Augmenting patient therapies with video game technology

PhD ThesisThere is an increasing body of work showing that video games can be used for more than just entertainment, but can also facilitate positive physical and mental changes. For people suffering debilitating side-effects from illnesses such as stroke, there is need to deliver and monitor effective rehabilitative physical therapies; video game technologies could potentially deliver an effective alternative to traditional rehabilitative physical therapy, and alleviate the need for direct therapist oversight. Most existing research into video game therapies has focussed on the use of offthe- shelf games to augment a patient’s ongoing therapy. There has currently been little progress into how best to design bespoke software capable of integrating with traditional therapy, or how to replicate common therapies and medical measurements in software. This thesis investigates the ability for video games to be applied to stroke rehabilitation, using modern gaming peripherals for input. The work presents a quantitative measurement of motion detection quality afforded by such hardware. An extendible game development framework capable of high quality movement data output is also presented, affording detailed analysis of player responsiveness to a video game delivered therapy for acute stroke. Finally, a system by which therapists can interactively create complex physical movements for their patients to replicate in a video game environment is detailed, enabling bespoke therapies to be developed, and providing the means by which rehabilitative games for stroke can provide an assessment of patient ability similar to that afforded by traditional therapies

Sviluppo e sperimentazione di un ambiente interattivo per il potenziamento della coordinazione visuo-motoria in bambini con ipovisione grave

In una società moderna basata sull'abilità del vedere, la vista gioca un ruolo critico in ogni momento e fase della vita di una persona. Purtroppo, non tutti "vedono" allo stesso modo. Con un team multidisciplinare che comprendeva ingegneri informatici e terapisti della Fondazione Robert Hollman, sono stati progettati e sviluppati una serie di mini giochi digitali esplicitamente rivolti a bambini con problemi di vista e che mirano a migliorare le loro abilità cognitive e/o motorio-sensoriali. Questa tesi analizza i requisiti dei giochi che hanno necessitato di un'attenta e dettagliata progettazione che tenesse conto delle caratteristiche e dei bisogni degli operatori (terapisti) e dei giocatori. Descrive anche i dettagli sull'implementazione di tre giochi. Questi si basano su un large-scale interactive environment e vengono giocati proiettando il campo sul pavimento. Sopra quest'area viene posto un sistema di motion capture che permette di tracciare la posizione dei bambini. I movimenti dei giocatori all'interno del campo vengono usati per farli interagire con gli elementi del gioco, producendo output visivi e uditivi adeguati. Infine, vengono discussi l'usabilità e la funzionalità del sistema tramite l'analisi dei dati raccolti durante uno studio pilota. Quattro terapisti e undici bambini sono stati coinvolti facendo utilizzare loro il sistema in un ambiente appositamente predisposto. I risultati hanno permesso al team di migliorare il prodotto e di definire una serie di linee guida utili a terapisti, progettisti e sviluppatori.In a modern society based on the ability to see, vision plays a critical role in every moment and stage of a person's life. Unfortunately, not everyone "sees" in the same way. With a multidisciplinary team including computer engineers and therapists from the Robert Hollman Foundation, a series of digital mini-games, explicitly aimed at children with visual impairment, were designed and developed with the aim of improving their cognitive and/or motor-sensory skills. This thesis analyses the design requirements of the games, which needed a careful and detailed design that took into account the characteristics and needs of the operators (therapists) and players. It also details the implementation of three games based on a large-scale interactive environment that are played by projecting the field onto the floor. Above this area a motion capture system is placed to track the position of the children. The players' movements within the field are used to make them interact with the game elements, producing appropriate visual and auditory outputs. Finally, the usability and functionality of the system are discussed through the analysis of data collected during a pilot study. Four therapists and eleven children has been involved making them use the system in a specially designed environment. The results allowed the team to improve the final product and to define a set of guidelines useful for designers, developers, and therapists

The Playful Citizen

This edited volume collects current research by academics and practitioners on playful citizen participation through digital media technologies

The Playful Citizen

This edited volume collects current research by academics and practitioners on playful citizen participation through digital media technologies

A Survey of Assistive Technology (AT) Knowledge and Experiences of Healthcare Professionals in the UK and France: Challenges and Opportunities for Workforce Development

