Wearable Sensor-Based Exercise Biofeedback for Orthopaedic Rehabilitation: A Mixed Methods User Evaluation of a Prototype System.
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SUBMITTER: Argent R
PROVIDER: S-EPMC6359655 | biostudies-literature | 2019 Jan
REPOSITORIES: biostudies-literature
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Wearable Sensor-Based Exercise Biofeedback for Orthopaedic Rehabilitation: A Mixed Methods User Evaluation of a Prototype System.
Argent Rob R Slevin Patrick P Bevilacqua Antonio A Neligan Maurice M Daly Ailish A Caulfield Brian B
Sensors (Basel, Switzerland) 20190121 2
The majority of wearable sensor-based biofeedback systems used in exercise rehabilitation lack end-user evaluation as part of the development process. This study sought to evaluate an exemplar sensor-based biofeedback system, investigating the feasibility, usability, perceived impact and user experience of using the platform. Fifteen patients participated in the study having recently undergone knee replacement surgery. Participants were provided with the system for two weeks at home, completing ...[more]
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Project description:ObjectivesThis study explores the opinions of orthopaedic healthcare professionals regarding the opportunities and challenges of using wearable technology in rehabilitation. It continues to assess the perceived impact of an exemplar exercise biofeedback system that incorporates wearable sensing, involving the clinician in the user-centred design process, a valuable step in ensuring ease of implementation, sustained engagement and clinical relevance.DesignThis is a qualitative study consisting of one-to-one semi-structured interviews, including a demonstration of a prototype wearable exercise biofeedback system. Interviews were audio-recorded and transcribed, with thematic analysis conducted of all transcripts.SettingThe study was conducted in the orthopaedic department of an acute private hospital.ParticipantsTen clinicians from a multidisciplinary team of healthcare professionals involved in the orthopaedic rehabilitation pathway participated in the study.ResultsParticipants reported that there is currently a challenge in gathering timely and objective data for the monitoring of patients in orthopaedic rehabilitation. While there are challenges in ensuring reliability and engagement of biofeedback systems, clinicians perceive significant value in the use of wearable biofeedback systems such as the exemplar demonstrated for use following total knee replacement.ConclusionsClinicians see an opportunity for wearable technology to continuously track data in real-time, and feel that feedback provided to users regarding exercise technique and adherence can further support the patient at home, although there are clear design and implementation challenges relating to ensuring technical accuracy and tailoring rehabilitation to the individual. There was perceived value in the prototype system demonstrated to participants which supports the ongoing development of such exercise biofeedback platforms.
| S-EPMC6224760 | biostudies-literature
Project description:Formulift is a newly developed mobile health (mHealth) app that connects to a single inertial measurement unit (IMU) worn on the left thigh. The IMU captures users' movements as they exercise, and the app analyzes the data to count repetitions in real time and classify users' exercise technique. The app also offers feedback and guidance to users on exercising safely and effectively.The aim of this study was to assess the Formulift system with three different and realistic types of potential users (beginner gym-goers, experienced gym-goers, and qualified strength and conditioning [S&C] coaches) under a number of categories: (1) usability, (2) functionality, (3) the perceived impact of the system, and (4) the subjective quality of the system. It was also desired to discover suggestions for future improvements to the system.A total of 15 healthy volunteers participated (12 males; 3 females; age: 23.8 years [SD 1.80]; height: 1.79 m [SD 0.07], body mass: 78.4 kg [SD 9.6]). Five participants were beginner gym-goers, 5 were experienced gym-goers, and 5 were qualified and practicing S&C coaches. IMU data were first collected from each participant to create individualized exercise classifiers for them. They then completed a number of nonexercise-related tasks with the app. Following this, a workout was completed using the system, involving squats, deadlifts, lunges, and single-leg squats. Participants were then interviewed about their user experience and completed the System Usability Scale (SUS) and the user version of the Mobile Application Rating Scale (uMARS). Thematic analysis was completed on all interview transcripts, and survey results were analyzed.Qualitative and quantitative analysis found the system has "good" to "excellent" usability. The system achieved a mean (SD) SUS usability score of 79.2 (8.8). Functionality was also deemed to be good, with many users reporting positively on the systems repetition counting, technique classification, and feedback. A number of bugs were found, and other suggested changes to the system were also made. The overall subjective quality of the app was good, with a median star rating of 4 out of 5 (interquartile range, IQR: 3-5). Participants also reported that the system would aid their technique, provide motivation, reassure them, and help them avoid injury.This study demonstrated an overall positive evaluation of Formulift in the categories of usability, functionality, perceived impact, and subjective quality. Users also suggested a number of changes for future iterations of the system. These findings are the first of their kind and show great promise for wearable sensor-based exercise biofeedback systems.
