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Song S, Seo Y, Hwang S, Kim HY, Kim J. Digital Phenotyping of Geriatric Depression Using a Community-Based Digital Mental Health Monitoring Platform for Socially Vulnerable Older Adults and Their Community Caregivers: 6-Week Living Lab Single-Arm Pilot Study. JMIR Mhealth Uhealth 2024; 12:e55842. [PMID: 38885033 PMCID: PMC11217709 DOI: 10.2196/55842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Revised: 05/03/2024] [Accepted: 05/23/2024] [Indexed: 06/18/2024] Open
Abstract
BACKGROUND Despite the increasing need for digital services to support geriatric mental health, the development and implementation of digital mental health care systems for older adults have been hindered by a lack of studies involving socially vulnerable older adult users and their caregivers in natural living environments. OBJECTIVE This study aims to determine whether digital sensing data on heart rate variability, sleep quality, and physical activity can predict same-day or next-day depressive symptoms among socially vulnerable older adults in their everyday living environments. In addition, this study tested the feasibility of a digital mental health monitoring platform designed to inform older adult users and their community caregivers about day-to-day changes in the health status of older adults. METHODS A single-arm, nonrandomized living lab pilot study was conducted with socially vulnerable older adults (n=25), their community caregivers (n=16), and a managerial social worker over a 6-week period during and after the COVID-19 pandemic. Depressive symptoms were assessed daily using the 9-item Patient Health Questionnaire via scripted verbal conversations with a mobile chatbot. Digital biomarkers for depression, including heart rate variability, sleep, and physical activity, were measured using a wearable sensor (Fitbit Sense) that was worn continuously, except during charging times. Daily individualized feedback, using traffic signal signs, on the health status of older adult users regarding stress, sleep, physical activity, and health emergency status was displayed on a mobile app for the users and on a web application for their community caregivers. Multilevel modeling was used to examine whether the digital biomarkers predicted same-day or next-day depressive symptoms. Study staff conducted pre- and postsurveys in person at the homes of older adult users to monitor changes in depressive symptoms, sleep quality, and system usability. RESULTS Among the 31 older adult participants, 25 provided data for the living lab and 24 provided data for the pre-post test analysis. The multilevel modeling results showed that increases in daily sleep fragmentation (P=.003) and sleep efficiency (P=.001) compared with one's average were associated with an increased risk of daily depressive symptoms in older adults. The pre-post test results indicated improvements in depressive symptoms (P=.048) and sleep quality (P=.02), but not in the system usability (P=.18). CONCLUSIONS The findings suggest that wearable sensors assessing sleep quality may be utilized to predict daily fluctuations in depressive symptoms among socially vulnerable older adults. The results also imply that receiving individualized health feedback and sharing it with community caregivers may help improve the mental health of older adults. However, additional in-person training may be necessary to enhance usability. TRIAL REGISTRATION ClinicalTrials.gov NCT06270121; https://clinicaltrials.gov/study/NCT06270121.
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Affiliation(s)
- Sunmi Song
- Department of Health and Environmental Science, Undergraduate School, Korea University, Seoul, Republic of Korea
- Department of Physical Therapy, College of Health Science, Korea University, Seoul, Republic of Korea
- Department of Public Health Sciences, Graduate School, Korea University, Seoul, Republic of Korea
| | - YoungBin Seo
- Department of Healthcare Sciences, Graduate School, Korea University, Seoul, Republic of Korea
- BK21FOUR: L-HOPE Program for Community-Based Total Learning Health Systems, College of Health Science, Korea University, Seoul, Republic of Korea
| | - SeoYeon Hwang
- Department of Public Health Sciences, Graduate School, Korea University, Seoul, Republic of Korea
- BK21FOUR: L-HOPE Program for Community-Based Total Learning Health Systems, College of Health Science, Korea University, Seoul, Republic of Korea
| | - Hae-Young Kim
- Department of Public Health Sciences, Graduate School, Korea University, Seoul, Republic of Korea
- Department of Healthcare Sciences, Graduate School, Korea University, Seoul, Republic of Korea
- BK21FOUR: L-HOPE Program for Community-Based Total Learning Health Systems, College of Health Science, Korea University, Seoul, Republic of Korea
- Department of Health Policy and Management, College of Health Science, Korea University, Seoul, Republic of Korea
| | - Junesun Kim
- Department of Health and Environmental Science, Undergraduate School, Korea University, Seoul, Republic of Korea
- Department of Physical Therapy, College of Health Science, Korea University, Seoul, Republic of Korea
- Department of Public Health Sciences, Graduate School, Korea University, Seoul, Republic of Korea
- BK21FOUR: L-HOPE Program for Community-Based Total Learning Health Systems, College of Health Science, Korea University, Seoul, Republic of Korea
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Arntz A, Weber F, Handgraaf M, Lällä K, Korniloff K, Murtonen KP, Chichaeva J, Kidritsch A, Heller M, Sakellari E, Athanasopoulou C, Lagiou A, Tzonichaki I, Salinas-Bueno I, Martínez-Bueso P, Velasco-Roldán O, Schulz RJ, Grüneberg C. Technologies in Home-Based Digital Rehabilitation: Scoping Review. JMIR Rehabil Assist Technol 2023; 10:e43615. [PMID: 37253381 PMCID: PMC10415951 DOI: 10.2196/43615] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 03/10/2023] [Accepted: 05/25/2023] [Indexed: 06/01/2023] Open
Abstract
