1. 1. The use of Technology to Motivate Active Ageing Ben Heller & Anna Lowe
2. 2. Workshop Structure: Introduction what is active ageing? What role can technology play How can we use technology to measure physical activity in older people? (sensors) How can we use technology to motivate physical activity in older people? (exercise in virtual worlds) Chance to play with the equipment Facilitated discussion
3. 3. What does Active Ageing mean? Active ageing aims to extend healthy life expectancy and quality of life for all people as they age. The word active refers to continuing participation in social, economic, cultural, spiritual and civic affairs, not just the ability to be physically active or to participate in the labour force.
4. 4. Focus on Physical Activity Key risk factor for premature death. 16.9% of "all-cause premature mortality" can be attributed to physical activity (BHF 2013). It is MODIFIABLE!
5. 5. PA & Older People PA reduces falls and fall-related injuries Delays the need for care, reduces decline in functional status Delays onset of cognitive decline. 3 in 5 adults have a long term condition, increases with age, PA is central to management of LTCs.
6. 6. Sustainability Health & Social Care Systems
7. 7. Technology in Active Ageing Measurement Motivation Communication Monitoring, safety
8. 8. Measurement of Physical Activity Big drivers to increase activity in older populations. Need to be able to measure in order to show improvement.
9. 9. Measurement: Who, What & Why? Who? Individuals Clinicians Researchers Provider of PA services What & Why? Quantity of PA Intensity of PA Type of PA Physiological parameters HR BP Oxygenation
10. 10. Direct versus Indirect Methods Direct measurement Gadget Objective Indirect measurement Self report, relies on recall Subjective
11. 11. Indirect Measures Questionnaire based (paper or online) Physical Activity Scale for the Elderly (PASE) Community Healthy Activities Model Program for Seniors (CHAMPS) GPPAQ (up to 74 years)
12. 12. Direct Measures Pedometers Activity Tracker Gadgets e.g. Fitbits Smartphone apps
13. 13. More on Apps Free (if you have a smart phone). Simple to use. Lots of options. Appropriate for some.
14. 14. Sheffield Physical Activity Observatory The Sheffield Physical Activity Observatory (SPAO) is a set of tools and methods for capturing, storing and analysing and displaying population-scale data on physical activity (PA) and its associated health corollaries. Provide feedback to individuals on their PA levels. Collect population-scale baseline data on PA levels. Allow the assessment of any interventions that may impact PA levels. Provide a secure repository of data for retrospective and meta-analysis
15. 15. Sheffield Physical Activity Observatory - detail SPAO was established in Spring 2014 following a grant of 90k from the Strategic Research Investment Fund of Sheffield Hallam University 50 tablet computers for e-questionnaire collection 1100 sensors for collection of objective PA data Tools for data analysis and presentation (infographics) Available for research projects and clinical initiatives Contact Dr Ben Heller for details
16. 16. Second lives for the third age: motivating exercise adherence using virtual worlds
17. 17. Context: social isolation
18. 18. Context - Falls Increased likelihood of falling with age Affects not just frail, but also independent well elderly Leading cause of injury-related hospitalisation in this population Fear of falling leads to reduced activity long-term adherence to exercise programs is imperative to reduce fall risk. (Vogler et al. 2012)
19. 19. Exercise works but you have to do it Targeted rehabilitation through active participation and engagement in contextually- appropriate repetitive and intensive movements (e.g. Otago programme) shown to promote recovery Exercises completed individually at home, can be tedious => problem with motivation. Only effective with good compliance Can serious games be used to motivate rehabilitation for older people?
20. 20. Second Lives for the Third Age Pilot funding to: Explore older peoples opinions and expectations of serious games. Develop an age-appropriate, safe serious game Develop a whole-body physical interface to allow rich interaction without requiring mouse or computer skills.
21. 21. We surveyed older people to see what would motivate them Common themes Socialisation - Going dancing at the local ballroom getting dressed up to go out tango, waltz etc., leave shoes at the cloakroom and put on "dancing shoes", silver ball, big band meet boys! Travel - problems with getting insurance to travel abroad when older would like to revisit places, or see new ones 18th Century "grand tour" of Europe, Grand Canyon Pets - virtual dog to take for walks Role play - play the leading role in an opera Gardening suggested possibility of "virtual garden" (to include pruning, weeding hoeing, planting, watering, nurturing) Physical - Running downhill really fast like kids do
22. 22. Walled-garden Rest + socialisation area Lake with fish Trees (climbable) Gardening activity Animals (birds, butterflies, peacock) Walled to prevent incursion/ users getting lost
23. 23. Physical / gesture interfaces Gesture-based interfaces have been proposed to create more natural and intuitive ways of communicating with computers Identify users movements (gestures). Send key-presses to Second Life viewer to trigger appropriate movements and animations Originally used Polhemus electromagnetic tracking system (wired), cost approx 10000. Now Kinect (100)
24. 24. Gestures Walking Turning Flying Waving Rowing Dancing Jumping Disconnect layer between gesture and avatar action, allows customisation, scalability and progression of gestures. Facilitates use of non- exergaming software.
25. 25. Initial evaluation 4 older users - two women, two men (Somali) Used both conventional and physical user interfaces Opinions sought by interview
26. 26. Comments So if you were to meet your grandchildren in Second Life, what kind of things do you think you'd like to do? Well I'd still like to hear __ play his clarinet, and perhaps we could have a bandstand. And __ a football pitch, he'd like that. And __ a netball pitch, you know. And you could just go and watch quite easily. You could even join in if you wanted to Yeah, that's right, you could couldn't you. Yeah, I hadn't thought of that Do you think you'd enjoy that? Oh I'm sure I would, yes. Netball, I used to play when I was younger, and that would be good. You can even do concerts and things in Second Life You could play in the concert in the orchestra!
27. 27. Implications Potentially improve quality and quantity of rehabilitation exercise whilst reducing cost. Potential additional benefits due to social and cognitive engagement as well as physical exercise => need to involve multiple practitioners. IT and organisational issues for delivery Ethical issues??
28. 28. Thank you! Any questions?
29. 29. Show & Tell Measure Accelerometers Pedometers fitbits Fitbug Runscribe Kinect Monitor HRM (bluetooth) BPM Pulse ox Lumoback
30. 30. Questions: Is this a vision of the future for the NHS? What barriers will hold-back widespread implementation? What can we do within our own practice? What support do we need from commissioners, policy makers, research funders, etc.
31. 31. References British Heart Foundation. (2013) Making the case for physical activity: Evidence briefing Lee I, Shiroma EJ, Lobelo F, Puska P, Blair SN, Katzmarzyk PT, for the Lancet Physical Activity Series Working Group. Effect of physical inactivity on major non communicable diseases worldwide: An analysis of burden of disease and life expectancy. The Lancet. 2012;380(9838):219-229. Department of Health (2011) Start active, stay active: a report on physical activity from the four home countries' Chief Medical Officers Intelligent Health (2013) Physical activity and long term conditions: A guide for GPs British Heart Foundation (2013) Older adults: practical strategies for increasing physical activity. Kowalski K, Rhodes R, Naylor P, Tuokko H and MacDonald S (2012) Direct and indirect measurement of physical activity in older adults: a systematic review of the literature Fei Sun, Norman I and While A. (2103) Physical activity in older people: a systematic review. McSeveny, K., Heller, B., Light, A., & Machaczek, K.. (2013) "You could, couldn't you?: A preliminary investigation of older people's interaction with a bespoke virtual environment using a gesture interface", Journal of Gaming and Virtual Worlds, Vol. 5, No. 3, pp. 235-249.