Healing Spaces: Feasibility of a Multisensory Experience for Older Adults with Advanced Dementia and their Caregivers

Healing Spaces proposes a new approach to multisensory interventions that show potential in ameliorating the behavioral and psychological symptoms of advanced dementia in older adults. Using smart technology, the project combines both digital and physical components to transform spaces and create unified, curated sensory experiences that provide meaningful context for interaction, and are easy for caregivers to deliver. A usability study was conducted for the Healing Spaces app followed by a feasibility evaluation of the full experience in a memory care facility recruiting caregivers, and residents in advanced stages of dementia. The feasibility evaluation successfully illuminated strengths as well as areas for improvement for the Healing Spaces experience in a memory care setting with older adults with advanced dementia. Caregivers and facility managers expressed interest in continuing to use Healing Spaces with the residents of the facility. Lessons learned about the technical and logistical implementation of Healing Spaces are discussed, as well as future directions for study design and potential therapeutic value of the experience.Comment: PETRA 20: Proceedings of the 13th ACM International Conference on PErvasive Technologies Related to Assistive Environments. June 2020. Article No 24. Pages 1 to

JMIR RESEARCH PROTOCOLS Gotsis et al Original Paper Wellness Partners: Design and Evaluation of a Web-Based Physical Activity Diary with Social Gaming Features for Adults

Background: The United States is currently in an age of obesity and inactivity despite increasing public awareness and scientific knowledge of detrimental long-term health effects of this lifestyle. Behavior-tracking diaries offer an effective strategy for physical activity adherence and weight management. Furthermore, Web-based physical activity diaries can engage meaningful partners in people’s social networks through fun online gaming interactions and generate motivational mechanisms for effective behavioral change and positive health outcomes. Objective: Wellness Partners (WP) is a Web-based intervention in the form of a physical activity diary with social networking and game features. Two versions were designed and developed for the purpose of this study—“Diary ” only and “Diary+Game”. The objectives of this study included pilot testing the research process of this intervention design, implementation, evaluation, and exploring the effectiveness of social gaming features on adult participants ’ physical activity and anthropometric measures. Methods: We conducted a field experiment with randomized crossover design. Assessments occurred at baseline, first follow-up (FU, 5-8 weeks after using one version of WP), and second FU (5-8 weeks of using the other version of WP). In the contro

Skyfarer: Design Case Study of a Mixed Reality Rehabilitation Video Game

Abstract. This paper outlines a design case study for Skyfarer, a mixed reality rehabilitation application developed for upper body exercise of individuals aging with disability. We describe how experience, experiential and participatory design methodologies were combined to develop a game, which was publicly exhibited at IEEE VR and ACM SIGGRAPH, and formally evaluated in a biomechanical study at Rancho Los Amigos National Rehabilitation Center RLANRC. Keywords. Mixed reality, virtual reality, rehabilitation, games, experience design, experiential design, participatory design, spinal cord injury Background Chronic shoulder pain is a common secondary condition in manual wheelchair users with spinal cord injury (SCI) and it affects up to 70% of the population Internal team analysis confirmed that it was difficult to communicate the qualities of a gesture in two dimensions, even with the addition of drawings, since gesture is a four dimensional action. Rehabilitation movements, in particular, require fine motorcontrol adjustments and enhanced body awareness that is affected by the proprioceptive abilities of the individual. Moreover, every patient has a different level of disability and various degrees of upper-body control. Methods. The first step toward design of a gesture-controlled interactive experience is to capture and analyze the expected movements within the context of the application. Both the quantity (e.g., number of repetitions) and the quality (e.g., trajectory, speed) of movements must be inventoried when working from an existing exercise protocol, such as STOMPS. The interaction designer (Lympouridis) and choreographer (Poulos) led this investigation with an extensive analysis of the movement rehabilitation protocol as it was provided to the patients/clients. This allowed the design team to gain insight and define a set of questions for the biomechanists and therapists, such as the range, velocity, and trajectory of each exercise, the position and alignment of the body, and the requirements for optimal performance. The next step was to visualize the expected motion data from optimally and sub-optimally performed movement phrases which were small, simple and complete motion units with a beginning, middle and end Pattern Discovery Workshop & Focus Groups Since the STOMPS home-based clinical trial did not evaluate quality or quantity of movements performed by the participants 1 , the design team wanted to know how patients performed the movements. It was also important to identify compensatory actions, such as leaning and/or twisting of the back or joints. Moreover, in order to transition to a technology-enabled exercise system, the design team needed to observe how users performed the exercises to determine how much "teaching" and "guiding" was required in the interactive feedback system. To this end, Poulos drew on her expertise in movement pedagogy training and organized a pattern discovery workshop. In addition, the team collected data about the user population's prior gaming experiences drawing on the nurse psychologist's (Jordan-Marsh) expertise in promoting adherence. It is important to note that however "good" or "bad" the participants performed the exercises at home, they performed them "good enough" to receive clinical benefits. Methods. We invited a subset of participants (N=7) who had already participated in the STOMPS clinical trial to come to RLANRC, demonstrate the STOMPS protocol exercises, and participate in a focus group discussion about their prior experience with gaming. This half-day study was video recorded. Poulos conducted a pattern discovery workshop in order to assess participant range of motion, somatic awareness, and compensatory movements Outcomes. The pattern discovery workshop revealed that although participants had performed the exercises many times in the past, they did not remember them well enough to show them spontaneously to our team. Thus, the team demonstrated the movements and asked the physical therapists to issue corrections during subsequent participant performance of the exercises. The choreographer observed that participants lacked somatic awareness for key qualitative aspects of the movement, especially speed, smoothness, start and end points. Participants also lacked movement autonomy and self-correction automation, which was mostly visible by observing their overall distractibility and expectation of directions/corrections under supervision. In addition, the range of motion varied a great deal depending on a participant's injury level (paraplegia vs. tetraplegia). Deficits in fine motor skill and manual dexterity was a complicating factor for executing some of the movements that required manipulation of the Bodylastics. Gotsis then asked participants about the types of games they typically played, their motivations for playing, drawbacks of existing games and asked for comment on the appeal of an initial concept for boat/vessel navigation as part of an exercise game. Focus group discussion audio was transcribed and analyzed by the nurse psychologist. Summary. An ideal system design would enable skipping exercises based on player ability and participant-specific calibration. The gaming experience of this group was fairly limited, but they were enthusiastic about adventure games. It is not clear to what extent gameplay experience was due to lack of awareness of game types, phrasing of questions, or anticipated inability to engage in a game because of physical limitations. Current popular casual games (e.g., Angry Birds) were not mentioned. Quality of the graphics was not a criterion, nor was level of violence embedded in play. Participants noted that playing games changed moods, consumed time, and built satisfaction (mastery/achievement). Goals not mentioned included motivating new behaviors, gaining new knowledge, making decisions, or tracking any behaviors (such as exercise), moods, or relationships. Social interaction goals will require extensive exploration before integration into our game. No participant gave any clue that game play (type, duration, etc.) was a topic in health care intakes or interactions. These observations were taken into account as game design evolved. Rapid Prototypin