The design project related to the doctoral research regards a mHealth system called PASSO (PArkinson Smart Sensory-cues for Older-users), an innovative biofeedback system specifically designed to rehabilitate gait and postural disturbances in persons with Parkinson’s Disease. Results obtained in the PASSO project are supposed to be used for people with PD in ambulatory contexts and outside specialized centers to rehabilitate postural and transient gait disturbances, and to provide training at home, respectively. The system is targeted to PD subjects that are facing the initial and intermediate stages of the disease (Hoehn and Yahr: I-II), dealing with several ailments but most of all with a physical decline that affects walking and motor skills in general, impacting functional independence, well-being, and health-related quality of life. Physical exercise and physiotherapy have been shown to improve PD motor impairments by decelerating the motor decline. Also, it has been suggested that exercise effects can be enhanced by increasing subjects’ cognitive engagement with practice through the provision of cueing or feedback in PD. Cueing is made of temporal or spatial sensory stimuli that ameliorate and facilitate repetitive movements by providing an explicit motor target. The PASSO project follows an iterative User-Centered Design methodology, the design process of the project was divided into three main iterative cycles, each one organized in four phases: planning (P1), analyzing (P2), creating (P3), and verifying (P4). Moreover, every design cycle was associated to the achievement of a specific Technology Readiness Level (TRL): • Cycle 1 (C1): Sensory cues and system. TRL 4 (technology validated in a laboratory). • Cycle 2 (C2): Devices submitting sensory cues. TRL 5 (technology validated in relevant environment). • Cycle 3 (C3): Rehabilitation system for PD users. TRL 6 (technology validated in relevant environment). The involvement of users in the design process aims to improve the system’s usability, allowing them to take advantage of a satisfying experience that will help them face, in a better way, specific activities of their life. The used methodology led to satisfactory results and proved to be particularly suitable for multidisciplinary design processes involving both human and technological factors related with the development of smart systems targeted to niche users. Specifically, the first design cycle aimed to analyze how visual, auditory, and sensory cues submitted to users using an existing system implemented with Smart Glasses (SG) can influence the users’ gait. Several auditory, visual, and haptic cues were tested to understand which sensory channels are most sensitive to which type of stimulation and which gait parameters are most influenced by this kind of stimuli, characterized by low cognitive involvement. During the second design cycle, a mHealth system based on a wireless body sensor network with a smartphone and different smartwatches has been developed. This wearable system enables the real-time monitoring of trunk postural features. Thanks to smartwatches, haptic cues are submitted to the users, encouraging them to correct their trunk postural behavior, depending on the specific clinical needs. The third and last design cycle was dedicated to the development of the system interface, following users’ usability requirements. In this part it was developed the graphic image of the web application managing the system, and the whole system was tested by patients with PD to assess its functionality, usability, ease of use and wearability. The applied methodological process led to satisfactory results, the project outputs can be considered as relevant in the field of design methodologies for the design of smart devices aiming to improve older users’ health and wellbeing.

Il progetto di ricerca relativo alla ricerca di dottorato riguarda un sistema mHealth denominato PASSO (PArkinson Smart Sensory-cues for Older-users), un innovativo sistema di biofeedback specificamente progettato per riabilitare i disturbi del cammino e della postura nelle persone con Malattia di Parkinson. I risultati ottenuti nel progetto PASSO dovrebbero servire alle persone affette da Sindrome di Parkinson in contesti ambulatoriali e al di fuori dei centri specializzati per riabilitare rispettivamente i disturbi posturali e transitori dell’andatura e per fornire assistenza sull’allenamento a casa. Il sistema è concepito per le persone che stanno affrontando le fasi iniziali e intermedie sindrome affrontando diversi disturbi ma soprattutto un declino fisico che colpisce la deambulazione e le capacità motorie in generale, incidendo sull’indipendenza funzionale, sul benessere, sulla salute e sulla qualità della vita. L’esercizio fisico e la fisioterapia hanno dimostrato di poter alleggerire le difficoltà motorie rallentando il declino fisico. Inoltre, viene suggerito che gli effetti dell’esercizio possono essere migliorati aumentando l’impegno cognitivo dei soggetti con la pratica attraverso la fornitura di segnali o feedback sensoriali. Il cueing è costituito da stimoli sensoriali temporali o spaziali che migliorano e facilitano i movimenti ripetitivi fornendo un target motorio esplicito. Il progetto PASSO segue una metodologia iterativa User Centered, il processo di progettazione del progetto è stato suddiviso in tre cicli, ognuno organizzato in quattro fasi: pianificazione (P1), analisi (P2), creazione (P4) e verifica (P4): Ciclo 1 (C1): Stimoli sensoriali e sistema. Ciclo 2 (C2): Dispositivi che trasmettono gli stimoli sensoriali. Ciclo (C3): Interfaccia del sistema. Il coinvolgimento degli utenti nel progetto di design mira a incrementare l’usabilità del sistema. Il coinvolgimento degli utenti nel processo di design mira a migliorare l’usabilità del sistema, consentendo loro di usufruire di un’esperienza appagante che li aiuterà ad affrontare, in modo migliore, specifiche attività della loro vita. La metodologia utilizzata ha portato a risultati soddisfacenti e si è rivelata particolarmente adatta a processi di progettazione multidisciplinari che coinvolgono fattori umani e tecnologici legati allo sviluppo di sistemi intelligenti rivolti a utenti di nicchia. In particolare, il primo ciclo di progettazione mirava ad analizzare come i segnali visivi, uditivi e sensoriali inviati agli utenti utilizzando un sistema esistente implementato con Smart Glasses possono influenzare l’andatura degli utenti. Sono stati testati diversi segnali uditivi, visivi e tattili per capire quali canali sensoriali sono più sensibili a quale tipo di stimolazione e quali parametri del cammino sono maggiormente influenzati da questo tipo di stimoli, caratterizzati da un basso coinvolgimento cognitivo. Durante il secondo ciclo di progettazione è stato sviluppato un sistema mHealth di sensori corporei wireless, composto da uno smartphone e diversi smartwatch. Questo sistema indossabile consente il monitoraggio in tempo reale delle caratteristiche posturali del tronco. Grazie agli smartwatch, i segnali tattili vengono trasmessi agli utenti, incoraggiandoli a correggere il comportamento posturale del tronco, a seconda delle specifiche esigenze cliniche. Il terzo ed ultimo ciclo di progettazione è stato dedicato allo sviluppo dell’interfaccia di sistema, seguendo le esigenze di usabilità degli utenti. La metodologia applicata ha portato a risultati soddisfacenti, gli esiti del progetto possono essere considerati rilevanti nel campo delle metodologie di progettazione per la progettazione di dispositivi intelligenti volti a migliorare la salute e il benessere degli utenti più anziani.

