Wheelchair-based game design for older adults

Few leisure activities are accessible to institutionalized older adults using wheelchairs; in consequence, they experience lower levels of perceived health than able-bodied peers. Video games have been shown to be an engaging leisure activity for older adults. In our work, we address the design of wheelchair-accessible motion-based games. We present KINECTWheels, a toolkit designed to integrate wheelchair movements into motion-based games, and Cupcake Heaven, a wheelchair-based video game designed for older adults using wheelchairs. Results of two studies show that KINECTWheels can be applied to make motion-based games wheelchair-accessible, and that wheelchair-based games engage older adults. Through the application of the wheelchair as an enabling technology in play, our work has the potential of encouraging older adults to develop a positive relationship with their wheelchair. Copyright 2013 ACM

Designing wheelchair-based movement games

People using wheelchairs have access to fewer sports and other physically stimulating leisure activities than nondisabled persons, and often lead sedentary lifestyles that negatively influence their health. While motion- based video games have demonstrated great potential of encouraging physical activity among nondisabled players, the accessibility of motion-based games is limited for persons with mobility disabilities, thus also limiting access to the potential health benefits of playing these games. In our work, we address this issue through the design of wheelchair-accessible motion-based game controls. We present KINECTWheels, a toolkit designed to integrate wheelchair movements into motion-based games. Building on the toolkit, we developed Cupcake Heaven, a wheelchair-based video game designed for older adults using wheelchairs, and we created Wheelchair Revolution, a motion-based dance game that is accessible to both persons using wheelchairs and nondisabled players. Evaluation results show that KINECTWheels can be applied to make motion-based games wheelchair-accessible, and that wheelchair-based games engage broad audiences in physically stimulating play. Through the application of the wheelchair as an enabling technology in games, our work has the potential of encouraging players of all ages to develop a positive relationship with their wheelchair

Motion-Based Video Games for Older Adults in Long-Term Care

Older adults in residential care often lead sedentary lifestyles despite physical and cognitive activities being crucial for their well-being. Care facilities face the challenge of encouraging their residents to participate in leisure activities, but as the impact of age-related changes grows, few activities remain accessible. Video games in general – and motion-based games in particular – hold the promise of providing mental, physical and social stimulation for older adults. However, the accessibility of commercially available games for older adults is not considered during the development process. Therefore, many older adults are unable to obtain any of the benefits. In my dissertation, this issue is addressed through the development of motion-based game controls that specifically address the needs of older adults. The first part of this thesis lays the foundation by providing an overview of motion-based game interaction for older adults. The second part demonstrates the general feasibility of motion-based game controls for older adults, develops full-body motion-based and wheelchair-based game controls, and provides guidelines for accessible motion-based game interaction for institutionalized older adults. The third part of this thesis builds on these results and presents two case studies. Motion-based controls are applied and further evaluated in game design projects addressing the special needs of older adults in long-term care, with the first case study focusing on long-term player engagement and the role of volunteers in care homes, and the second case study focusing on connecting older adults and caregivers through play. The results of this dissertation show that motion-based game controls can be designed to be accessible to institutionalized older adults. My work also shows that older adults enjoy engaging with motion-based games, and that such games have the potential of positively influencing them by providing a physically and mentally stimulating leisure activity. Furthermore, results from the case studies reveal the benefits and limitations of computer games in long-term care. Fostering inclusive efforts in game design and ensuring that motion-based video games are accessible to broad audiences is an important step toward allowing all players to obtain the full benefits of games, thereby contributing to the quality of life of diverse audiences

