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Background: Falls and fall-related injuries are a serious public health issue. Exercise programs can effectively reduce fall risk in older people. The iStoppFalls project developed an Information and Communication Technology-based system to deliver an unsupervised exercise program in older people’s homes. The primary aims of the iStoppFalls randomized controlled trial were to assess the feasibility (exercise adherence, acceptability and safety) of the intervention program and its effectiveness on common fall risk factors.
Methods: A total of 153 community-dwelling people aged 65+ years took part in this international, multicentre, randomized controlled trial. Intervention group participants conducted the exercise program for 16 weeks, with a recommended duration of 120 min/week for balance exergames and 60 min/week for strength exercises. All intervention and control participants received educational material including advice on a healthy lifestyle and fall prevention. Assessments included physical and cognitive tests, and questionnaires for health, fear of falling, number of falls, quality of life and psychosocial outcomes.
Results: The median total exercise duration was 11.7 h (IQR = 22.0) over the 16-week intervention period. There were no adverse events. Physiological fall risk (Physiological Profile Assessment, PPA) reduced significantly more in the intervention group compared to the control group (F1,127 = 4.54, p = 0.035). There was a significant three-way interaction for fall risk assessed by the PPA between the high-adherence (>90 min/week; n = 18, 25.4 %), low-adherence (<90 min/week; n = 53, 74.6 %) and control group (F2,125 = 3.12, n = 75, p = 0.044). Post hoc analysis revealed a significantly larger effect in favour of the high-adherence group compared to the control group for fall risk (p = 0.031), postural sway (p = 0.046), stepping reaction time (p = 0.041), executive functioning (p = 0.044), and quality of life (p for trend = 0.052).
Conclusions: The iStoppFalls exercise program reduced physiological fall risk in the study sample. Additional subgroup analyses revealed that intervention participants with better adherence also improved in postural sway, stepping reaction, and executive function.
Background: Falls are common in older adults and can result in serious injuries. Due to demographic changes, falls and related healthcare costs are likely to increase over the next years. Participation and motivation of older adults in fall prevention measures remain a challenge. The iStoppFalls project developed an information and communication technology (ICT)-based system for older adults to use at home in order to reduce common fall risk factors such as impaired balance and muscle weakness. The system aims at increasing older adults’ motivation to participate in ICT-based fall prevention measures. This article reports on usability, user-experience and user-acceptance aspects affecting the use of the iStoppFalls system by older adults.
Methods: In the course of a 16-week international multicenter study, 153 community-dwelling older adults aged 65+ participated in the iStoppFalls randomized controlled trial, of which half used the system in their home to exercise and assess their risk of falling. During the study, 60 participants completed questionnaires regarding the usability, user experience and user acceptance of the iStoppFalls system. Usability was measured with the System Usability Scale (SUS). For user experience the Physical Activity Enjoyment Scale (PACES) was applied. User acceptance was assessed with the Dynamic Acceptance Model for the Re-evaluation of Technologies (DART). To collect more detailed data on usability, user experience and user acceptance, additional qualitative interviews and observations were conducted with participants.
Results: Participants evaluated the usability of the system with an overall score of 62 (Standard Deviation, SD 15.58) out of 100, which suggests good usability. Most users enjoyed the iStoppFalls games and assessments, as shown by the overall PACES score of 31 (SD 8.03). With a score of 0.87 (SD 0.26), user acceptance results showed that participants accepted the iStoppFalls system for use in their own home. Interview data suggested that certain factors such as motivation, complexity or graphical design were different for gender and age.
Conclusions: The results suggest that the iStoppFalls system has good usability, user experience and user acceptance. It will be important to take these along with factors such as motivation, gender and age into consideration when designing and further developing ICT-based fall prevention systems.
In this paper, we provide a participatory design study of a mobile health platform for older adults that provides an integrative perspective on health data collected from different devices and apps. We illustrate the diversity and complexity of older adults’ perspectives in the context of health and technology use, the challenges which follow on for the design of mobile health platforms that support active and healthy ageing (AHA) and our approach to addressing these challenges through a participatory design (PD) process. Interviews were conducted with older adults aged 65+ in a two-month study with the goal of understanding perspectives on health and technologies for AHA support. We identified challenges and derived design ideas for a mobile health platform called “My-AHA”. For researchers in this field, the structured documentation of our procedures and results, as well as the implications derived provide valuable insights for the design of mobile health platforms for older adults.
There has been increasing interest in designing for dementia in recent years. Empirical investigation is now needed of the long-term role of caregivers in appropriating ICTs into the complex daily life of people with dementia (PwD). We present here the outcomes of a 4-month evaluation of the individual, social and institutional impact of a videogame-based training system. The everyday behavior and interactions of 52 PwD and 25 caregivers was studied qualitatively, focusing on the role played by caregivers in integrating the system into daily routines. Our results indicate that the successful appropriation of ICT for PwD depends partly on the physical, cognitive and social benefits for PwD, but especially on the added value perceived by their social care-network. We discuss the need for design in dementia to develop more socially embedded innovations that can address the social actors involved and thus contribute to practical solutions for professional and private care.
Dementia not only affects the cognitive capabilities, especially memory and orientation, but also physical capabilities, which are associated with a decrease of physical activities. Here, ICT can play a major role to improve health, quality of life and wellbeing in older adults suffering from dementia and related stakeholders, such as relatives, professional and informal caregivers. The aim of the presented system is to increase physical and cognitive capabilities of people with dementia and their caregivers to support them in daily life activities, reduce the strain of the caregivers and improve both their wellbeing.