3 research outputs found
The design and evaluation of novel technologies for the self monitoring and management of Parkinson's symptoms
PhD ThesisThis thesis explores how digital technologies might better support people with Parkinson’s
(PwP) to take control of their condition, by engaging in self monitoring and management
practices. The specific focus of this thesis is around issues managed by Speech and Language
Therapists (SLTs) (namely drooling and speech and voice changes). Three case studies were
used to explore the ways that different technologies might be configured to aid the self
monitoring and management of these speech and drooling symptoms.
The first case study describes an evaluation of PDCue, a wrist worn device to assist
the self management of drooling through the use of a temporal cueing method, to increase
swallowing frequency. This study showed evidence that drooling can be behaviourally self
managed through cueing—like other symptoms of Parkinson’s such as gait freezing—and
proved a viable first step towards re-considering the use of additional medications as a first
option for drooling treatment. However, whilst this study proved successful in
understanding the ways in which a simple, temporal cueing technique might support
drooling management, it opened up questions around the ways in which PwP might use
technology to actively think about and understand their condition through self monitoring,
and use this information to support self management practices further. In response, the
second case study describes the design and evaluation of LApp, an application to support
both the self monitoring and management of vocal loudness issues through the use of an insitu
cueing approach. The Google Glass was chosen as the platform to run the cueing
method on, due to its technical capabilities as a multi-sensor, wearable platform, to analyse
a constant stream of audio and provide real time visual prompts to support the wearer in
increasing their volume at times when it is needed in conversation. This study highlighted
how participants saw value in LApp in supporting their loudness issues, but also noted a
desire for participants to understand more about their speech and the SLT strategies that
they were required to do in order to improve it. The third case study drew upon this desire
for increased understanding by developing and evaluating Speeching, which employed
crowdsourcing through a smartphone application to support the self monitoring of speech
and voice changes, through the provision of human feedback, and the subsequent effect
that this feedback had on self management practices. This study yielded positive responses
from participants, who valued the anonymous feedback from the crowd and the support
that this provided them in configuring their home based speech practice.
A final discussion chapter draws the 3 case studies together and discusses the
lessons learned throughout the research. It discusses the overall research questions for the
thesis in detail and describes the implications of the research for the wider HCI and medical
communities. A framework is presented which aims to visualise the levels of agency that the
studied technologies afforded and the levels of responsiveness required by participants to
make sense of, and implement the information being provided by the devices in order to
facilitate a change to the self monitoring and management practices. Through the design
and evaluation of the described technologies and a synthesis of the findings across the span
of the research, this thesis explores the ways in which PwP, with a diverse range of
symptoms and related physical, social and emotional issues, might value digital technologies
and their potential to facilitate new forms of self monitoring and self management in their
everyday lives.The National Institute of Health Research (NIHR):
The Engineering and Physical Sciences Research Council (EPSRC):
Gordon Chapman Memorial Fund