A Cohort Practicum Model: Physical Education Student Teachers' Experience

The Faculty of Education at the University of Alberta has recently moved to a cohort practicum policy that encompasses a reflective practitioner model, encouraging whole-school experiences while maintaining positive one-on-one mentorships. The intent of this case study was to investigate the lived world of 10 physical education student teachers who were placed together in groups of five at two secondary school sites for their final eight-week field experience. Specifically, the benefits of the cohort experience were explored through a continual process of triangulation, employing a variety of data-collecting techniques: observing and recording field notes, conversing, journal-writing, and interviewing. Findings revealed overwhelmingly positive responses to the cohort field experience, as expressed by the participating student teachers and cooperating teachers through the emergent themes: Collegial Support, Multiple Ways of Knowing and Doing, Lifelong Learning, Time to Talk, Whole- School Experiences, and Becoming Critically Reflective. At the two school sites a supportive learning environment that valued trust, openness, and mutual respect allowed professional growth to occur. What began as a mentorship of a student teacher with a cooperating teacher evolved into a collaboration of "experts." Having several student teachers in one department was advantageous in many ways, fostering reflective practice, joint thought, and collaborative action. Insights from this study have implications for the preservice education of physical education teachers and other teacher education programs.La faculté d'éducation de la University of Alberta vient d’adopter une politique sur les stages qui se caractérise par une politique de collaboration, l'inclusion de la réflexion professionnelle et l'appui des expériences tenant compte de l'école dans son intégralité, tout en conservant l’encadrement individuel avec un mentor. Le but de cette étude de cas était d'évaluer le vécu de 10 stagiaires en éducation physique que l'on avait places dans deux écoles secondaires pendant huit semaines (en deux groupes de cinq) pour leurs derniers stages. Plus précisément, on a étudie les avantages de l'expérience collaboratrice par le biais d'un processus continu de validation reposant sur diverses techniques de cueillette de données: I 'observation et la prise de notes en milieu scolaire, la conversation, la tenue d'un journal et l'entrevue. Une très grande proportion des commentaires des stagiaires et des enseignants coopérants sont des plus positifs quant à l'expérience de collaboration. Les résultats peuvent être regroupes selon les thèmes suivants: «l'appui des collègues», «diverses façons de savoir et de faire», «l'apprentissage continu», «temps a la discussion», «des expériences englobant toute l'école» et «la réflexion critique». Les deux écoles ont fournit un encadrement a l'apprentissage qui valorisait la confiance, l'ouverture et le respect mutuel, permettant ainsi l'épanouissement professionnel. L'expérience qui a débute comme un stage dirige par un mentor s'est développée en une collaboration entre «experts». Le fait d'avoir plusieurs stagiaires dans un mime département s'est avère avantageux sur plusieurs plans et a encourage la pratique réfléchie, le partage d'idées et les démarches collaboratrices

Qualitative evaluation of Fit Kids and Exercise Referral staying healthy projects

There is considerable research on the short term effects of physical activity programmes such as exercise referral, but less is know about long term impact. This qualitative review of Exercise Referral and Fit Kids programmes within Lincolnshire uncovers the long term impact of being part of physical activity interventions, the barriers and enablers to participation

Towards a Wearable Wheelchair Monitor: Classification of push style based on inertial sensors at multiple upper limb locations

Measuring manual wheelchair activity by using wearable sensors is becoming increasingly common for rehabilitation and monitoring purposes. Until recently most research has focused on the identification of activities of daily living or on counting the number of strokes. However, how a person pushes their wheelchair - their stroke pattern - is an important descriptor of the wheelchair user's quality of movement. This paper evaluates the capability of inertial sensors located at different upper limb locations plus the wheel of the wheelchair, to classify two types of stroke pattern for manual wheelchairs: semicircle and arc. Data was collected using bespoke inertial sensors with a wheelchair fixed to a treadmill. Classification was completed with a linear SVM algorithm, and classification performance was computed for each sensor location in the upper limb, and then in combination with wheel sensor. For single sensors, forearm location had the highest accuracy (96%) followed by hand (93%) and arm (90%). For combined sensor location with wheel, best accuracy came in combination with forearm. These results set the direction towards a wearable wheelchair monitor that can measure the quality as well as the quantity of movement and which offers multiple on-body locations for increased usability