| S-EPMC5812980 | biostudies-literature
Project description:We describe a wearable sensor developed for cardiac rehabilitation (CR) exercise. To effectively guide CR exercise, the dedicated CR wearable sensor (DCRW) automatically recommends the exercise intensity to the patient by comparing heart rate (HR) measured in real time with a predefined target heart rate zone (THZ) during exercise. The CR exercise includes three periods: pre-exercise, exercise with intensity guidance, and post-exercise. In the pre-exercise period, information such as THZ, exercise type, exercise stage order, and duration of each stage are set up through a smartphone application we developed for iPhones and Android devices. The set-up information is transmitted to the DCRW via Bluetooth communication. In the period of exercise with intensity guidance, the DCRW continuously estimates HR using a reflected pulse signal in the wrist. To achieve accurate HR measurements, we used multichannel photo sensors and increased the chances of acquiring a clean signal. Subsequently, we used singular value decomposition (SVD) for de-noising. For the median and variance of RMSEs in the measured HRs, our proposed method with DCRW provided lower values than those from a single channel-based method and template-based multiple-channel method for the entire exercise stage. In the post-exercise period, the DCRW transmits all the measured HR data to the smartphone application via Bluetooth communication, and the patient can monitor his/her own exercise history.
| S-EPMC5663433 | biostudies-literature
Project description:INTRODUCTION:Technology has been placed at the centre of global health policy and has been cited as having the potential to increase efficiency and remove geographical boundaries for patients to access care. Communication technology may support patients with orthopaedic problems, which is one of the leading causes of disability worldwide. There are several examples of technology being used in clinical research, although uptake in practice remains low. An understanding of patient preferences will support the design of a communication technology supported treatment pathway for patients undergoing orthopaedic rehabilitation. METHODS AND ANALYSIS:This mixed methods project will be conducted in four phases. In phase I, a systematic review of qualitative studies reporting communication technology use for orthopaedic rehabilitation will be conducted to devise a taxonomy of tasks patients' face when using these technologies to access their care. In phase II, qualitative interviews will investigate how the work of being a patient changes during face-to-face and communication technology consultations and how these changes influence preference. In phase III, a discrete choice experiment will investigate the factors that influence preferences for the use of communication technology for orthopaedic rehabilitation consultations. Phase IV will be a practical application of these results. We will design a 'minimally disruptive' communication technology supported pathway for patients undergoing orthopaedic rehabilitation. ETHICS AND DISSEMINATION:The design of a pathway and underpinning patient preference will assist in understanding factors that might influence technology implementation for clinical care. This study requires ethical approval for phases II, III and IV. Approvals have been received for phase II (approval received on 4 December 2016 from the South Central-Oxford C Research Ethics Committee (IRAS ID: 255172, REC Reference 18/SC/0663)) and phase III (approval received on 18 October 2019 from the London-Hampstead Research Ethics Committee (IRAS ID: 248064, REC Reference 19/LO/1586)) and will be sought for phase IV. All participants will provide informed written consent prior to being enrolled onto the study. PROSPERO REGISTRATION NUMBER:CRD42018100896.
| S-EPMC6924859 | biostudies-literature
Project description:BackgroundThe burden of influenza-like illness (ILI) is typically estimated via hospitalizations and deaths. However, ILI-associated morbidity that does not require hospitalization remains poorly characterized.ObjectiveThe main objective of this study was to characterize ILI burden using commercial wearable sensor data and investigate the extent to which these data correlate with self-reported illness severity and duration. Furthermore, we aimed to determine whether ILI-associated changes in wearable sensor data differed between care-seeking and non-care-seeking populations as well as between those with confirmed influenza infection and those with ILI symptoms only.MethodsThis study comprised participants enrolled in either the FluStudy2020 or the Home Testing of Respiratory Illness (HTRI) study; both studies were similar in design and conducted between December 2019 and October 2020 in the United States. The participants self-reported ILI-related symptoms and health care-seeking behaviors via daily, biweekly, and monthly surveys. Wearable sensor data were recorded for 120 and 150 days for FluStudy2020 and HTRI, respectively. The following features were assessed: total daily steps, active time (time spent with >50 steps per minute), sleep duration, sleep efficiency, and resting heart rate. ILI-related changes in wearable sensor data were compared between the participants who sought health care and those who did not and between the participants who tested positive for influenza and those with symptoms only. Correlative analyses were performed between wearable sensor data and patient-reported outcomes.ResultsAfter combining the FluStudy2020 and HTRI data sets, the final ILI population comprised 2435 participants. Compared with healthy days (baseline), the participants with ILI exhibited significantly reduced total daily steps, active time, and sleep efficiency as well as increased sleep duration and resting heart rate. Deviations from baseline typically began before symptom onset and were greater in the participants who sought health care than in those who did not and greater in the participants who tested positive for influenza than in those with symptoms only. During an ILI event, changes in wearable sensor data consistently varied with those in patient-reported outcomes.ConclusionsOur results underscore the potential of wearable sensors to discriminate not only between individuals with and without influenza infections but also between care-seeking and non-care-seeking populations, which may have future application in health care resource planning.Trial registrationClinicaltrials.gov NCT04245800; https://clinicaltrials.gov/ct2/show/NCT04245800.
