OrthoGrow Recovery

Luke Dowling

Colin Farrell

Simon Dunne

An Assistive Smartphone Application for Treatment and Rehabilitation of

Physical Impairment

Concept

• Smartphone based personal planner application, designed for exercises of those with orthopaedic injuries and conditions arising from:

1. Trauma

2. Sports participation

3. Particular focus on personal treatment of spinal injury

4. Debilitating illnesses and conditions, neurological or otherwise

Vision

• This proposed method of self guided treatment with professional supervision could increase independence of the patient and decrease workload on therapeutic professionals (Hoffman & Cantoni, 2008)

• Idea is to create a method of rehabilitation and treatment which can hopefully increase self-efficacy and self-esteem in physically impaired individuals

• Despite decreased contact time, it would be necessary for rehabilitative experts to have a comprehensive and up-to-date knowledge of the technology to supervise clients on their personal treatment (Verdonck, McCormack, & Chard, 2011)

Participant Selection

• User Group: Individuals recovering from spinal, sporting, or traumatic injuries, or being treated for debilitating illnesses and conditions

• Professional Group: Physical and Occupational Therapists from the National Rehabilitation Hospital in Dun Laoghaire have acted as informal advisors during concept development

User Persona

Name: David Walsh

Age: 31

Occupation: Solicitor

Personality Traits: Intelligent, highly motivated, independent, organised

About: David Walsh is young lawyer with a successful reputation and was seen as an up and coming solicitor, he has high hopes for becoming a judge in the Supreme Court. He is known for being extremely motivated and does everything for himself, be it work related or in his personal life.On his way home from work, David was involved in a serious car accident which left him with severe spinal injuries, and loss of primary movement on the right hand side of his body. He has spent several months in a rehabilitation centre, making considerable progress. His treatment team have said that if he perseveres with the programme set for him, there is a good chance he will regain a measure of control on the right hand side of his body. He is eager to get back to work as soon as possible and does not have time to visit or wait on a physiotherapist. David is looking for a device to help him with his exercises and won’t take too much time from hopefully returning to his a reduced work schedule.

Inclusive Design Aspects

• Gesture Search and Swype – Ease of touch screen usage

Inclusive Design Aspects

Vlingo/ Siri – Voice orientated phone Navigation

Dragon Remote Mic/ Naturally Speaking – Type based voice recognition

Inclusive Design Aspects

• Aibilities Blink Control

• Tecla Access – Wheelchair and head based switch controller for smartphone

Market Research

Similar applications have been developed for iOS and Android OS, and many features can be incorporated into this personal treatment and rehabilitation application such as;

1. Physioadvisor – This application has a selection of useful tools in order to meet your recovery needs for participation in sport, along with exercise reminder alarm and programme planner

2. Restore Physical Therapy – Broader range of injury focus, but is at an early stage of development and is not widely used

3. Prevent Back and Spine Pain – More informative in that it gives introductory information, tutorials, and illustrated guides to explain exercise benefits; but requires specific gym equipment for treatment

Research

Psychological effects of physical impairment

• Physical impairments can affect all aspects of a patient’s life, including their physical, behavioural, psychological and social functioning (North, 1999)

• SCI can lead to cognitive deficits and difficulties with memory, attention and concentration, learning, and problem solving ability. These deficiencies can further complicate the rehabilitation and treatment processes (Roth, Davidoff, Thomas, Doljanac, Dijkers, Berent, Morris, & Yarkony,1989)

• 6 “D’s” which have high comorbidity with spinal injury – Dependency, Depression, Drug addiction, Divorce, Debilitation, and Demanding (Gill, 1999)

Research

Self efficacy, self-esteem, and independence in recovery/ treatment

• Exercise contributes to improved physical health, improves the quality of life and contributes to a sense of wellbeing. This can ease recovery and treatment processes and add to the indivuals’ subjective sense of self worth (National Rehabilitation Hospital, US Department of Education, 2005)

