paper therefore was to investigate whether we could design certain multimodal interactions which would produce certain reactions and capture this using a carefully selected set of capture methods from logs to self report. In order to test the different interactions we designed a location based game that can be played on any Bluetooth enabled mobile phone that has an accelerometer. The game has been designed to interweave with a persons’ normal activity: as a result there is little distinction between gaming time and non-gaming time.

Inclusively designing IDA: effectively communicating falls risk to stakeholders

Although gait/balance analysis methods have proven effective for assessing falls risk (FR), they are mostly confined to the laboratory and rely on expensive specialist equipment. Recent sensor technologies have made it possible to capture FR data accurately; however, no exploration has been done on how to effectively communicate these data to seniors in both healthcare and free-living settings. We describe IDA (Insole Device for Assessment of Falls Risk), comprising a relatively inexpensive insole and prototype application that provides feedback to stakeholders. To explore what level of FR data should best be communicated to different stakeholders, we conducted workshops with 26 seniors and interviewed 7 healthcare workers in the UK. We highlight stakeholder preferences on viewing FR data to foster greater understanding of outcomes and enhance communication between stakeholders. Finally, we identify opportunities for design on enhancing understanding of gait/balance outcomes; these have potential applications in other areas of physical rehabilitation.