| S-EPMC10131710 | biostudies-literature
Project description:Recently, the popularity of smart wearable technologies, such as Fitbit, has significantly increased. There are numerous potential benefits in using these devices, especially among seniors. Yet, little is known about seniors' adoption behavior. Through a mixed-methods approach, this study investigates the factors that impact seniors' intention to use wearable devices. Results from an online survey and interviews showed that seniors' perception of the complexity of working with these devices is a barrier to their adoption decisions. Looking more deeply into the role of complexity revealed that seniors' concern about the complexity of reading and interpreting the output of wearable devices is the main deterring element. Furthermore, we explored the role of two important elements: seniors' cognitive age, and the influence of their subjective well-being on their adoption behavior. Results demonstrated that cognitive age does not significantly impact use intention by itself; nonetheless, subjective well-being moderates its effect. This result revealed an interesting finding, which is that the influence of cognitive age on seniors' use intention depends on seniors' level of subjective well-being. When seniors' subjective well-being is low, surprisingly, cognitive age increases seniors' intention to use the device. These findings provide interesting implications for practice and future research.
| S-EPMC7402656 | biostudies-literature
Project description:Machine learning models are being utilized to provide wearable sensor-based exercise biofeedback to patients undertaking physical therapy. However, most systems are validated at a technical level using lab-based cross validation approaches. These results do not necessarily reflect the performance levels that patients and clinicians can expect in the real-world environment. This study aimed to conduct a thorough evaluation of an example wearable exercise biofeedback system from laboratory testing through to clinical validation in the target setting, illustrating the importance of context when validating such systems. Each of the various components of the system were evaluated independently, and then in combination as the system is designed to be deployed. The results show a reduction in overall system accuracy between lab-based cross validation (>94%), testing on healthy participants (n = 10) in the target setting (>75%), through to test data collected from the clinical cohort (n = 11) (>59%). This study illustrates that the reliance on lab-based validation approaches may be misleading key stakeholders in the inertial sensor-based exercise biofeedback sector, makes recommendations for clinicians, developers and researchers, and discusses factors that may influence system performance at each stage of evaluation.
| S-EPMC8037109 | biostudies-literature
Project description:BACKGROUND:Effective human-robot interactions in rehabilitation necessitates an understanding of how these should be tailored to the needs of the human. We report on a robotic system developed as a partner on a 3-D everyday task, using a gamified approach. OBJECTIVES:To: (1) design and test a prototype system, to be ultimately used for upper-limb rehabilitation; (2) evaluate how age affects the response to such a robotic system; and (3) identify whether the robot's physical embodiment is an important aspect in motivating users to complete a set of repetitive tasks. METHODS:62 healthy participants, young (<30 yo) and old (>60 yo), played a 3D tic-tac-toe game against an embodied (a robotic arm) and a non-embodied (a computer-controlled lighting system) partner. To win, participants had to place three cups in sequence on a physical 3D grid. Cup picking-and-placing was chosen as a functional task that is often practiced in post-stroke rehabilitation. Movement of the participants was recorded using a Kinect camera. RESULTS:The timing of the participants' movement was primed by the response time of the system: participants moved slower when playing with the slower embodied system (p?=?0.006). The majority of participants preferred the robot over the computer-controlled system. Slower response time of the robot compared to the computer-controlled one only affected the young group's motivation to continue playing. CONCLUSION:We demonstrated the feasibility of the system to encourage the performance of repetitive 3D functional movements, and track these movements. Young and old participants preferred to interact with the robot, compared with the non-embodied system. We contribute to the growing knowledge concerning personalized human-robot interactions by (1) demonstrating the priming of the human movement by the robotic movement - an important design feature, and (2) identifying response-speed as a design variable, the importance of which depends on the age of the user.