BACKGROUND Due to growing pressure on the health care system, a shift in rehabilitation to home settings is essential. However, efficient support for home-based rehabilitation is lacking. The COVID-19 pandemic has further exacerbated these challenges and has affected individuals and health care professionals during rehabilitation. Digital rehabilitation (DR) could support home-based rehabilitation. To develop and implement DR solutions that meet clients' needs and ease the growing pressure on the health care system, it is necessary to provide an overview of existing, relevant, and future solutions shaping the constantly evolving market of technologies for home-based DR. OBJECTIVE In this scoping review, we aimed to identify digital technologies for home-based DR, predict new or emerging DR trends, and report on the influences of the COVID-19 pandemic on DR. METHODS The scoping review followed the framework of Arksey and O'Malley, with improvements made by Levac et al. A literature search was performed in PubMed, Embase, CINAHL, PsycINFO, and the Cochrane Library. The search spanned January 2015 to January 2022. A bibliometric analysis was performed to provide an overview of the included references, and a co-occurrence analysis identified the technologies for home-based DR. A full-text analysis of all included reviews filtered the trends for home-based DR. A gray literature search supplemented the results of the review analysis and revealed the influences of the COVID-19 pandemic on the development of DR. RESULTS A total of 2437 records were included in the bibliometric analysis and 95 in the full-text analysis, and 40 records were included as a result of the gray literature search. Sensors, robotic devices, gamification, virtual and augmented reality, and digital and mobile apps are already used in home-based DR; however, artificial intelligence and machine learning, exoskeletons, and digital and mobile apps represent new and emerging trends. Advantages and disadvantages were displayed for all technologies. The COVID-19 pandemic has led to an increased use of digital technologies as remote approaches but has not led to the development of new technologies. CONCLUSIONS Multiple tools are available and implemented for home-based DR; however, some technologies face limitations in the application of home-based rehabilitation. However, artificial intelligence and machine learning could be instrumental in redesigning rehabilitation and addressing future challenges of the health care system, and the rehabilitation sector in particular. The results show the need for feasible and effective approaches to implement DR that meet clients' needs and adhere to framework conditions, regardless of exceptional situations such as the COVID-19 pandemic.
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Affiliation(s)
- Angela Arntz
- Division of Physiotherapy, Department of Applied Health Sciences, University of Applied Health Sciences Bochum, Bochum, Germany
- Faculty of Human Sciences, University of Cologne, Cologne, Germany
| | - Franziska Weber
- Division of Physiotherapy, Department of Applied Health Sciences, University of Applied Health Sciences Bochum, Bochum, Germany
- Department of Rehabilitation, Physiotherapy Science & Sports, University Medical Center Utrecht, Utrecht, Netherlands
| | - Marietta Handgraaf
- Division of Physiotherapy, Department of Applied Health Sciences, University of Applied Health Sciences Bochum, Bochum, Germany
| | - Kaisa Lällä
- Institute of Rehabilitation, Jamk University of Applied Sciences, Jyväskylä, Finland
| | - Katariina Korniloff
- Institute of Rehabilitation, Jamk University of Applied Sciences, Jyväskylä, Finland
| | - Kari-Pekka Murtonen
- Institute of Rehabilitation, Jamk University of Applied Sciences, Jyväskylä, Finland
| | - Julija Chichaeva
- Institute of Rehabilitation, Jamk University of Applied Sciences, Jyväskylä, Finland
| | - Anita Kidritsch
- Institute of Health Sciences, St. Pölten University of Applied Sciences, St. Pölten, Austria
| | - Mario Heller
- Department of Media & Digital Technologies, St. Pölten University of Applied Sciences, St. Pölten, Austria
| | - Evanthia Sakellari
- Department of Public and Community Health, Laboratory of Hygiene and Epidemiology, University of West Attica, Athens, Greece
| | | | - Areti Lagiou
- Department of Public and Community Health, Laboratory of Hygiene and Epidemiology, University of West Attica, Athens, Greece
| | - Ioanna Tzonichaki
- Department of Occupational Therapy, University of West Attica, Athens, Greece
| | - Iosune Salinas-Bueno
- Health Research Institute of the Balearic Islands (IdISBa), Palma de Mallorca, Spain
- Department of Nursing and Physiotherapy, University of the Balearic Islands, Palma de Mallorca, Spain
| | - Pau Martínez-Bueso
- Health Research Institute of the Balearic Islands (IdISBa), Palma de Mallorca, Spain
- Department of Nursing and Physiotherapy, University of the Balearic Islands, Palma de Mallorca, Spain
| | - Olga Velasco-Roldán
- Health Research Institute of the Balearic Islands (IdISBa), Palma de Mallorca, Spain
- Department of Nursing and Physiotherapy, University of the Balearic Islands, Palma de Mallorca, Spain
| | | | - Christian Grüneberg
- Division of Physiotherapy, Department of Applied Health Sciences, University of Applied Health Sciences Bochum, Bochum, Germany
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Smith G, Dixon C, Neiva Ganga R, Greenop D. How Do We Know Co-Created Solutions Work Effectively within the Real World of People Living with Dementia? Learning Methodological Lessons from a Co-Creation-to-Evaluation Case Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14317. [PMID: 36361197 PMCID: PMC9654242 DOI: 10.3390/ijerph192114317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 10/27/2022] [Accepted: 10/30/2022] [Indexed: 06/16/2023]
Abstract
Living Labs (LL) are a novel and potentially robust way of addressing real-life health challenges, especially within the dementia field. Generally, LLs focus on co-creating through implementing the quadruple helix partnership as a user-centric approach to co-creating. In the context of this paper, the users were people with dementia and their informal carers. LL are not necessarily environments that evaluate these co-created innovations within the real world. Considering this disconnect between co-creation and real-world evaluation, this paper, as a critical commentary, will reflect on the methodological lessons learnt during the development of an LL model aimed at addressing this discrepancy. The LL at Liverpool John Moores University (LJMU) was commissioned to co-create and then evaluate a new Dementia Reablement Service. The case study findings revealed that the Dementia Reablement Service had a positive impact on the quality of life of people with dementia, suggesting that the service is a catalyst for positive change. In addition, the critical learning from this case study highlights the potential role of LLs in seamlessly co-creating and then evaluating the co-created solution within the real world. A benefit of this way of working is that it provides opportunities for LLs to secure access to traditional research funding.
