A serious game for COPD patients to perform physiotherapeutic exercises

The goal of this research was 1) to investigate the usability of the Orange Submarine game, and 2) to explore the changes in saturation and pulse rate in COPD patients while playing the game. The game was positively received by the patients and could provide a new fun way for performing exercises, either at home or as part of the regular treatment

Telemedicine provides new treatment possibilities in COPD care

Chronic Obstructive Pulmonary Disease (COPD) is a chronic, progressive lung disease. COPD has a high impact on quality of life, large social consequences, a progressive course and it cannot be cured. Physiotherapy, increasing physical participation in daily activities, and early detection and treatment of exacerbations are important elements in current COPD disease management. Home-exercise programmes and self-management of exacerbations are effective new treatment methods. When these programmes are offered as a telemedicine application, they could contribute to a reduction in labour and costs. This paper describes a number of telemedicine applications designed for implementation in COPD care: 1) remote monitoring of physical activity and symptoms; 2) coaching and feedback in daily life to gain an active lifestyle; 3) a web portal for online exercising, self-management of exacerbations and communication between professionals and patient and; 4) serious gaming. For each application we share the motivation, design, and (future) evaluations with the target group: COPD patients. The designed applications are in general positively received by patients and professionals and seem to be able to improve the patient’s well-being. Further development and further scaling of these technologies in everyday care would be an important next step

Relating physical activity, pleasure, and daily satisfaction of older adults: a pilot study

Backround:\ud Literature has shown the potential of physical exercise in promoting well-being in the older population. However, the relation between everyday physical activity (PA) and positive emotions is still unknown.\ud \ud Objective:\ud Analyze the relation between physical activity and positive emotions in the daily living of the 65+ population.\ud \ud Methods:\ud • 5 participants (67.4±2.19 yrs) monitored during 29±3 days\ud • Objective measurements: PA assessed with 3D accelerometer counting average IMA/min\ud • Subjective measurements: Positive emotional factors (pleasure and daily satisfaction) assessed on smartphone (Figure 1). Pleasure assessed by experience sampling (ES).\ud \ud Results:\ud • ES-level analysis: negative correlation between pleasure and PA (rsall_sub=-.102*). Correlation within subject ranges from rsmax=.038 to rsmin-0.235*. (Fig. 2). Significant negative correlation between PA and hour of day (rsall_sub=-.215*; rsmax=-0.135; -0.345*) (Fig. 3);\ud • Day-level analysis: average PA is not significantly related to pleasure or daily satisfaction.\ud \ud Conclusion:\ud Daily level of PA is not correlated with the two positive emotional factors chosen in our sample. We suggest analyze of other elements of daily living (e.g. location) as mediators when analyzing relation between PA and positive emotions within individuals. Interventions for promotion of physical activity based on positive emotions must be personalized

Embodied Conversational Agents in eHealth:How Facial and Textual Expressions of Positive and Neutral Emotions Influence Perceptions of Mutual Understanding

Embodied conversational agents (ECAs) could engage users in eHealth by building mutual understanding (i.e. rapport) via emotional expressions. We compared an ECA’s emotions expressed in text with an ECA’s emotions in facial expressions on users’ perceptions of rapport. We used a 2×2 design, combining a happy or neutral facial expression with a happy or neutral textual expression. Sixty-three participants (mean, 48±22 years) had a dialogue with an ECA on healthy living and rated multiple rapport items. Results show that participants’ perceived rapport for an ECA with a happy facial expression and neutral textual expression and an ECA with a neutral facial expression and happy textual expression was significantly higher than the neutral value of the rapport scale (⁠P=0.049 and P=0.008⁠, respectively). Furthermore, results show no significant difference in overall rapport between the conditions (⁠P=0.062⁠), but a happy textual expression for an ECA with a neutral facial expression shows higher ratings of the individual rapport items helpfulness (⁠P=0.019⁠) and enjoyableness (⁠P=0.028⁠). Future research should investigate users’ rapport towards an ECA with different emotions in long-term interaction and how a user’s age and personality and an ECA’s animations affect rapport building. Optimizing rapport building between a user and an ECA could contribute to achieving long-term interaction with eHealth

Increasing motivation in eHealth through gamification

ICT solutions can help to alleviate the increasing demand for elderly care by e.g. enabling medical professionals to remotely provide care, and activating a healthier lifestyle which extends autonomy and independence of elderly [1].\ud We present an overview providing insights in current motivational approaches, addressing underlying theory from psychology, behavioural science and game design. In order to create sustained engagement, we should aim to address the intrinsic motivation of users and satisfy their psychological needs [6]. However, psychological and motivational aspects cannot be generically applied to individuals, and classifications of the user and its preferences are needed. Preliminary results indicate a link between personality and the preference for certain game elements

Time-related feedback messages for changing activity behaviour of patients with COPD

Background: The promotion of physical activity in daily life is an important aspect in the treatment of COPD patients [1]. We developed a telemedicine application – the Activity Coach – that aims to increase activity levels and to balance activities over the day. Activity levels are measured using a triaxial accelerometer, and time-related feedback text messages are provided on a smartphone. The objective of this study was to investigate how COPD patients responded to the feedback messages on a short-term notice. Conclusions: COPD patients significantly change their activity level on a short-term notice in response to time-related feedback messages provided on a smartphone. Ambulant feedback messages might therefore be a valuable component of telemedicine interventions that aim to improve activity behaviour of COPD patients

Online gaming and training platform against frailty in elderly people

Frailty, a condition associated with functional decline caused by insufficient mental stimulation, physical activity and healthy nutrition (Gomez et al., 2013), is a common occurrence among older adults. To counter this effect and decrease the risks for disability, dementia and hospitalisation, we developed a community-based service supported by technology called PERSSILAA (PERsonalised ICT Supported Services for Independent Living and Active Ageing). People who can particularly benefit from such a self-management service platform are in a so-called pre-frail state; declining but not yet in need of professional care. Since becoming frail is often going unnoticed by the person itself, the service starts with a screening process to identify the older adults with functional decline. They are offered a monitoring and training program that supports them in maintaining or improving on the three abovementioned dimensions of daily functioning. In addition, subjects with proper levels of functioning are also encouraged to use the service since by training in the different modules vulnerability for age related health decline can be prevented. To realise indispensable long-term engagement of the user to the service, an online gaming platform has been developed. Its user experience design relies on our previous research outcomes on gaming, gamification strategies and player motivation for the older adult (De Vette et al., 2015) to match the various preferences, abilities and prior game experience of this target group as well as possible. The game serves as an alternative interface to the standard way of exercising by providing access to the other modules from within the game environment. In the game, the player is an adventurer that is shipwrecked on an unknown island in a storm. A meaningful and motivating experience is created by reflecting the user’s performance on the training modules in the progression of the game. For example, every next level is opened after passing a predefined threshold of performance on the PERSSILAA services. Both in the Netherlands and in Italy, end-users have been involved in short evaluation cycles to quickly investigate and solve issues, thereby ensuring optimal acceptance and usability. In an ongoing evaluation study among long-term users, information is gathered on preference for game content, usability, clarity and accessibility through an online questionnaire, and provides direct input for further implementation. In addition, actual use is monitored objectively through data logs. The refinement of the game environment by means of new study outcomes and developments is an ongoing iterative process toward the realisation of an enjoyable game-based service platform for the older adult that is also employable in similar future services. Final evaluation results are expected end of 2016