Background: Assistive Technologies (AT) in healthcare can increase independence and quality of life for users. Concurrently, new AT devices offer opportunities for individualised care solutions. Nonetheless, AT remains under-utilised and is poorly integrated in practice by healthcare professionals (HCPs). Although occupational therapists (OTs), physiotherapists and speech and language therapists (SLTs) consider that AT solutions can offer problem-solving approaches to personalised care, they have a lesser understanding of application of AT in their practice. In this paper, we report findings of a survey on AT knowledge and experiences of HCPs in UK and France. Training needs also explored in the survey are presented in a separate paper on development of online training for the ADAPT project. Method: A survey of 37 closed/open questions was developed in English and French by a team of healthcare researchers. Content was informed by published surveys and studies. Email invitations were circulated to contacts in Health Trusts in UK and France ADAPT regions and the survey was hosted on an online platform. Knowledge questions addressed AT understanding and views of impact on user’s lives. Experience questions focussed on current practices, prescription, follow-up, abandonment and practice standards. 429 HCPs completed the survey (UK = 167; FR = 262) between June and November 2018. Key results: Participants were mainly female (UK 89.2%; FR 82.8%) and qualified 10+ years (UK 66.5%; FR 62.2%). A key group in both countries were OTs (UK 34.1%; FR 46.6%), with more physiotherapists and SLTs in UK (16.8%, 16.8%; vs. FR 6.5%, 2.3%), and more nurses in France (22.1% Vs. UK 10.8%). More HCPs were qualified to degree level in France (75.2%; UK 48.5%, p < 0.001). In terms of knowledge, all HCPs agreed that AT helps people complete otherwise difficult or impossible tasks (UK 86.2%; FR 94.3%) and that successful AT adoption always depends on support from carers, family and professionals (UK 52.7%; FR 66.2%). There were some notable differences between countries that require further exploration. For example, more French HCPs thought that AT is provided by trial and error (84.7%, UK 45.5%, p < 0.001), while more UK HCPs believed that AT promotes autonomous living (93.4%; FR 42.8%, p < 0.001). Also, more French HCPs considered that AT refers exclusively to technologically advanced electronic devices (71.8%, UK 28.8%, p <0.001). In both countries, top AT prescribers were OTs, physiotherapists and SLTs. Respondents had little/no knowledge in comparing/choosing AT (UK 86.8%; FR 76.7%) and stated they would benefit from interdisciplinary clinical standards (UK 80.8%; FR 77.1%). A third of HCPs did not know if AT users had access to adequate resources/support (UK 34.1%; FR 27.5%) and rated themselves as capable to monitor continued effective use of AT (UK 38.9%; FR 34.8%). Conclusion: Knowledge and application of AT was varied between the two countries due to differences in health care provision and support mechanisms. Survey findings suggest that HCPs recognised the value of AT for users’ improved care, but had low confidence in their ability to choose appropriate AT solutions and monitor continued use, and would welcome AT interdisciplinary clinical standards

Training Needs and Development of Online AT Training for Healthcare Professionals in UK and France

Background: Assistive Technology (AT) solutions for people with disabilities has become part of mainstream care provision. Despite advantages of AT on offer, abandonment and non-compliance are challenges for healthcare professionals (HCPs), introducing this technology to clients. Studies of abandonment reveal that 1/3 of all devices provided to service users end up stored unused. Key need is training to make informed decisions about AT tailored to individual needs and circumstances. In an online survey undertaken by the ADAPT project, HPCs identified AT training needs and barriers. Currently, a programme is being developed aimed at introducing AT concepts and enhancing practices to a wide range of HCPs. Method: Survey questions explored gaps, availability, qualifications and barriers to AT training in England and France. A series of consultation meetings with ADAPT partners took place. An advisory group consisting of longstanding AT users and their formal/informal carers and HCPs (occupational therapist, speech and language therapist, psychologist and biomedical engineer) contributed to the discussions on survey findings, development and evaluation of AT training for HCPs, key content areas and means of delivery. Key results: HCPs had no AT specific qualifications (UK 94.6%; FR 81.3%) nor in-service AT training (UK 65.1%; FR 66.4%). They either did not know of AT courses (UK 63.3%) or knew that none existed (FR 72.5%). Barriers to AT training were mainly local training (UK 62.7%, FR 50%) and funding (UK 62.7%, FR 55.7%). Some training priorities were clearer for French HCPs – overall knowledge of AT devices (82.1%, UK 45.8%), customization of AT (65.3%, UK 30.1%), assessing patient holistically (53.4%, UK 25.3%), educating patient/carers (56.5%, UK 28.3%) (p < 0.001). Variances may be due to differing country-specific HCP education approach. A third of both groups highlighted also abandonment, client follow-up, powered wheelchair training and prescribing AT. To bridge gaps in knowledge and identified training needs of HCPs, the online interactive training programme starts by introducing foundations of AT, including definitions, types/uses of AT, legislation/policies and AT in practice. More specialist units build and expand on specific areas, e.g. AT for mobility, communication, assessment and evidence-based practice. The biopsychosocial model of Health and World Health Organisation’s (WHO) International Classification of Functioning, Disability and Health (ICF) framework underpin development of content. ICF shifts focus from disability to health and functioning, in line with a social model of rehabilitation. E-learning comprises existing videos, AT textbook material and bespoke animated presentations. Selfassessment and evaluation of training are embedded and learners receive certificate of completion. Training was piloted to a group of HCPs trainees and postregistration HCPs who commented on relevance of AT content, clarity, accessibility of presentation, and usefulness. Users found training very useful, especially legislation/policies and AT literature. Conclusion: Overall, survey results suggest that both UK and French HCPs’ training on AT solutions is limited and highly variable. There is need for crosschannel AT professional competencies, availability of work-based training and funding support. Development of online, interactive training aims to increase professional confidence and competence in this area as well as the evidence base for AT