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Affiliation(s)
- Grahame Smith
- Faculty of Health, Liverpool John Moores University, Liverpool L2 2ER, UK
| | - Chloe Dixon
- Faculty of Health, Liverpool John Moores University, Liverpool L2 2ER, UK
| | - Rafaela Neiva Ganga
- Faculty of Business and Law, Liverpool John Moores University, Liverpool L3 5UG, UK
| | - Daz Greenop
- Faculty of Health, Liverpool John Moores University, Liverpool L2 2ER, UK
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Luengo-Polo J, Conde-Caballero D, Rivero-Jiménez B, Ballesteros-Yáñez I, Castillo-Sarmiento CA, Mariano-Juárez L. Rationale and Methods of Evaluation for ACHO, A New Virtual Assistant to Improve Therapeutic Adherence in Rural Elderly Populations: A User-Driven Living Lab. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18157904. [PMID: 34360194 PMCID: PMC8345470 DOI: 10.3390/ijerph18157904] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 07/19/2021] [Accepted: 07/22/2021] [Indexed: 11/23/2022]
Abstract
Low therapeutic adherence is a concern for health professionals as it decreases therapeutic efficiency while increasing costs, especially in elderly populations. To increase therapeutic adherence in elderly populations, the technology applied in the medical devices that are used must be adapted to improve usability. This paper outlines the rationale behind, and methods applied to assess the usability of, ACHO (Assistant on Care and Health Offline), a voice assistant that provides elderly patients with reminders of medical appointments to attend and when they need to take their medication. This work is a descriptive, cross-sectional, observational study, and will include a three-phase (analysis, testing and refinement) multidimensional usability analysis of an initial prototype, in the setting of a user-driven Living Lab, which enables the needs and characteristics of the end users to be identified and incorporated into the prototype with each iteration, in which a multidisciplinary team of researchers and users will participate as co-creators. This methodology will allow us to develop a better prototype, increasing usability and, thus, increasing therapeutic adherence.
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Affiliation(s)
- Jeronimo Luengo-Polo
- Department of Nursing, Faculty of Nursing & Occupational Therapy, University of Extremadura, 10003 Cáceres, Spain; (J.L.-P.); (D.C.-C.); (L.M.-J.)
| | - David Conde-Caballero
- Department of Nursing, Faculty of Nursing & Occupational Therapy, University of Extremadura, 10003 Cáceres, Spain; (J.L.-P.); (D.C.-C.); (L.M.-J.)
| | - Borja Rivero-Jiménez
- Department of Computer Systems and Telematics, Polytechnic School, University of Extremadura, 10003 Cáceres, Spain;
| | - Inmaculada Ballesteros-Yáñez
- Department of Inorganic, Organic Chemistry and Biochemistry, School of Medicine, University of Castilla-La Mancha, 13071 Ciudad Real, Spain;
- Regional Center for Biomedical Research, University of Castilla-La Mancha, 02008 Albacete, Spain
| | - Carlos A. Castillo-Sarmiento
- Regional Center for Biomedical Research, University of Castilla-La Mancha, 02008 Albacete, Spain
- Department of Nursing, Physiotherapy and Occupational Therapy, School of Physiotherapy and Nursing, University of Castilla-La Mancha, 45071 Toledo, Spain
- Correspondence: ; Tel.: +34-926-295-300 (ext. 5670)
| | - Lorenzo Mariano-Juárez
- Department of Nursing, Faculty of Nursing & Occupational Therapy, University of Extremadura, 10003 Cáceres, Spain; (J.L.-P.); (D.C.-C.); (L.M.-J.)
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Godefroy V, Levy R, Bouzigues A, Rametti-Lacroux A, Migliaccio R, Batrancourt B. ECOCAPTURE@HOME: Protocol for the Remote Assessment of Apathy and Its Everyday-Life Consequences. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18157824. [PMID: 34360133 PMCID: PMC8345445 DOI: 10.3390/ijerph18157824] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 07/20/2021] [Accepted: 07/21/2021] [Indexed: 12/01/2022]
Abstract
Apathy, a common neuropsychiatric symptom associated with dementia, has a strong impact on patients’ and caregivers’ quality of life. However, it is still poorly understood and hard to define. The main objective of the ECOCAPTURE programme is to define a behavioural signature of apathy using an ecological approach. Within this program, ECOCAPTURE@HOME is an observational study which aims to validate a method based on new technologies for the remote monitoring of apathy in real life. For this study, we plan to recruit 60 couples: 20 patient-caregiver dyads in which patients suffer from behavioral variant Fronto-Temporal Dementia, 20 patient-caregiver dyads in which patients suffer from Alzheimer Disease and 20 healthy control couples. These dyads will be followed for 28 consecutive days via multi-sensor bracelets collecting passive data (acceleration, electrodermal activity, blood volume pulse). Active data will also be collected by questionnaires on a smartphone application. Using a pool of metrics extracted from these passive and active data, we will validate a measurement model for three behavioural markers of apathy (i.e., daytime activity, quality of sleep, and emotional arousal). The final purpose is to facilitate the follow-up and precise diagnosis of apathy, towards a personalised treatment of this condition within everyday life.