Community reintegration among Latino stroke survivors: An ecological framework

Purpose: In the United States, stroke is the leading cause of disability. The majority of survivors sustain permanent physical and/or cognitive impairments. Stroke survivors with impairments experience depression, loss of functional independence, and poor quality of life (QOL). Stroke disparities exist among different racial and ethnic groups of the US population. Latinos experience a first time stroke at a younger age compared to non-Latino Whites. As a result, Latinos live with impairments for a greater number of years. The vast majority of stroke survivors return to live in their communities. Reintegrating into home and social activities is key to survivors’ perceived QOL. This dissertation project sought to understand from an ecological framework the post-stroke community reintegration experiences of Latino older adults in an urban New York City neighborhood. The study also sought to examine the viewpoints of health and social service providers, whose opinions, actions, and programs can support stroke survivors’ reintegration into community. Methods: Qualitative in-depth interviews were conducted with 30 Latino stroke survivors 50 years of age and older who had experienced a disabling stroke within 36 months. In addition, 20 health and social service providers based in a large medical center, and multiple senior centers in the northern Manhattan section of New York City were interviewed. The stroke survivor data was analyzed using a phenomenological approach. A thematic analysis approach was used to analyze the data from the health and social service informants. Data analysis identified physical, psychological, social, and environmental factors pertinent to stroke survivors’ community integration experiences. These identified factors were categorized into macro-, exo-, meso-, and micro-levels to capture the psycho, social, and environmental ecology in which community reintegration takes place for Latino stroke survivors. Results: Qualitative accounts of survivors revealed several microsystem factors, including a struggle to maintain a positive self-concept and to engage in activities associated with valued identities and roles, while simultaneously suffering chronic pain, fatigue, and functional limitations. Changes in their affect lead survivors to socially isolate themselves. In addition, they relied more on women than men for social support, a salient mesosystem factor. Survivors encountered significant exosystem level barriers in the environment that limited their ability to travel and access activities. For some, these barriers inadvertently left survivors homebound. Survivors also encountered a societal culture, a macrosystem factor, which stigmatized them due to their impairments. Interviews with health and social service professionals revealed various factors that influenced community reintegration of people with stroke. At the macrosystem level, funding for programs and healthcare financing dictated services and eligibility criteria. In the exosystem, a segmented medical model of care postponed the conversation on community integration. Professional practices, organizational level constraints and culture were mesosystem level factors that influenced community reintegration. The confluence of these factors created an ecological system that influenced stroke survivors’ opportunities to socially engage in their home and community life. Conclusion: An ecological approach provides a useful framework to understand the complexity and potential interplay of factors that contribute to community integration post-stroke for Latino older adults in an urban area

Perspectives, Winter/Spring 2021, Volume 9, Number 1

https://nsuworks.nova.edu/hpd_hcs_magazine/1017/thumbnail.jp

The role of exercise in negotiating an identity as disabled: A qualitative exploration of the experiences of individuals with multiple sclerosis