User Centered Methodologies for the design of smart devices for older people affected by Parkinson’s Disease

Imbesi, Silvia
2022

Abstract

The design project related to the doctoral research regards a mHealth system called PASSO (PArkinson Smart Sensory-cues for Older-users), an innovative biofeedback system specifically designed to rehabilitate gait and postural disturbances in persons with Parkinson’s Disease. Results obtained in the PASSO project are supposed to be used for people with PD in ambulatory contexts and outside specialized centers to rehabilitate postural and transient gait disturbances, and to provide training at home, respectively. The system is targeted to PD subjects that are facing the initial and intermediate stages of the disease (Hoehn and Yahr: I-II), dealing with several ailments but most of all with a physical decline that affects walking and motor skills in general, impacting functional independence, well-being, and health-related quality of life. Physical exercise and physiotherapy have been shown to improve PD motor impairments by decelerating the motor decline. Also, it has been suggested that exercise effects can be enhanced by increasing subjects’ cognitive engagement with practice through the provision of cueing or feedback in PD. Cueing is made of temporal or spatial sensory stimuli that ameliorate and facilitate repetitive movements by providing an explicit motor target. The PASSO project follows an iterative User-Centered Design methodology, the design process of the project was divided into three main iterative cycles, each one organized in four phases: planning (P1), analyzing (P2), creating (P3), and verifying (P4). Moreover, every design cycle was associated to the achievement of a specific Technology Readiness Level (TRL): • Cycle 1 (C1): Sensory cues and system. TRL 4 (technology validated in a laboratory). • Cycle 2 (C2): Devices submitting sensory cues. TRL 5 (technology validated in relevant environment). • Cycle 3 (C3): Rehabilitation system for PD users. TRL 6 (technology validated in relevant environment). The involvement of users in the design process aims to improve the system’s usability, allowing them to take advantage of a satisfying experience that will help them face, in a better way, specific activities of their life. The used methodology led to satisfactory results and proved to be particularly suitable for multidisciplinary design processes involving both human and technological factors related with the development of smart systems targeted to niche users. Specifically, the first design cycle aimed to analyze how visual, auditory, and sensory cues submitted to users using an existing system implemented with Smart Glasses (SG) can influence the users’ gait. Several auditory, visual, and haptic cues were tested to understand which sensory channels are most sensitive to which type of stimulation and which gait parameters are most influenced by this kind of stimuli, characterized by low cognitive involvement. During the second design cycle, a mHealth system based on a wireless body sensor network with a smartphone and different smartwatches has been developed. This wearable system enables the real-time monitoring of trunk postural features. Thanks to smartwatches, haptic cues are submitted to the users, encouraging them to correct their trunk postural behavior, depending on the specific clinical needs. The third and last design cycle was dedicated to the development of the system interface, following users’ usability requirements. In this part it was developed the graphic image of the web application managing the system, and the whole system was tested by patients with PD to assess its functionality, usability, ease of use and wearability. The applied methodological process led to satisfactory results, the project outputs can be considered as relevant in the field of design methodologies for the design of smart devices aiming to improve older users’ health and wellbeing.
MINCOLELLI, Giuseppe
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11392/2485796
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