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Affiliation(s)
- Valérie Godefroy
- Sorbonne Université, Institut du Cerveau—Paris Brain Institute—ICM, Inserm, CNRS, AP-HP, Hôpital de la Pitié Salpêtrière, F-75013 Paris, France; (R.L.); (A.B.); (A.R.-L.); (R.M.); (B.B.)
- Correspondence: ; Tel.: +33-06-09-86-29-47
| | - Richard Levy
- Sorbonne Université, Institut du Cerveau—Paris Brain Institute—ICM, Inserm, CNRS, AP-HP, Hôpital de la Pitié Salpêtrière, F-75013 Paris, France; (R.L.); (A.B.); (A.R.-L.); (R.M.); (B.B.)
- Département de Neurologie, Institut de la Mémoire et de la Maladie d’Alzheimer (IM2A), AP-HP, Hôpital de la Pitié Salpêtrière, F-75013 Paris, France
- Unité de Neuropsychiatrie Comportementale, Département de Neurologie, AP-HP, Hôpital de la Pitié Salpêtrière, F-75013 Paris, France
| | - Arabella Bouzigues
- Sorbonne Université, Institut du Cerveau—Paris Brain Institute—ICM, Inserm, CNRS, AP-HP, Hôpital de la Pitié Salpêtrière, F-75013 Paris, France; (R.L.); (A.B.); (A.R.-L.); (R.M.); (B.B.)
| | - Armelle Rametti-Lacroux
- Sorbonne Université, Institut du Cerveau—Paris Brain Institute—ICM, Inserm, CNRS, AP-HP, Hôpital de la Pitié Salpêtrière, F-75013 Paris, France; (R.L.); (A.B.); (A.R.-L.); (R.M.); (B.B.)
| | - Raffaella Migliaccio
- Sorbonne Université, Institut du Cerveau—Paris Brain Institute—ICM, Inserm, CNRS, AP-HP, Hôpital de la Pitié Salpêtrière, F-75013 Paris, France; (R.L.); (A.B.); (A.R.-L.); (R.M.); (B.B.)
- Département de Neurologie, Institut de la Mémoire et de la Maladie d’Alzheimer (IM2A), AP-HP, Hôpital de la Pitié Salpêtrière, F-75013 Paris, France
| | - Bénédicte Batrancourt
- Sorbonne Université, Institut du Cerveau—Paris Brain Institute—ICM, Inserm, CNRS, AP-HP, Hôpital de la Pitié Salpêtrière, F-75013 Paris, France; (R.L.); (A.B.); (A.R.-L.); (R.M.); (B.B.)
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Kafri M, Weiss PL, Zeilig G, Bondi M, Baum-Cohen I, Kizony R. Performance in complex life situations: effects of age, cognition, and walking speed in virtual versus real life environments. J Neuroeng Rehabil 2021; 18:30. [PMID: 33557894 PMCID: PMC7871373 DOI: 10.1186/s12984-021-00830-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 01/26/2021] [Indexed: 11/10/2022] Open
Abstract
Background Virtual reality (VR) enables objective and accurate measurement of behavior in ecologically valid and safe environments, while controlling the delivery of stimuli and maintaining standardized measurement protocols. Despite this potential, studies that compare virtual and real-world performance of complex daily activities are scarce. This study aimed to compare cognitive strategies and gait characteristics of young and older healthy adults as they engaged in a complex task while navigating in a real shopping mall and a high-fidelity virtual replica of the mall. Methods Seventeen older adults (mean (SD) age = 71.2 (5.6) years, 64% males) and 17 young adults (26.7 (3.7) years, 35% males) participated. In two separate sessions they performed the Multiple Errands Test (MET) in a real-world mall or the Virtual MET (VMET) in the virtual environment. The real-world environment was a small shopping area and the virtual environment was created within the CAREN™ (Computer Assisted Rehabilitation Environment) Integrated Reality System. The performance of the task was assessed using motor and physiological measures (gait parameters and heart rate), MET or VMET time and score, and navigation efficiency (cognitive performance and strategy). Between (age groups) and within (environment) differences were analyzed with ANOVA repeated measures. Results There were no significant age effects for any of the gait parameters but there were significant environment effects such that both age groups walked faster (F(1,32) = 154.96, p < 0.0001) with higher step lengths (F(1,32) = 86.36, p < 0.0001), had lower spatial and temporal gait variability (F(1,32) = 95.71–36.06, p < 0.0001) and lower heart rate (F(1,32) = 13.40, p < 0.01) in the real-world. There were significant age effects for MET/VMET scores (F(1,32) = 19.77, p < 0.0001) and total time (F(1,32) = 11.74, p < 0.05) indicating better performance of the younger group, and a significant environment effect for navigation efficiency (F(1,32) = 7.6, p < 0.01) that was more efficient in the virtual environment. Conclusions This comprehensive, ecological approach in the measurement of performance during tasks reminiscent of complex life situations showed the strengths of using virtual environments in assessing cognitive aspects and limitations of assessing motor aspects of performance. Difficulties by older adults were apparent mainly in the cognitive aspects indicating a need to evaluate them during complex task performance.
