Fall prevention intervention technologies: A conceptual framework and survey of the state of the art

In recent years, an ever increasing range of technology-based applications have been developed with the goal of assisting in the delivery of more effective and efficient fall prevention interventions. Whilst there have been a number of studies that have surveyed technologies for a particular sub-domain of fall prevention, there is no existing research which surveys the full spectrum of falls prevention interventions and characterises the range of technologies that have augmented this landscape. This study presents a conceptual framework and survey of the state of the art of technology-based fall prevention systems which is derived from a systematic template analysis of studies presented in contemporary research literature. The framework proposes four broad categories of fall prevention intervention system: Pre-fall prevention; Post-fall prevention; Fall injury prevention; Cross-fall prevention. Other categories include, Application type, Technology deployment platform, Information sources, Deployment environment, User interface type, and Collaborative function. After presenting the conceptual framework, a detailed survey of the state of the art is presented as a function of the proposed framework. A number of research challenges emerge as a result of surveying the research literature, which include a need for: new systems that focus on overcoming extrinsic falls risk factors; systems that support the environmental risk assessment process; systems that enable patients and practitioners to develop more collaborative relationships and engage in shared decision making during falls risk assessment and prevention activities. In response to these challenges, recommendations and future research directions are proposed to overcome each respective challenge.The Royal Society, grant Ref: RG13082

Improving personalized elderly care: an approach using cognitive agents to better assist elderly people

Tesis por compendio de publicaciones[ES]El envejecimiento de la población a nivel global es una constante cada vez más presente en el día a día y las consecuencias derivadas de este problema son cada vez más impactantes para el correcto funcionamiento y estructuración de la sociedad. En este contexto, hablamos de consecuencias a nivel de crecimiento económico, estilos de vida (y jubilación), relaciones familiares, recursos disponibles por el gobierno a la franja etaria más anciana e inevitablemente la prevalencia de enfermedades crónicas. Es ante esta realidad que surge la necesidad de desarrollo y promoción de estrategias eficaces en el acompañamiento, prevención y estímulo al envejecimiento activo y saludable de la población para garantizar que las personas ancianas continúen teniendo un papel relevante en la sociedad en lugar de someterse al aislamiento y fácil deterioro de las capacidades físicas, cognitivas, emocionales y sociales. De esta forma, tiene todo el sentido aprovechar todos los desarrollos tecnológicos verificados en los últimos años, principalmente en lo que se refiere a avances en las áreas de dispositivos móviles, inteligencia artificial y sistemas de monitoreo y crear soluciones capaces de brindar apoyo diariamente al recopilar datos e indicadores del estado de salud y, en respuesta, proporcionar diversas acciones personalizadas que motiven la adopción de mejores hábitos de salud y medios para lograr este envejecimiento activo y saludable. El desafío consiste en motivar a esta población a conciliar su día a día con el interés y la voluntad de utilizar aplicaciones y sistemas que brinden este apoyo personalizado. Algunas de las abordajes recientemente explorados en la literatura con este objetivo y que han alcanzado resultados prometedores se basan en la utilización de técnicas de gamificación e incentivo al cumplimiento de desafíos a nivel de salud (como si la persona estuviera jugando un juego) y la utilización de interacciones personalizadas con objetos (ya sean físicos como robots o virtuales como avatares) capaces de brindar feedback más personal, creando así una conexión más cercana entre ambas entidades. El trabajo aquí presentado combina estas ideas y resulta en un enfoque inteligente para la promoción del bienestar de la población anciana a través de un sistema de cuidados de salud personalizado. Este sistema incorpora diversas técnicas de gamificación para la promoción de mejores hábitos y comportamientos, y la utilización de un asistente virtual cognitivo capaz de entender las necesidades e intereses del usuario para posibilitar un feedback e interacción personalizados con el fin de ayudar y motivar al cumplimiento de los diferentes desafíos y objetivos que se identifiquen. El enfoque propuesto fue validado a través de un estudio con 12 usuarios ancianos y se lograron resultados significativos en términos de usabilidad, aceptación y efectos de salud. Específicamente, los resultados obtenidos permiten respaldar la importancia y el efecto positivo de combinar técnicas de gamificación e interacción con un asistente virtual cognitivo que traduzca el progreso del estado de salud del usuario, ya que se lograron mejoras significativas en los resultados de salud después de la intervención. Además, los resultados de usabilidad obtenidos mediante la cumplimentación de un cuestionario de usabilidad confirmaron la buena adhesión a el enfoque presentado. Estos resultados validan la hipótesis de la investigación estudiada en el desarrollo de esta disertación