| S-EPMC5870005 | biostudies-literature
Project description:BackgroundWearable devices permit the continuous, unobtrusive collection of data from children in their natural environments and can transform our understanding of child development. Although the use of wearable devices has begun to emerge in research involving children, few studies have considered families' experiences and perspectives of participating in research of this kind.ObjectiveThrough a mixed methods approach, we assessed parents' and children's experiences of using a new wearable device in the home environment. The wearable device was designed specifically for use with infants and young children, and it integrates audio, electrocardiogram, and motion sensors.MethodsIn study 1, semistructured phone interviews were conducted with 42 parents of children aged 1 month to 9.5 years who completed 2 day-long recordings using the device, which the children wore on a specially designed shirt. In study 2, a total of 110 parents of children aged 2 months to 5.5 years responded to a questionnaire assessing their experience of completing 3 day-long device recordings in the home. Guided by the Digital Health Checklist, we assessed parental responses from both studies in relation to the following three key domains: (1) access and usability, (2) privacy, and (3) risks and benefits.ResultsIn study 1, most parents viewed the device as easy to use and safe and remote visits as convenient. Parents' views on privacy related to the audio recordings were more varied. The use of machine learning algorithms (vs human annotators) in the analysis of the audio data, the ability to stop recordings at any time, and the view that the recordings reflected ordinary family life were some reasons cited by parents who expressed minimal, if any, privacy concerns. Varied risks and benefits were also reported, including perceived child comfort or discomfort, the need to adjust routines to accommodate the study, the understanding gained from the study procedures, and the parent's and child's enjoyment of study participation. In study 2, parents' ratings on 5 close-ended items yielded a similar pattern of findings. Compared with a "neutral" rating, parents were significantly more likely to agree that (1) device instructions were helpful and clear (t109=-45.98; P<.001), (2) they felt comfortable putting the device on their child (t109=-22.22; P<.001), and (3) they felt their child was safe while wearing the device (t109=-34.48; P<.001). They were also less likely to worry about the audio recordings gathered by the device (t108=6.14; P<.001), whereas parents' rating of the burden of the study procedures did not differ significantly from a "neutral" rating (t109=-0.16; P=.87).ConclusionsOn the basis of parents' feedback, several concrete changes can be implemented to improve this new wearable platform and, ultimately, parents' and children's experiences of using child wearable devices in the home setting.
| S-EPMC10884896 | biostudies-literature
Project description:BackgroundExtended scope physiotherapists (ESP) are increasingly supplementing orthopaedic surgeons (OS) in diagnosing patients with musculoskeletal disorders. Studies have reported satisfactory diagnostic and treatment agreement between ESPs and OSs, but methodological study quality is generally low, and only few studies have evaluated inter-professional collaboration. Our aims were: 1) to evaluate agreement on diagnosis and treatment plan between ESPs and OSs examining patients with shoulder disorders, 2) to explore and evaluate their inter-professional collaboration.Methods1) In an orthopaedic outpatient shoulder clinic, 69 patients were examined independently twice on the same day by an ESP and an OS in random order. Primary and secondary diagnoses (nine categories) and treatment plan (five categories, combinations allowed) were registered by each professional and compared. Percentage of agreement and kappa-values were calculated. 2) Two semi-structured focus-group interviews were performed with ESPs and OSs, respectively. Interviews were based on the theoretical concept of Relational Coordination, encompassing seven dimensions of communication and relationship among professionals. A thematic analysis was conducted.Results1) Agreement on primary diagnosis was 62% (95% CI: [50; 73]). ESPs and OSs agreed on the combination of diagnoses in 79% (95% CI: [70; 89]) of the cases. Partial diagnostic agreement (one professional's primary diagnosis was also registered as either primary or secondary diagnosis by the other) was 96% (95% CI: [91; 100]). Across treatment categories, agreement varied between 68% (95% CI: [57; 79]) and 100%. In 43% (95% CI: [31; 54]) of the cases, ESP and OS had full concordance between treatment categories chosen, while they agreed on at least one recommendation in 96% (95% CI: [91; 100]). 2) Positive statements of all dimensions of relational coordination were found. Three themes especially important in the inter-professional collaboration emerged: Close communication, equal and respectful relationship and professional skills.ConclusionsIn the majority of cases, the ESP and OS registered the same or partly the same diagnosis and treatment plan. Indications of a high relational coordination implying a good inter-professional collaboration were found. Our results support that ESPs and OSs can share the task of examining selected patients with shoulder disorders in an orthopaedic clinic.Trial registrationClinicalTrials.gov Identifier: NCT03343951 . Registered 10 November 2017.
| S-EPMC7784386 | biostudies-literature