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Affiliation(s)
- Michal Kafri
- Department of Physical Therapy, Faculty of Social Welfare & Health Sciences, University of Haifa, Haifa, Israel.
| | - Patrice L Weiss
- Department of Occupational Therapy, Faculty of Social Welfare & Health Sciences, University of Haifa, Haifa, Israel
| | - Gabriel Zeilig
- Department of Neurological Rehabilitation, Sheba Medical Center, Tel Hashomer, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Health Professional Faculty, Ono Academic College, Kiryat Ono, Israel
| | - Moshe Bondi
- Department of Neurological Rehabilitation, Sheba Medical Center, Tel Hashomer, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ilanit Baum-Cohen
- "Steps" Center for Rehabilitation, Sheba Medical Center, Tel Hashomer, Israel.,Occupational Therapy, Sheba Medical Center, Tel Hashomer, Israel
| | - Rachel Kizony
- Department of Occupational Therapy, Faculty of Social Welfare & Health Sciences, University of Haifa, Haifa, Israel.,Center of Advanced Technologies in Rehabilitation, Sheba Medical Center, Tel Hashomer, Israel
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Noublanche F, Jaglin-Grimonprez C, Laignel L, Sacco G, Allain P, Annweiler C. Adapting Gerontechnological Development to Hospitalized Frail Older People: Implementation of the ALLEGRO Hospital-Based Geriatric Living Lab. J Am Med Dir Assoc 2020; 21:550-554. [PMID: 32122796 DOI: 10.1016/j.jamda.2020.01.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Revised: 12/30/2019] [Accepted: 01/02/2020] [Indexed: 11/30/2022]
Abstract
Gerontechnology aims at improving the functioning of older people and their carers in their daily lives as well as improving gerontological practices. To promote gerontechnology innovation in the hospital and bridge the gap between gerontechnology developers and hospitalized frail older patients, our objective was to create and implement a hospital-based geriatric living lab. We designed a hospital-based living lab, providing reflexive workshops bringing around the table gerontechnology users and developers, supplemented with an experimental hospital room receiving both the users and the devices to be tested. Three different types of users were distinguished: seriously ill older inpatients, professional hospital caregivers, and informal carers. Three different kinds of devices were also distinguished: prototypes under development, new services and/or care organizations, and new uses. Finally, we were able to open in 2018 the Angers Living Lab En GéRiatrie hOspitalière (ALLEGRO) hospital-based geriatric living lab. ALLEGRO offers the organization of "idea incubator workshops" for users and developers, together with one "experimental hospital room" equipped with validated devices to provide reference measures used as a standard to test the diagnostic efficacy of prototypes. The room is intended to accommodate one older inpatient with severe acute organic failures. No patient selection is planned at admission, apart from consent to research. Until now, no refusal to participate in a study was noted. In conclusion, we offer a new and unprecedented hospital-based geriatric living lab to improve hospital care for older inpatients and to promote successful aging through gerontechnology.
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Affiliation(s)
- Frédéric Noublanche
- Department of Geriatric Medicine and Memory Clinic, Research Center on Autonomy and Longevity, University Hospital, Angers, France; Laboratoire de Psychologie des Pays de la Loire, LPPL EA 4638, SFR Confluences, University Angers and University Nantes, France
| | | | | | - Guillaume Sacco
- Department of Geriatric Medicine and Memory Clinic, Research Center on Autonomy and Longevity, University Hospital, Angers, France; Laboratoire de Psychologie des Pays de la Loire, LPPL EA 4638, SFR Confluences, University Angers and University Nantes, France
| | - Philippe Allain
- Laboratoire de Psychologie des Pays de la Loire, LPPL EA 4638, SFR Confluences, University Angers and University Nantes, France
| | - Cédric Annweiler
- Department of Geriatric Medicine and Memory Clinic, Research Center on Autonomy and Longevity, University Hospital, Angers, France; Laboratoire de Psychologie des Pays de la Loire, LPPL EA 4638, SFR Confluences, University Angers and University Nantes, France; Department of Medical Biophysics, Schulich School of Medicine and Dentistry, Robarts Research Institute, The University of Western Ontario, London, Ontario, Canada.
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Tao G, Charm G, Kabacińska K, Miller WC, Robillard JM. Evaluation Tools for Assistive Technologies: A Scoping Review. Arch Phys Med Rehabil 2020; 101:1025-1040. [PMID: 32059944 DOI: 10.1016/j.apmr.2020.01.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Accepted: 01/02/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Assistive technologies (ATs) support independence and well-being in people with cognitive, perceptual, and physical limitations. Given the increasing availability and diversity of ATs, evaluating the usefulness of current and emerging ATs is crucial for informed comparison. We aimed to chart the landscape and development of AT evaluation tools (ETs; ATETs) across disparate fields in order to improve the process of AT evaluation and development. DATA SOURCES We performed a scoping review of ATETs through database searching of MEDLINE, Embase, CINAHL, HaPI, PsycINFO, Cochrane Reviews, and Compendex as well as citation mining. STUDY SELECTION Articles explicitly referencing ATETs were retained for screening. We included ETs if they were designed to specifically evaluate ATs. DATA EXTRACTION We extracted 5 attributes of ATETs: AT category, construct evaluated, conceptual frameworks, type of end user input used for ATET development, and presence of validity testing. DATA SYNTHESIS From screening 23,434 records, we included 159 ATETs. Specificity of tools ranged from single to general ATs across 40 AT categories. Satisfaction, functional performance, and usage were the most common constructs of 103 identified. We identified 34 conceptual frameworks across 53 ETs. Finally, 36% incorporated end user input and 80% showed validation testing. CONCLUSIONS We characterized a wide range of AT categories with diverse approaches to their evaluation based on varied conceptual frameworks. Combining these frameworks in future ATETs may provide more holistic views of AT usefulness. ATET selection may be improved with guidelines for conceptually reconciling results of disparate ATETs. Future ATET development may benefit from more integrated approaches to end user engagement.