Serious Games and Mixed Reality Applications for Healthcare

Virtual reality (VR) and augmented reality (AR) have long histories in the healthcare sector, offering the opportunity to develop a wide range of tools and applications aimed at improving the quality of care and efficiency of services for professionals and patients alike. The best-known examples of VR–AR applications in the healthcare domain include surgical planning and medical training by means of simulation technologies. Techniques used in surgical simulation have also been applied to cognitive and motor rehabilitation, pain management, and patient and professional education. Serious games are ones in which the main goal is not entertainment, but a crucial purpose, ranging from the acquisition of knowledge to interactive training.These games are attracting growing attention in healthcare because of their several benefits: motivation, interactivity, adaptation to user competence level, flexibility in time, repeatability, and continuous feedback. Recently, healthcare has also become one of the biggest adopters of mixed reality (MR), which merges real and virtual content to generate novel environments, where physical and digital objects not only coexist, but are also capable of interacting with each other in real time, encompassing both VR and AR applications.This Special Issue aims to gather and publish original scientific contributions exploring opportunities and addressing challenges in both the theoretical and applied aspects of VR–AR and MR applications in healthcare

Augmented Reality App to improve quality of life of people with cognitive and sensory disabilities

In the last decades, number of people affected by cognitive decline is rising significantly. The main cause of this problem is believed to be the overall drift of the average population age. In general, cognitive impairment varies from mild to severe with mild represented as people may begin to notice a slight change in their cognitive functions while still be able to conduct their daily activities without major limitations; on the other hand, severe state of cognitive impairment leads to a progressive loss of comprehensive abilities as well as evaluating situations. These impairments may be represented by losing the ability to talk and write that leads to the inability to conduct an independent lifestyle. The decay of intellectual functions is associated with a progressive increase of sensory impairment (vision and hearing). In this paper we present a tool to help and support people who suffer from both mild age- related cognitive decline and sensory impairment. We developed an augmented reality home-made App designed for smart glasses. This App would be a useful tool to provide more independence to patients during actual daily living activities and it will be able to notify users about a potentially dangerous situations, by providing cues in real time. In this way, elderly people, will be able continue their life at home for a longer time before having the need to move into an assisting living facility

Use of nonintrusive sensor-based information and communication technology for real-world evidence for clinical trials in dementia

Cognitive function is an important end point of treatments in dementia clinical trials. Measuring cognitive function by standardized tests, however, is biased toward highly constrained environments (such as hospitals) in selected samples. Patient-powered real-world evidence using information and communication technology devices, including environmental and wearable sensors, may help to overcome these limitations. This position paper describes current and novel information and communication technology devices and algorithms to monitor behavior and function in people with prodromal and manifest stages of dementia continuously, and discusses clinical, technological, ethical, regulatory, and user-centered requirements for collecting real-world evidence in future randomized controlled trials. Challenges of data safety, quality, and privacy and regulatory requirements need to be addressed by future smart sensor technologies. When these requirements are satisfied, these technologies will provide access to truly user relevant outcomes and broader cohorts of participants than currently sampled in clinical trials

Video Games and Outdoor Physical Activity for the Elderly: Applications of the HybridPLAY Technology

The incorporation of the elderly into digital leisure has been especially driven by the development of games and applications that link the experience of play with beneficial effects for the user. Some of these benefits arise at a cognitive level, fostering intellectual activity of adults through playful experiences that combine audio-visual entertainment with brain training. Seniors are also engaged by active video games that use control interfaces to perform physical actions or activities, encouraging motor play. In this paper, we present the application of HybridPLAY for the elderly, a self-developed technology initially thought to transform playgrounds into scenarios for a set of interactive digital games. In this paper, we show that, although HybridPLAY was initially developed for children and teenagers, the versatile features of this technology make it appropriate also for the elderly. After having tested HybridPLAY with a small group of seniors who completed a usability test and a satisfaction questionnaire, we show that it is possible to combine playful entertainment with physical and mental activities in outdoor environments for the elderly

