Assistive technologies for the older people: Physical activity monitoring and fall detection

The advancements in information and communications technologies (ICT) and micro-nano manufacturing lead to innovative developments of smart sensors and intelligent devices as well as related assistive technologies which have been directly contributing to improving the life quality, from early detection of diseases to assisting daily living activities. Physical activity monitoring and fall detection are two specific examples where assistive technologies with the use of smart sensors and intelligent devices may play a key role in enhancing the life quality, especially improving the musculoskeletal health which is an essential aspect of health and wellbeing; and it is more important for the older people. This paper presents and dis-cusses about how sensors and wearable devices, such as accelerometers and mobile phones, may be employed to promote the musculoskeletal health. Assistive technologies and methods for physical activity monitoring and fall detection are discussed, with the focus on the fall detection using mobile phone technology, and assessments of the loading intensity of physical activity in a non-laboratory environment. The possible research directions, challenges and potential collaborations in the areas of assistive technologies and ICT solutions for the older populations are proposed and addressed

Combined use of smartphone and smartband technology in the improvement of lifestyles in the adult population over 65 years: study protocol for a randomized clinical trial (EVIDENT-Age study)

Background The increasing use of smartphones by older adults also increases their potential for improving different aspects of health in this population. Some studies have shown promising results in the improvement of cognitive performance through lifestyle modification. All this may have a broad impact on the quality of life and carrying out daily living activities. The objective of this study is to evaluate the effectiveness of combining the use of smartphone and smartband technology for 3 months with brief counseling on life habits, as opposed to providing counseling only, in increasing physical activity and improving adherence to the Mediterranean diet. Secondary objectives are to assess the effect of the intervention on body composition, quality of life, independence in daily living activities and cognitive performance. Methods This study is a two-arm cluster-randomized trial that will be carried out in urban health centers in Spain. We will recruit 160 people aged between 65 and 80 without cardiovascular disease or cognitive impairment (score in the Mini-mental State Examination ≥24). On a visit to their center, intervention group participants will be instructed to use a smartphone application for a period of 3 months. This application integrates information on physical activity received from a fitness bracelet and self-reported information on the patient’s daily nutritional composition. The primary outcome will be the change in the number of steps measured by accelerometer. Secondary variables will be adherence to the Mediterranean diet, sitting time, body composition, quality of life, independence in daily living activities and cognitive performance. All variables will be measured at baseline and on the assessment visit after 3 months. A telephone follow-up will be carried out at 6 months to collect self-reported data regarding physical activity and adherence to the Mediterranean diet. Discussion Preventive healthy aging programs should include health education with training in nutrition and lifestyles, while stressing the importance of and enhancing physical activity; the inclusion of new technologies can facilitate these goals. The EVIDENT-AGE study will incorporate a simple, accessible intervention with potential implementation in the care of older adults.This study was supported in part by grants funded by the Instituto de Salud Carlos III, Institute of Biomedical Research of Salamanca (IBSAL)-IBY17/00003, and the Spanish Research Network for Preventive Activities and Health Promotion in Primary Care (REDIAPP)-RD16/0007

Liikuntakaavoitus – Physical activity in the context of land use planning

Health benefits gained from physical activity are well acknowledged. A great amount of our daily and recreational physical activities take place outdoors, in the built environment. Yet physical activity has been unrecognized in the Finnish Land Use and Building Act. Research in the field of land use planning combined with physical activity has been carried out in Oulu University since year 2003. From various case studies the team of researchers, including both master and PhD students and conducted by Professor Helka-Liisa Hentilä have accumulated background information on how to create physically activating environments. The information has been gathered to the project web page Liikuntakaavoitus.fi. It includes general recommendations for planning as a checklist, guidance for interactive planning processes, tangible “idea cards” with proposals and instructions for planning certain physically activating environments and both publications on the subject and links to other pages with similar objectives.The focus of the project, since the past three years, has been in informing and educating the target groups; architects and land use planners, policy-makers and officials, association members and citizens interested in improving circumstances of physical activity as well as creating new content and updating the web page. Numerous workshops on the subject have been organized in Turku, Hämeenlinna, Espoo, Oulu to name a few. A shorter, so called breakfast seminar including a healthy morning snack and a brief bulletin has proven to work well in smaller cities and municipalities like Tuusula and Valkeakoski. In addition online distance education has been organized with the use of videoconference technology to give opportunities for residents living in sparsely inhabited areas to participate.Altogether the different kind of educational occasions have reached hundreds of people acting in the field and the frequently updated web page thousands. The greatest challenge of the work has been bringing people from the different fields of operation together, creating genuine interaction and comprehension between them, resulting in solutions perceiving promotion of physically activating environments

Integration of HeartSmart Kids into Clinical Practice: A Quality Improvement Project

Presented to the Faculty of the University of Alaska, Anchorage in partial fulfillment of requirements for the degree of MASTER OF SCIENCE, FAMILY PRACTICE NURSEIn 2009, the Centers for Medicare & Medicaid (CMS), established “Meaningful Use” regulations through an incentive program, as part of the American Recovery and Reinvestment Act of 2009 (Gance-Cleveland, Gilbert, Gilbert, Dandreaux, & Russell, 2014). Meaningful Use (MU) is tied to reimbursement and focuses on how the Electronic Health Record (EHR) is being used (Center for Disease Control and Prevention, 2012). The goal of MU is to transform the use of the EHR from a documentation tool, to a data reservoir which allows for meaningful reviews and interpretations of the quality of care (Gance-Cleveland et al, 2014).Project / Background / Significance / Review of Literature / Problem Overview / Problem Statement / Purpose / Design / Method / Plan Do Study Act (PDSA) / Ethical Considerations / Significance to Nursing / Dissemination / Conclusion

