(Envisage) Promoting Physical Independence by Involving Users in Rehabilitation Through Dynamic Visualisation of Biomechanical Data
The Envisage project is about “Promoting independence by involving users in rehabilitation through dynamic visualisation of biomechanical data through visualization”. Our premise is that a biomechanical understanding of movement problems can be the key to physical rehabilitation following stroke, falls or joint replacement in elderly people. But use of biomechanical data in a clinical setting has been limited in the past because it is so difficult to communicate. The Envisage team has bridged this gap by developing software that allows movement to be visualized. We are now testing the hypothesis that “the visualisation of relevant biomechanical data to users (participants, carers, therapists and clinicians) will enhance understanding of and motivation to rehabilitation and hence produce better outcomes from rehabilitation”.
Led by Professor of Rehabilitation, Philip Rowe, at the University of Strathclyde, With Professor Macdonald at Glasgow School of Art and Professor Baillie at Glasgow Caledonian University, envisage brings together a mix of disciplines including software engineering, interaction design, sensor design, clinical rehabilitation and qualitative research. Engineers, scientists, designers, healthcare professionals and members of the public are collaborating to develop bespoke software that allows data captured by a specialist motion analysis system and portable motion sensors to be converted into clear and simple visualisations. The technology will enable healthcare professionals to communicate movement information that was previously only available in graphical, tabular or numerical form, thereby helping patients to improve their own mobility and prevent injury. The envisage team is performing five Phase II randomised controlled trials to evaluate a dynamic visualisation intervention that monitors real time movement rehabilitation in stroke, falls and joint replacement patients.
The long-term goal of envisage research is to empower patients to manage their own conditions by making rehabilitation therapies more effective. The visualization methodology is being tested with patients in home, community and hospital settings. The researchers hope using the animations will help to reduce injury and ill health in older people by improving their understanding, motivation and adherence to exercise plans.
For more information about envisage project visit: http://www.envisagerehab.co.uk
The project is funded by the Lifelong Health and Wellbeing programme - a cross research council initiative in partnership with the UK Health Departments.
The project runs from: Jan 2010 - Nov 2013
Figure 1. The wireless motion sensor components.
Figure 2. A home setup in a compact living room.
Figure 3. Straight Leg Raise.
Figure 4. River Gems Game for Fallers.
Figure 5. Participant Playing River Gems Exergame in their own home.
Figure 6. The use of the Knee replacement Interactive Visualisation System (IVS) in the experimental group accelerated the recovery of knee extension compared to the control group (exercise handbook and DVD) as shown in the graph. Also the IVS prevented decline of knee extension as shown by the positive change compared to the standard care.
One of the most successful interventions for reducing the rate (and risk) of falls is the use of specially tailored exercises designed to improve strength and balance in older people. In the UK, the most commonly used exercise programmes used in community settings are based on the Otago Exercise Programme and the Falls Management Exercise Programme. The tailored exercises included in these programmes have been designed to target individual muscle groups to recover muscle strength and balance in older adults. Essentially the issue in practice is ensuring that the exercises are done regularly and with good movement quality. Certainly in the home setting, the use of home exercise booklets does not feasibly work, as motivation is very low. If exercise to improve strength and balance is to be effective there must, certainly in home dwelling older people, be a dose of at least 50 hours before which there is a definite effect on falls, rather than just an improvement in functional outcomes such as strength and balance which are known risk factors for falls. Therefore ways of making the exercises more fun, whilst also ensuring good movement quality are vital to ensure effectiveness.
Computer games and in particular serious games have received a high level of interest from researchers and health professionals alike. There are studies that have demonstrated the effectiveness of specially tailored exergames, for rehabilitation in stroke. However, there is a lack of evidence regarding the effectiveness of the use of such tailored exergames to aid the rehabilitation of fallers. To address this problem we designed and developed, in conjunction with elderly users at risk of falling, four exergames based on falls rehabilitation exercises (marching, side stepping, sit to stand and knee bends).
These games were then piloted for use in the home with a small number of fallers e.g. 8, over 12 weeks and it was found that the games encouraged greater adherence to the falls exercise programme compared to standard care. We had two groups use standard care (booklet and DVD) and a games group, the only group to maintain the prescribed number of exercise per week was the games group. Some games users performed well over the “prescribed” number of exercises as they enjoyed the games so much and in particular wanted to beat their scores. Their scores cannot increase unless they perform the movements with better movement quality and so this aids not only adherence but also correct movement technique. So, in home dwelling fallers, we have shown that the use of the exergames has increased adherence as well as significant gains in functional performance (Timed up and go, gait speed etc.).
These exergames require two sensors to be strapped to the person’s leg (to provide real time movement quality for the particular exercises) and all participants put these sensors on themselves and operated the computer system themselves with only minor problems (some were completely naïve to computers. The current project will trial a full set of 9 games in a large scale trial in collaboration with the falls service and community/ day care establishments.
Project Leader: Lynne Baillie
Project Researchers: Dr Stephen Uzor, Prof Dawn Skelton
Project Collaborators: Glasgow NHS, Greater Glasgow Falls Service and North Glasgow Homes Housing Association
Project Funder: Digital Health Institute
EMMI: Enhancing The User Experience by Employing Innovative Methods for Multimodal Input and Output
The project shall investigate novel ways of interacting with our mobile devices from sensing technologies to effective media.
The main aim of the project is to explore completely new and untried ways of interacting with our mobile devices in order to first, discover new untried methods of interaction and second, to see if once designed and implemented these new methods make using the device more enjoyable and engaging.
Co-Guide : A User Centred Guide to Our Collective Sporting Heritage in the East End of Glasgow: Past, Present and Future
A unique opportunity has arisen due to the advent of the commonwealth games in 2014 to re-examine Glasgow’s heritage with regards to the place of sport.
One of the aims of the games organisers is to produce a lasting legacy of engagement in sports for future generations after the games has finished and one of the most prominent reminders of that legacy will be the venues that are refurbished, extended and created.
Researchers are working in collaboration with local schools and communities to examine and build a mixed reality mobile guide (utilising cutting edge technology in order that the community can keep on adding information through various devices after implementation) for Glasgow.
There will be a launch of the guide at a showcase at the National Stadium at the conclusion of the project.
Destination: A Location Aware Multimodal Mobile Game
Location based games offer opportunities for us to learn more about peoples interactions and feelings towards the environment they are in as well as to understand more about the mental models and locations associated with known environments e.g. a university campus with its associations of learning. Our project investigates ways to manipulate the activities in a game to take advantage of certain locations in the hope of producing certain emotional reactions and to trial new methodologies for location based games.