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Affiliation(s)
- Gordon Tao
- GF Strong Rehabilitation Research Lab, Vancouver Coastal Research Institute, Vancouver, British Columbia; Department of Occupational Science and Occupational Therapy, The University of British Columbia, Vancouver, British Columbia
| | - Geoffrey Charm
- GF Strong Rehabilitation Research Lab, Vancouver Coastal Research Institute, Vancouver, British Columbia; Department of Integrated Sciences, The University of British Columbia, Vancouver, British Columbia
| | - Katarzyna Kabacińska
- Division of Neurology, Department of Medicine, The University of British Columbia, Vancouver, British Columbia
| | - William C Miller
- GF Strong Rehabilitation Research Lab, Vancouver Coastal Research Institute, Vancouver, British Columbia; Department of Occupational Science and Occupational Therapy, The University of British Columbia, Vancouver, British Columbia
| | - Julie M Robillard
- Division of Neurology, Department of Medicine, The University of British Columbia, Vancouver, British Columbia; British Columbia Women's and Children's Hospital, Vancouver, British Columbia, Canada.
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9
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Callari TC, Moody L, Saunders J, Ward G, Woodley J. Stakeholder Requirements for an Ethical Framework to Sustain Multiple Research Projects in an Emerging Living Lab Involving Older Adults. J Empir Res Hum Res Ethics 2019; 15:111-127. [PMID: 31530076 DOI: 10.1177/1556264619873790] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Living Lab (LL) research should follow clear ethical guidelines and principles. While these exist in specific disciplinary contexts, there is a lack of tailored and specific ethical guidelines for the design, development, and implementation of LL projects. As well as the complexity of these dynamic and multi-faceted contexts, the engagement of older adults, and adults with reducing cognitive and physical capacity in LL research, poses additional ethical challenges. Semi-structured interviews were undertaken with 26 participants to understand multistakeholder experiences related to user engagement and related ethical issues in emerging LL research. The participants' experiences and concerns are reported and translated into an ethical framework to guide future LL research initiatives.
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Affiliation(s)
| | | | | | - Gill Ward
- Royal College of Occupational Therapists, London, UK
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10
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Korman M, Weiss PL, Hochhauser M, Kizony R. Effect of age on spatial memory performance in real museum vs. computer simulation. BMC Geriatr 2019; 19:165. [PMID: 31196006 PMCID: PMC6567498 DOI: 10.1186/s12877-019-1167-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Accepted: 05/23/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Healthy older adults frequently complain on difficulty in recalling the locations of objects of everyday use. Cognitive abilities decline with normal aging; inefficiencies of information processing, as well as deterioration of neuronal structures, may impede the performance of complex cognitive skills such as spatial memory. Extraneous, task-irrelevant cognitive load in real environments is usually high and might interfere with spatial memory abilities of older adults. The purpose of this study was to determine (1) the extent to which older adults maintain their cognitive capacity during a spatial memory task as compared to young adults and (2) whether this capacity is affected by performance of the task in a real environment setting where the cognitive demands are similar to a simulation, but the physical demands (navigating via walking versus via a mouse) vary. METHODS In the museum, participants physically moved between display stations to locate hidden tokens performing a task in which an ongoing representation of previous searches had to be remembered. A comparable task was implemented via mouse actions on a computer simulation. Seventeen healthy older (60-80 years) and twenty younger (20-45 years) adults performed both tasks in a counterbalanced order. RESULTS The younger group was superior to the older group in terms of success rate and completion time for both conditions. All participants performed better during the simulated task. The delta between the total performance score in the two settings of the older group was significantly larger as compared to the younger group, suggesting a differential impact of setting on the groups. CONCLUSIONS Our results highlight the importance and feasibility of experimentation in ecologically relevant settings: differences were found in the way the cognitive performance of older and younger adults was affected by setting. Older adults appear to preserve basic cognitive abilities required for successful performance of object-location memory tasks. However, real museum setting appeared to impose higher demands on the older adults.
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Affiliation(s)
- Maria Korman
- E.J. Safra Brain Research Center for the Study of Learning Disabilities, University of Haifa, 199 Aba Khoushy Ave. Mount Carmel, Haifa, Israel.