A Literature Review of the Challenges Encountered in the Adoption of Assistive Technology (AT) and Training of Healthcare Professionals

Background: Long-term disabilities often result in loss of autonomy and social interaction. Accordingly, there is a demand for Assistive Technology (AT) devices to enable individuals to live independently for as long as possible. However, many people experience difficulties in obtaining and using AT. This paper presents findings from a narrative literature review undertaken as part of the development of AT training for healthcare professionals, one of the work areas of the ADAPT project (Assistive Devices for Empowering Disabled People through Robotic Technologies), funded by EU INTERREG France (Channel) England. The results of the review informed the design of a survey of healthcare professionals regarding their views and experiences of AT and the development of AT training. Method: The review sought to understand challenges encountered in the adoption and use of AT as well as how training of healthcare professionals in AT takes place. A narrative approach was adopted as the most appropriate way to synthesise published literature on this topic and describe its current state-of-art. Narrative reviews are considered an important educational tool in continuing professional development. An initial search was conducted via databases in the UK and France, including CINAHL, Academic Search Index, Social Sciences Citation Index, BDSP (Base de données en Santé Publique), Documentation EHESP/MSSH (Ecole des Hautes Etudes en Santé Publique/Maison des Sciences Sociales et Handicap), Cairn, Google Scholar and Pubmed. Inclusion criteria for the review included: covering issues relating to AT provision and training, English or French language, and published from 1990 onwards. Application of these criteria elicited 79 sources, including journal papers (48), reports (11), online sources (11), books (6) and conference papers (3). Sources were thematically analysed to draw out key themes. Key results: The majority of papers were from USA and Canada (27), then UK (20) and France (19). Others were from Europe (7), Australia (3), country unknown (2), and one joint UK/France publication. The main source of literature was journal papers (48), of which the most common types were practice reports (18), evaluation surveys (10) and qualitative studies (9). The review uncovered a number of key challenges related to the adoption of devices, including: difficulty defining AT across disciplines, lack of knowledge of healthcare professionals and users, obtrusiveness and stigmatisation AT users can experience when using devices, and shortfalls in communication amongst professional groups and between professionals and users. These issues can lead to abandonment of AT devices. Furthermore, substantial barriers to healthcare professionals exist, including inconsistent provision and quality of training, lack of evaluation of training, lack of resources and funding, shortage of qualified professionals to teach, and the increasingly rapid development of the technologies. Conclusion: Support, training and education for prescribers, distributors, users, and their carers is vital in the adoption and use of AT. Evidence indicates a need for comprehensive education in the AT field, as well as ongoing assessment, updates and evaluation which is embedded in programmes

Research and innovation 2019

Research and innovation are two pillars that come together when universities are at stake. The expansion of the frontiers of human knowledge, in all areas and disciplines, is an irrefutable commitment of higher education institutions. Together with public and private entities, they are also committed to promoting knowledge transfer to society and the economy, in the form of new ideas, new products and new processes. Universities are supposed to transform ideas into value for society. To achieve these goals, higher education institutions have to assure their human resources are highly qualified, that they have an adequate atmosphere, that research is of high quality, and finally that adequate interactions take place. At UMinho we have a clear strategy to be an open and permanent space for knowledge production and furtherance of nationally and internationally relevant innovation across different social and economic sectors. For many years, UMinho has adopted the principles of open access and open science. We aim at carrying out our scientific activity and the dissemination of the corresponding results transparently and collaboratively; this implies that researchers, citizens, policymakers, state agencies, companies, and third sector organizations work in close cooperation facing research and innovation processes. We believe this is the shorter way to trigger smart and sustainable growth and qualified job creation. At UMinho, we encourage the coupling between research and education. Our goal is to expand research opportunities and to give our students occasions to experience vibrant research environments, ensuring that learning goes beyond the “common” routines. Joining research and learning processes provides both undergraduate and postgraduate students with opportunities to own their learning process. We believe that research experience has a role to play in improving students’ motivation for learning, in the pursuit of their interests. Doing better science occurs when we make it both more sensitive to the needs of society and also more efficient in what concerns the allocated resources. It is also a question of accountability. This is fundamental for reinforcing society awareness about our contributions to human and social development. Following the 2018 publication, we present here the 2019 edition of Research and Innovation, a series that draws on the outcomes of the activity of the UMinho research and innovation ecosystem. This comprehensive volume gives particular emphasis to the Research Units outcomes, namely in terms of funding, research projects, papers, and the most important achievements; the activity of the Interface Units and Collaborative Laboratories in which UMinho participates is also reported, through their activities and institutional projects, making evident their importance for the continuous growth of our Institution, our region, and our country. Rui Vieira de Castro RectorPublishe