• Desire to interact with the social environment tends to be lower due to decreased motility (Gill, 1999)

• A population of male SCI patients reported that inactive body parts lead to them feeling lower in self-esteem and quality of life (Anderson, Borisoff, Johnson, Steins & Elliot, 2006)

ResearchRehabilitation through IT usage

• Assistive technology such as the Smartphone has been found to elicit optimism from users and clinicians regards its use as a cognitive aid (de Joode, van Heugten, Verhev, & van Boxtel, 2010)

• Individuals with disabilities relating to neurological conditions have described access to new assistive technologies as beneficial to their overall independence and wellbeing (Gentry, 2011)

• Multitouch technologies such as smartphones have been found to hold an advantage over other technologies in cognitive and neurological rehabilitation settings (Alcaniz, Abarca, Lozano, & Herrero, 2009)

• Government subsidies and funding have previously been made available for procurement of assistive technologies to physically impaired individuals in Sweden (Bartfai & Boman, 2011)

Our Data Collection

• Questionnaire 1 (User Group) – Focus on personal viewpoints of physically impaired individuals, with focus on practical difficulties associated with debilitation and lack of mobility. Distributed among a population of patients of the National Rehabilitation Hospital, Dun Laoghaire (Appendix A)

• Questionnaire 2 (Professional Group) – Emphasis on expert knowledge of physical impairment aids, assistive technologies, and treatment techniques. Distributed among a population of physical rehab and Occupational Therapy specialists in the National Rehabilitation Hospital, Dun Laoghaire (Appendix B)

• Coding of data to modify exact exercise system and interface yet to be completed

• Focus Group – Unstructured interview to be conducted with both patients and employees of the NRH on the 15/11/12

ReferencesAlcaniz, M., Abarca, V., Lozano, J.A., & Herrero, N. (2009). Analysis of multitouch technology for neurorehabilitation. Journal of CyberTherapy and Rehabilitation, 2(3), 183-190.

Anderson, K., Borisoff, J., Johnson, R., Steins, S., & Elliot, S. (2006). The impact of spinal chord injury on sexual function; concerns of the general population. Spinal Cord. doi: 45, 328–337.

Bartfai, A., & Boman, I.L. (2011). Policies concerning assistive technology and home modification services for people with physical and cognitive disabilities in Sweden. NeuroRehabilitation, 28(3), 303-308.

de Joode, E., van Heugten, C., Verhey, F., & van Boxtel, M. (2010). Efficacy and usability of assistive technology for patients with cognitive deficits: A systematic review. Clinical Rehabilitation, 24(8), 701-714.

Gentry, T., (Ed.). (2011). Assistive technology for people with neurological disability. NeuroRehabilitation, 28(3), 181-182.

Gill, M. (1999). Psychosocial implications of spinal injuries. Critical Care Nursing Quarterly, 22(2), 1-7.

Gill, M. (1999). Psychosocial implications of spinal cord injury. Pennsylvania, USA: Allegheny General Hospital.

Hoffman, T., & Cantoni, N. (2008). Occupational therapy services for adult neurological clients in Queensland and therapists' use of telehealth to provide services. Australian Occupational Therapy Journal, 55(4), 239-248.

North N.T. (1999). The psychological effects of spinal cord injury. Salisbury, UK: Wiltshire

Roth E. , Davidoff G, , Thomas P, , Doljanac R, , Dijkers M, , Berent S, , Morris J, , & Yarkony G, (1989).A controlled study of neuropsychological deficits in acute spinal cord injury patients. Chicago, IL: Northwestern University Medical School.

US Department of Education, N. Research Division, (2005). Exercise and science. Retrieved from National Rehabilitation Hospital website: www.sci-health.org

Verdonck, M., McCormack, C., & Chard, G. (2011). Irish occupational therapists' views of electronic assistive technology. The British Journal of Occupational Therapy, 74(4), 185-195.

Appendix A

Appendix B

Appendix C

Appendix D