| | - Patrice L Weiss
- Department of Occupational Therapy, University of Haifa, Haifa, Israel
| | | | - Rachel Kizony
- Department of Occupational Therapy, University of Haifa, Haifa, Israel.,Center of Advanced Technologies in Rehabilitation, Sheba Medical Center, Tel Hashomer, Israel
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11
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Gilboa Y, Maeir T, Karni S, Eisenberg ME, Liebergall M, Schwartz I, Kaufman Y. Effectiveness of a tele-rehabilitation intervention to improve performance and reduce morbidity for people post hip fracture - study protocol for a randomized controlled trial. BMC Geriatr 2019; 19:135. [PMID: 31109289 PMCID: PMC6528189 DOI: 10.1186/s12877-019-1141-z] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Accepted: 04/22/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Most surviving hip-fracture patients experience reduced mobility and lose some of their functional ability, which increases the risk of complications and rehospitalization. Post-discharge transitional programs to reduce readmissions and disabilities have shown some success. Telerehabilitation refers to the use of technologies to provide rehabilitation services to people in their homes. Considering the need for long-term follow-up care for people with hip fracture, in-home telerehabilitation could increase independence, decrease hospital stays and reduce the burden for caregivers. The objective of this study is to investigate the effectiveness of an intervention program based on telerehabilitation on activities of daily living (ADL), quality of life (QOL), depression and burden on caregivers compared to face-to-face home visits and usual care of community-dwelling older adults after hip fracture. METHODS/DESIGN This will be a three-armed randomized control trial (RCT) including pre/post intervention and follow-up. The trial will include 90 older people with hip fractures who will be randomly assigned to a telerehabilitation group (N = 30), face-to-face visits (N = 30) and a control group. The aim of the intervention is to improve the transition from rehabilitation units to community dwelling. It will include 10 videoconferencing/ face-to-face sessions from an occupational therapist in the presence of the primary caregiver. Each session will be utilized to guide the participants to achieve their self-identified goals, focusing on problem-solving for daily life situations and on the ability to implement the discussed strategies for a variety of activities. Outcome measures include Functional Independence Measure (FIM) for evaluation of ADL, SF-12 for evaluation of Health-related QOL, The Geriatric Depression Scale (GDS) and The Zarit Caregiver Burden Scale. Data will be analyzed using Repeated measures MANOVA. DISCUSSION The current study will enable the cost-effectiveness examination of a suggested rehabilitation service based on available technology. The proposed intervention will increase accessibility of in-home rehabilitation services, improve function and health, and reduce economic burden. TRIAL REGISTRATION NCT03376750 (12/15/2017).
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Affiliation(s)
- Yafit Gilboa
- School of Occupational Therapy, Faculty of Medicine, Hadassah and the Hebrew University of Jerusalem, Mount Scopus, 91240 Jerusalem, Israel
| | - Talia Maeir
- School of Occupational Therapy, Faculty of Medicine, Hadassah and the Hebrew University of Jerusalem, Mount Scopus, 91240 Jerusalem, Israel
| | - Sharon Karni
- Herzog Medical Center, Givat Shaul, P.O.Box 3900, 91035 Jerusalem, Israel
| | | | - Meir Liebergall
- Hadassah University Hospital, P.O.Box 12000, 91120 Jerusalem, Israel
| | - Isabella Schwartz
- Hadassah University Hospital, P.O.Box 12000, 91120 Jerusalem, Israel
| | - Yakir Kaufman
- Herzog Medical Center, Givat Shaul, P.O.Box 3900, 91035 Jerusalem, Israel
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12
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Noublanche F, Jaglin-Grimonprez C, Sacco G, Lerolle N, Allain P, Annweiler C. The development of gerontechnology for hospitalized frail elderly people: The ALLEGRO hospital-based geriatric living lab. Maturitas 2019; 125:17-19. [PMID: 31133211 DOI: 10.1016/j.maturitas.2019.04.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2019] [Accepted: 04/01/2019] [Indexed: 11/24/2022]
Abstract
Our objective was to bridge the gap between gerontechnology developers and hospitalized frail elderly people, in order to promote open gerontechnology innovation in hospitals. We designed a hospital-based living lab that provides reflexive "idea incubator workshops" that gather both the users and the developers of technology, supplemented with an "experimental hospital room" for the testing of devices by older inpatients. The ALLEGRO living lab was delivered in 2018 at the Geriatric Department of Angers University Hospital, France. The workshops and experimental hospital room should help frail older inpatients to participate in the co-design and co-development of new technologies to improve hospital care and promote successful aging.
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Affiliation(s)
- Frédéric Noublanche
- Department of Geriatric Medicine and Memory Clinic, Research Center on Autonomy and Longevity, University Hospital, Angers, France; UPRES EA 4638, University of Angers, France
| | | | - Guillaume Sacco
- Department of Geriatric Medicine and Memory Clinic, Research Center on Autonomy and Longevity, University Hospital, Angers, France; Center for Healthcare Innovation and Uses (CIU-santé), University Hospital, Nice, France; CoBTeK Cognition Behaviour Technology EA 7276, Research Center Edmond and Lily Safra, Nice Sophia-Antipolis University, Nice, France
| | - Nicolas Lerolle
- Direction, Health Faculty, University of Angers, Angers, France
| | | | - Cédric Annweiler
- Department of Geriatric Medicine and Memory Clinic, Research Center on Autonomy and Longevity, University Hospital, Angers, France; UPRES EA 4638, University of Angers, France; Direction, Health Faculty, University of Angers, Angers, France; Robarts Research Institute, Department of Medical Biophysics, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, ON, Canada.
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13
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Annweiler C, Noublanche F, Jaglin-Grimonprez C, Bubien Y. Built environments for frail older adults: The now and next. Maturitas 2018; 116:137-138. [PMID: 29803332 DOI: 10.1016/j.maturitas.2018.05.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Accepted: 05/14/2018] [Indexed: 10/16/2022]
Affiliation(s)
- Cédric Annweiler
- Department of Geriatric Medicine and Memory Clinic, Research Center on Autonomy and Longevity, University Hospital, Angers, France; School of Medicine and UPRES EA 4638, University of Angers, France; Robarts Research Institute, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, ON, Canada.