The Use of digital games to enhance the physical exercise activity of the elderly : a case of Finland

According to the World Health Organization (WHO), population ageing is a global phenomenon, which brings both challenges and opportunities for society. The current longer expected lifespan can create opportunities for the elderly to contribute in many ways to their families and communities. However, it greatly depends on their quality of life, which is affected by many factors, including physical and functional health, social well-being, and cognitive abilities. The WHO (2012) states that physical health is one of the indicators for the elderly’s quality of life, and it declines with increasing age. Participation in regular physical exercises can help the elderly improve their physical and mental health, and this has been aided by the use of modern technologies to promote the elderly’s physical and functional health. Of these latest technologies, digital games have shown promise to improve and enhance the elderly’s physical activities through fun and engaging gameplay. The literature highlights that some commercial games in the market (e.g. Microsoft Kinect- Sports and Nintendo Wii Sports games) have the potential to improve the elderly’s physical health such as gait, balance, and fall prevention. However, researchers argue that these commercial games are not designed specifically for the elderly and their physical exercise activities. They state that most commercial games are not user-friendly for the elderly whose functional and physical abilities are limited due to their advanced years. The literature points out that more studies need to be undertaken to understand the usability and usefulness of digital games for physical exercise activities so that game designers can create elderly-friendly digital games in the future. In Finland, the government has been focusing on promoting healthy ageing and increasing home care services for the elderly. In recent years, Finnish researchers have used digital games to promote older Finns’ healthy and active ageing. The existing literature, whilst showing the potential of digital games for elderly Finns’ physical health, also acknowledges further research is needed particularly in the context of Finland. Thus, in this study, we aimed at investigating digital games to specifically assess their applications for older Finns’ physical activities, focusing on the quality of users’ experiences, and their reported ease of use and perceived usefulness. We used the mixed methods approach, which applies both qualitative and quantitative research methods. The study design included four stages: requirements gathering, analysis and design, prototyping, and evaluation. Firstly, we conducted pre-studies to elicit users’ requirements. This was followed by the analysis of the resulting data to identify trends and patterns, which fuelled ideas in the brainstorming game design and development phases. The final product was a digital game-based physical exercise called the Skiing Game. We then evaluated the Skiing Game in Finland with 21 elderly Finns (M=7, F=14, Average Age =76). By using questionnaires, observation, and interviews, we investigated user experiences, focusing on the game’s usability, and usefulness for enhancing the physical activity and wellbeing of the elderly. We also conducted a comparative test of the Skiing Game in Japan with 24 elderly Japanese participants (M=12, F=12, Average Age = 72) to further understand non-Finnish elderly users’ experiences. The findings from the usability study of the Skiing Game in Finland demonstrated that elderly Finns had a positive experience in the gameplay, and their motivation was noticeably high. It also confirmed that elderly Finns have a genuine interest in digital game-based exercises and strong intentions to play digital games as a form of physical exercise in the future. Although prior to the study most of them had negative views and misconceptions about digital games, after the gameplay their attitudes were decidedly positive. They acknowledged that whilst playing digital games could be an alternative way of exercising for them their use would primarily be when they don’t have access to their usual non-digital physical exercise. The Japanese usability of the Skiing Game showed that the elderly Japanese people also had positive user experiences in playing digital games, and also intend to use them in the future. Similarly, after playing the game they reported that their attitudes towards digital games become positive, and indicated playing digital games could be an alternative way of exercising. Although the comparison of the two studies suggests that the elderly Finns had relatively more positive experiences whilst playing the Skiing Game, compared to their Japanese counterparts, in general, both groups had a positive experience in the gameplay and showed interest in digital games as an alternative exercise. Based on the usability lessons learned from these two studies, recommendations for practitioners and designers regarding improvements in game design and development are made in this report. Implementing these modifications into future designs and further development of digital games for the elderly will improve their commercial viability and user uptake. The findings from this study can provide valuable insights, particularly for Finnish policymakers and healthcare practitioners who are keen to introduce digital games into the aged-care sector in Finland. The studies have also provided valuable insights into the optimal methods for introducing Finnish digital games to international markets, in particular, digital games tailored specifically for the physical exercise needs and motivations of the elderly. By taking into consideration the limitations of the study, we provide our future studies and further improvements of the game to be conducted