BACKGROUND: Multiple sclerosis (MS) is a chronic condition resulting in a wide range of physical, cognitive and affective impairments that can either fluctuate, or remain and worsen depending upon the disease course. The episodic nature of symptoms in relapsing-remitting MS (RRMS) results in an in-between or liminal embodiment; situated in-between sick and well states, ‘able-bodied’ and disabled. Because of this, MS has a tenuous relationship to the field of Disability Studies and mainstream disability activism. Furthermore, the recent surge in research on the impact of exercise/physical activity (PA) participation on symptoms and quality of life among those with MS has shifted exercise and PA promotion to individuals with MS in ways that reinforce ableist ideas about the human body (e.g. for managing or minimizing impairment/disability). This increasingly medicalized version of exercise promotion can cause increased guilt over inactivity, and result in constrained views of PA that may be compounded by the uncertain nature of having MS and negotiating a disabled identity. Thus, it is important to further explore the relationship between MS, exercise and Disability Studies. PURPOSE: This dissertation explores the myriad and contradictory ways that individuals with MS perceive exercise and physical activity as part of their self-care, as well as the ways that exercise and physical activity are used to negotiate an identity as disabled. METHODS: The aims of the current analysis are to explore the roles of exercise and physical activity in their MS management and prevention of disability. I use Interpretive Phenomenological Analysis (IPA) to analyze interviews from two previously conducted qualitative research projects related to exercise and MS. The first (RELAPSE) is an exploration of the experiences and concerns related to physical activity of individuals with MS following a relapse. The second study (PEMS) is a photoelicitation project focusing on the people, places, and things that influence physical activity behavior among adults with MS. RESULTS: I identify eight themes relevant to my original research questions which are organized into three categories: Exercise, Identity, and Disability. The Exercise category describes orientations to exercise as a disciplinary activity, as promoting self-transformation and social engagement, and as medicine for managing MS and for self-care. The Identity category describes notions of fractured self-concept across a multitude of dualisms, as well as the ambiguity of embodied experiences relative to health and disability. The Disability category explores experiences with and perspectives of ableism, the use of assistive devices, and the development of a disability identity. Overall, participants describe many different roles that exercise occupies for them, as well as different orientations and motivations for engaging in exercise. This contributes to a fractured self-concept across a variety of continuums, including mind/body, old self/new self, MS self/true self, and healthy/unhealthy. The relationship between exercise and disability identity was also complex and contradictory, including using exercise to push away from or reject a disability identity and minimize visible impairment; or using exercise to recognize ableism, structural disablism, and develop a political disability identity; and using exercise to adapt to and prepare for situations inhospitable to disabled individuals. CONCLUSIONS: Contextualizing these results within the Social Relational Model of Disability, exercise is used by individuals with MS to manage impairment in positive ways but contributes to psychoemotional disablism by reinforcing compulsory ablebodiedness. Because of the uncertain and liminal characteristics of MS, exercise seems to occupy several contradictory roles that both challenge compulsory ablebodiedness and reify it. Therefore, this study supports the need for addressing problematic aspects of exercise promotion paradigms that contribute to compulsory ablebodiedness while preserving and building on positive benefits of exercise. I propose an alternative exercise promotion paradigm where emphasis shifts from exercise as discipline towards exercise as a resource. Some may wish to use exercise as a resource to navigate and alleviate aspects of their disability and impairment, while others who are working towards affirming their descriptive disability could participate in exercise for reasons other than to change their embodiment. This paradigm has implications for other chronic disease and disability populations

Inclusive adventure by design: The development of opportunities in outdoor sport for disabled people through co-ordinated people centred research and development in design and coaching

This thesis was submitted for the degree of Doctor of Philosophy and awarded by Brunel University.Structured to help readers from a range of disciplines, the thesis looks at the creation of opportunities for participation in adventure sport, specifically the development of a postural support for intermediate level performers with spinal cord injury in sea kayaking. The research has shown that it is possible to increase the performance level of disabled athletes in paddle sport through the development of appropriate adaptive equipment, which in turn promotes inclusion and the broadening of opportunities. This research project takes place against a backdrop of national events and developments; notably, changes in UK legislation to do with disability access (DDA 1995), and developments in legislation to do with outdoor safety. The research also takes place against a backdrop of national campaigns, such as the ‘Campaign for Adventure’, and an increasing number of drives to make the UK’s population more active. The broad-based multidisciplinary approach is in line with reported priorities in international disability sport research, while encompassing paddlesport specific criteria. The research takes the approach of design research to develop the product. Initially the reported studies evaluate the design process utilising desk-based research. They then proceed to utilise design methodology in field-based short and longer expedition settings. The design process utilises existing user-centred staged design approaches to explore methods for wider application. The findings reveal that the development of opportunities in adventure sport with disabled people involves engaging with a social mess. The action of problem definition and resolution can be termed in this paradigm as a wicked problem, being that is does not have one clear solution. The information needing to be exchanged in the problem resolution can be considered as sticky, being that the research process takes place in a specialised arena characterised by sparse resources and with a multidisciplinary team. The research has informed the creation of twelve tools to support those practitioners involved in this area. Used from the bottom up or top down, they provide a common language between the participant, coach, therapist and researcher to help educate and inspire each person to understand the true nature of the problem, improve the shared understanding within the team, and thereby reducing the stickiness of the information. The effect on the development of new equipment is to improve focus and user participation, so making it easier to work within the social mess. A new postural support was designed for use by intermediate level sea kayakers with spinal cord injury, the design of which is given in study 9, which is evaluated in study 10. The study suggests that future work in this area should focus on the coordination of sport science support, further exploration of the link between design research and social change, explore the validity of the tools across a broader population, and further develop the design so that the new equipment can be of benefit to the broader population