| | - Frédéric Noublanche
- Department of Geriatric Medicine, Research Center on Autonomy and Longevity, University Hospital, Angers, France
| | | | - Yann Bubien
- Minister of Health and Solidarity, Paris, France
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14
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Peleg-Adler R, Lanir J, Korman M. The effects of aging on the use of handheld augmented reality in a route planning task. COMPUTERS IN HUMAN BEHAVIOR 2018. [DOI: 10.1016/j.chb.2017.12.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Cogollor JM, Rojo-Lacal J, Hermsdörfer J, Ferre M, Arredondo Waldmeyer MT, Giachritsis C, Armstrong A, Breñosa Martinez JM, Bautista Loza DA, Sebastián JM. Evolution of Cognitive Rehabilitation After Stroke From Traditional Techniques to Smart and Personalized Home-Based Information and Communication Technology Systems: Literature Review. JMIR Rehabil Assist Technol 2018; 5:e4. [PMID: 29581093 PMCID: PMC5891670 DOI: 10.2196/rehab.8548] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Revised: 09/11/2017] [Accepted: 09/12/2017] [Indexed: 01/31/2023] Open
Abstract
Background Neurological patients after stroke usually present cognitive deficits that cause dependencies in their daily living. These deficits mainly affect the performance of some of their daily activities. For that reason, stroke patients need long-term processes for their cognitive rehabilitation. Considering that classical techniques are focused on acting as guides and are dependent on help from therapists, significant efforts are being made to improve current methodologies and to use eHealth and Web-based architectures to implement information and communication technology (ICT) systems that achieve reliable, personalized, and home-based platforms to increase efficiency and level of attractiveness for patients and carers. Objective The goal of this work was to provide an overview of the practices implemented for the assessment of stroke patients and cognitive rehabilitation. This study puts together traditional methods and the most recent personalized platforms based on ICT technologies and Internet of Things. Methods A literature review has been distributed to a multidisciplinary team of researchers from engineering, psychology, and sport science fields. The systematic review has been focused on published scientific research, other European projects, and the most current innovative large-scale initiatives in the area. A total of 3469 results were retrieved from Web of Science, 284 studies from Journal of Medical Internet Research, and 15 European research projects from Community Research and Development Information Service from the last 15 years were reviewed for classification and selection regarding their relevance. Results A total of 7 relevant studies on the screening of stroke patients have been presented with 6 additional methods for the analysis of kinematics and 9 studies on the execution of goal-oriented activities. Meanwhile, the classical methods to provide cognitive rehabilitation have been classified in the 5 main techniques implemented. Finally, the review has been finalized with the selection of 8 different ICT–based approaches found in scientific-technical studies, 9 European projects funded by the European Commission that offer eHealth architectures, and other large-scale activities such as smart houses and the initiative City4Age. Conclusions Stroke is one of the main causes that most negatively affect countries in the socioeconomic aspect. The design of new ICT-based systems should provide 4 main features for an efficient and personalized cognitive rehabilitation: support in the execution of complex daily tasks, automatic error detection, home-based performance, and accessibility. Only 33% of the European projects presented fulfilled those requirements at the same time. For this reason, current and future large-scale initiatives focused on eHealth and smart environments should try to solve this situation by providing more complete and sophisticated platforms.
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Affiliation(s)
- José M Cogollor
- Centre for Automation and Robotics UPM-CSIC, Universidad Politécnica de Madrid, Madrid, Spain
| | - Javier Rojo-Lacal
- Life Supporting Technologies, Universidad Politécnica de Madrid, Madrid, Spain
| | - Joachim Hermsdörfer
- Institute of Movement Science, Department of Sport and Health Science, Technische Universität München, Munich, Germany
| | - Manuel Ferre
- Centre for Automation and Robotics UPM-CSIC, Universidad Politécnica de Madrid, Madrid, Spain
| | | | | | - Alan Armstrong
- Institute of Movement Science, Department of Sport and Health Science, Technische Universität München, Munich, Germany
| | | | | | - José María Sebastián
- Centre for Automation and Robotics UPM-CSIC, Universidad Politécnica de Madrid, Madrid, Spain
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Classification of physical activities based on body-segments coordination. Comput Biol Med 2016; 76:134-42. [PMID: 27441831 DOI: 10.1016/j.compbiomed.2016.06.024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2015] [Revised: 06/23/2016] [Accepted: 06/23/2016] [Indexed: 01/10/2023]
Abstract
Numerous innovations based on connected objects and physical activity (PA) monitoring have been proposed. However, recognition of PAs requires robust algorithm and methodology. The current study presents an innovative approach for PA recognition. It is based on the heuristic definition of postures and the use of body-segments coordination obtained through external sensors. The first part of this study presents the methodology required to define the set of accelerations which is the most appropriate to represent the particular body-segments coordination involved in the chosen PAs (here walking, running, and cycling). For that purpose, subjects of different ages and heterogeneous physical conditions walked, ran, cycled, and performed daily activities at different paces. From the 3D motion capture, vertical and horizontal accelerations of 8 anatomical landmarks representative of the body were computed. Then, the 680 combinations from up to 3 accelerations were compared to identify the most appropriate set of acceleration to discriminate the PAs in terms of body segment coordinations. The discrimination was based on the maximal Hausdorff Distance obtained between the different set of accelerations. The vertical accelerations of both knees demonstrated the best PAs discrimination. The second step was the proof of concept, implementing the proposed algorithm to classify PAs of new group of subjects. The originality of the proposed algorithm is the possibility to use the subject's specific measures as reference data. With the proposed algorithm, 94% of the trials were correctly classified. In conclusion, our study proposed a flexible and extendable methodology. At the current stage, the algorithm has been shown to be valid for heterogeneous subjects, which suggests that it could be deployed in clinical or health-related applications regardless of the subjects' physical abilities or characteristics.
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