How a Diverse Research Ecosystem Has Generated New Rehabilitation Technologies: Review of NIDILRR’s Rehabilitation Engineering Research Centers

Over 50 million United States citizens (1 in 6 people in the US) have a developmental, acquired, or degenerative disability. The average US citizen can expect to live 20% of his or her life with a disability. Rehabilitation technologies play a major role in improving the quality of life for people with a disability, yet widespread and highly challenging needs remain. Within the US, a major effort aimed at the creation and evaluation of rehabilitation technology has been the Rehabilitation Engineering Research Centers (RERCs) sponsored by the National Institute on Disability, Independent Living, and Rehabilitation Research. As envisioned at their conception by a panel of the National Academy of Science in 1970, these centers were intended to take a “total approach to rehabilitation”, combining medicine, engineering, and related science, to improve the quality of life of individuals with a disability. Here, we review the scope, achievements, and ongoing projects of an unbiased sample of 19 currently active or recently terminated RERCs. Specifically, for each center, we briefly explain the needs it targets, summarize key historical advances, identify emerging innovations, and consider future directions. Our assessment from this review is that the RERC program indeed involves a multidisciplinary approach, with 36 professional fields involved, although 70% of research and development staff are in engineering fields, 23% in clinical fields, and only 7% in basic science fields; significantly, 11% of the professional staff have a disability related to their research. We observe that the RERC program has substantially diversified the scope of its work since the 1970’s, addressing more types of disabilities using more technologies, and, in particular, often now focusing on information technologies. RERC work also now often views users as integrated into an interdependent society through technologies that both people with and without disabilities co-use (such as the internet, wireless communication, and architecture). In addition, RERC research has evolved to view users as able at improving outcomes through learning, exercise, and plasticity (rather than being static), which can be optimally timed. We provide examples of rehabilitation technology innovation produced by the RERCs that illustrate this increasingly diversifying scope and evolving perspective. We conclude by discussing growth opportunities and possible future directions of the RERC program

Evaluating the impact of physical activity apps and wearables: interdisciplinary review

Background: Although many smartphone apps and wearables have been designed to improve physical activity, their rapidly evolving nature and complexity present challenges for evaluating their impact. Traditional methodologies, such as randomized controlled trials (RCTs), can be slow. To keep pace with rapid technological development, evaluations of mobile health technologies must be efficient. Rapid alternative research designs have been proposed, and efficient in-app data collection methods, including in-device sensors and device-generated logs, are available. Along with effectiveness, it is important to measure engagement (ie, users’ interaction and usage behavior) and acceptability (ie, users’ subjective perceptions and experiences) to help explain how and why apps and wearables work. Objectives: This study aimed to (1) explore the extent to which evaluations of physical activity apps and wearables: employ rapid research designs; assess engagement, acceptability, as well as effectiveness; use efficient data collection methods; and (2) describe which dimensions of engagement and acceptability are assessed. Method: An interdisciplinary scoping review using 8 databases from health and computing sciences. Included studies measured physical activity, and evaluated physical activity apps or wearables that provided sensor-based feedback. Results were analyzed using descriptive numerical summaries, chi-square testing, and qualitative thematic analysis. Results: A total of 1829 abstracts were screened, and 858 articles read in full. Of 111 included studies, 61 (55.0%) were published between 2015 and 2017. Most (55.0%, 61/111) were RCTs, and only 2 studies (1.8%) used rapid research designs: 1 single-case design and 1 multiphase optimization strategy. Other research designs included 23 (22.5%) repeated measures designs, 11 (9.9%) nonrandomized group designs, 10 (9.0%) case studies, and 4 (3.6%) observational studies. Less than one-third of the studies (32.0%, 35/111) investigated effectiveness, engagement, and acceptability together. To measure physical activity, most studies (90.1%, 101/111) employed sensors (either in-device [67.6%, 75/111] or external [23.4%, 26/111]). RCTs were more likely to employ external sensors (accelerometers: P=.005). Studies that assessed engagement (52.3%, 58/111) mostly used device-generated logs (91%, 53/58) to measure the frequency, depth, and length of engagement. Studies that assessed acceptability (57.7%, 64/111) most often used questionnaires (64%, 42/64) and/or qualitative methods (53%, 34/64) to explore appreciation, perceived effectiveness and usefulness, satisfaction, intention to continue use, and social acceptability. Some studies (14.4%, 16/111) assessed dimensions more closely related to usability (ie, burden of sensor wear and use, interface complexity, and perceived technical performance). Conclusions: The rapid increase of research into the impact of physical activity apps and wearables means that evaluation guidelines are urgently needed to promote efficiency through the use of rapid research designs, in-device sensors and user-logs to assess effectiveness, engagement, and acceptability. Screening articles was time-consuming because reporting across health and computing sciences lacked standardization. Reporting guidelines are therefore needed to facilitate the synthesis of evidence across disciplines