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Chronic obstructive pulmonary disease (COPD) is a progressive life-threatening lung disease that causes breathlessness, chronic cough, and overall decrease in patients’ quality of life. Pulmonary rehabilitation (PR) slows COPD progression and reduces the overall economic burden of the disease. However, only a small portion of patients participate in conventional face-to-face PR due to a lack of resources, or motivation. Digital PR interventions may reduce these barriers, but only a few digital PR interventions available are rigorously designed and tested. The purposes of this study were to (1) develop a high-fidelity prototype app for digital PR using an experience-based co-design (EBCD) approach, and (2) conduct a usability testing of the PR prototype app. We engaged 15 COPD patients and 11 healthcare providers in the EBCD process. Following the development, 7 patients participated in the usability testing and a semi-structured interview to provide their feedback on the prototype app. The EBCD approach resulted in a prototype of a digital PR intervention – COPDTrack, with features suggested from patients and providers. These features include: digital PR exercise courses, real-time health monitoring, digital 6-min walk test, visualization of progress, patient reported outcomes, and the ability to communicate with healthcare providers. The usability testing results indicated that most participants completed tasks successfully and were able to navigate smoothly throughout the app. Our study demonstrates the feasibility of integrating EBCD into the HCD process to facilitate the design and development of the digital PR intervention for COPD patients.

Background Patients who receive rehabilitation after hip replacement surgery are shown to have increased muscle strength and better functional performance. However, traditional physiotherapy is often tedious and leads to poor adherence. Exercise games, provide ways for increasing the engagement of elderly patients and increase the uptake of rehabilitation exercises. Objective The objective of this study was to evaluate Fietsgame (Dutch for cycling game), which translates existing rehabilitation exercises into fun exercise games. The system connects exercise games with a patient’s personal record and a therapist interface by an Internet of Things server. Thus, both the patient and physiotherapist can monitor the patient’s medical status. Methods This paper describes a pilot study that evaluates the usability of the Fietsgame. The study was conducted in a rehabilitation center with 9 participants, including 2 physiotherapists and 7 patients. The patients were asked to play 6 exercise games, each lasting about 5 min, under the guidance of a physiotherapist. The mean age of the patients was 74.57 years (standard deviation [SD] 8.28); all the patients were in the recovery process after hip surgery. Surveys were developed to quantitatively measure the usability factors, including presence, enjoyment, pain, exertion, and technology acceptance. Comments on advantages and suggested improvements of our game system provided by the physiotherapists and patients were summarized and their implications were discussed. Results The results showed that after successfully playing the games, 75% to 100% of the patients experienced high levels of enjoyment in all the games except the squats game. Patients reported the highest level of exertion in squats when compared with other exercise games. Lunges resulted in the highest dropout rate (43%) due to interference with the Kinect v2 from support chairs. All the patients (100%) found the game syst

BACKGROUND: Patients who receive rehabilitation after hip replacement surgery are shown to have increased muscle strength and better functional performance. However, traditional physiotherapy is often tedious and leads to poor adherence. Exercise games, provide ways for increasing the engagement of elderly patients and increase the uptake of

Background Huntington’s disease (HD) is a chronic neurodegenerative disorder characterised by a progressive loss of cognitive function, motor control and psychiatric features. Individuals also display a variety of systemic features. Progressive neuronal dysfunction and neuronal cell death are thought to underlie the onset and progression of many clinical features of HD. Despite scientific progress, there is still no cure or disease modifying therapy for HD, and available pharmaceutical agents only provide partial relief of motor and psychiatric features. An emerging body of evidence indicates that lifestyle enrichment may delay the onset and progression of clinical features, and exert favourable effects on neuropathological aspects of HD. Few studies have evaluated the effects of lifestyle enrichment strategies like multidisciplinary rehabilitation on the clinical features of HD. Moreover, no study has evaluated the effects of multidisciplinary rehabilitation on neuropathological aspects of HD. Aims The initial aim of this thesis was to determine factors that contribute to features of the disease that negatively impact on activities of daily living such as mobility and balance (Chapter 2), and to identify, using a literature review, a rehabilitation strategy that could positively impact on these features of HD (Chapter 3). These studies informed our ultimate aim which was to investigate the clinical utility of multidisciplinary rehabilitation on clinical and neuropathological features of HD (Chapters 4, 5 and 6) Methods In study 1 (Chapter 2), 22 participants were assessed using a battery of balance, mobility, cognitive tests, assessments of muscle strength and body composition measures. Data was . then statistically examined using stepwise linear regression to identify factors that contribute to balance and mobility impairments in individuals with manifest HD. In study 2 (Chapter 3), a systematic search of journal databases was made from inception to July 2014 for

Background Huntington’s disease (HD) is a chronic neurodegenerative disorder characterised by a progressive loss of cognitive function, motor control and psychiatric features. Individuals also display a variety of systemic features. Progressive neuronal dysfunction and neuronal cell death are thought to underlie the onset and progression of many clinical features of HD. Despite scientific progress, there is still no cure or disease modifying therapy for HD, and available pharmaceutical agents only provide partial relief of motor and psychiatric features. An emerging body of evidence indicates that lifestyle enrichment may delay the onset and progression of clinical features, and exert favourable effects on neuropathological aspects of HD. Few studies have evaluated the effects of lifestyle enrichment strategies like multidisciplinary rehabilitation on the clinical features of HD. Moreover, no study has evaluated the effects of multidisciplinary rehabilitation on neuropathological aspects of HD. Aims The initial aim of this thesis was to determine factors that contribute to features of the disease that negatively impact on activities of daily living such as mobility and balance (Chapter 2), and to identify, using a literature review, a rehabilitation strategy that could positively impact on these features of HD (Chapter 3). These studies informed our ultimate aim which was to investigate the clinical utility of multidisciplinary rehabilitation on clinical and neuropathological features of HD (Chapters 4, 5 and 6) Methods In study 1 (Chapter 2), 22 participants were assessed using a battery of balance, mobility, cognitive tests, assessments of muscle strength and body composition measures. Data was . then statistically examined using stepwise linear regression to identify factors that contribute to balance and mobility impairments in individuals with manifest HD. In study 2 (Chapter 3), a systematic search of journal databases was made from inception to July 2014 for

In recent years, emergence of telerehabilitation systems for home-based therapy has altered healthcare systems. Telerehabilitation enables therapists to observe patients status via Internet, thus a patient does not have to visit rehabilitation facilities for every rehabilitation session. Despite the fact that telerehabilitation provides great opportunities, there are two major issues that affect effectiveness of telerehabilitation: relegation of the patient at home, and loss of direct supervision of the therapist. Since patients have no actual interaction with other persons during the rehabilitation period, they will become isolated and gradually lose their social skills. Moreover, without direct supervision of therapists, rehabilitation exercises can be performed with bad compensation strategies that lead to a poor quality recovery. To resolve these issues, we propose telelife, a new concept for future rehabilitation systems. The idea is to use media technology to create a totally new immersive media experience for rehabilitation. In telerehabilitation patients locally execute exercises, and therapists remotely monitor patients' status. In telelife patients, however, remotely perform exercises and therapists locally monitor. Thus, not only telelife enables rehabilitation at distance, but also improves the patients' social competences, and provides direct supervision of therapists. In this paper we introduce telelife to enhance telerehabilitation, and investigate technical challenges and possible methods to achieve telelife., QC 20151208