Quality of life of adolescent idiopathic scoliosis patients under brace treatment: a brief communication of literature review.

PURPOSE: To identify the life domains that are most frequently reported to be affected in scoliosis patients undergoing brace treatment. METHODS: A search within the PubMed database was conducted and a total of 60 publications were selected. We classified the studies based on the methods used to measure patients' quality of life (QoL) and categorized the life domains reported to be affected. RESULTS: Self-image/body configuration was the most reported affected domain of patients' QoL, identified in 32 papers, whilst mental health/stress was the second most reported affected domain. Mental health was identified in 11 papers, and 11 papers using the BSSQ questionnaire reported medium stress amongst their participants. Vitality was the third most reported affected domain, identified in 12 papers. CONCLUSIONS: Our review indicates that scoliotic adolescents treated with bracing suffer in their quality of life most from psychological burdens. To improve these patients' life quality, more attention should be focussed on supporting their mental health.

Neckio: Motivating Neck Exercises in Computer Workers.

Neck pain is common among computer workers who may spend too much time in a static posture facing their display. Regular breaks and variety in one's posture can help to prevent discomfort and pain. In order to understand how to support computer workers to do so regularly, we surveyed a convenience sample of computer workers (N = 130) regarding their work habits and their attitudes towards neck exercises at the workplace. The survey showed that they are highly motivated, but not able to comply with a neck exercise program. To address this challenge, we designed Neckio, a system that is aimed at encouraging posture variation and facilitating neck exercises at work. Neckio consists in an interactive application and a wireless angulation sensing appliance that can be mounted on the headset that office workers often use for reasons of privacy. Next to providing an interactive exercise program suitable for the workplace, its design places emphasis on an engaging user experience. We report a short-term user experience valuation of Neckio in an actual office environment (N = 10). Participants rated the overall user experience positively and reported to be intrinsically motivated to do the neck exercises. These results indicate the potential of the Neckio as a behavior change support technology to reduce the risk of developing neck pain in computer workers.

Crowd of Oz: A Crowd-Powered Social Robotics System for Stress Management.

Coping with stress is crucial for a healthy lifestyle. In the past, a great deal of research has been conducted to use socially assistive robots as a therapy to alleviate stress and anxiety related problems. However, building a fully autonomous social robot which can deliver psycho-therapeutic solutions is a very challenging endeavor due to limitations in artificial intelligence (AI). To overcome AI's limitations, researchers have previously introduced crowdsourcing-based teleoperation methods, which summon the crowd's input to control a robot's functions. However, in the context of robotics, such methods have only been used to support the object manipulation, navigational, and training tasks. It is not yet known how to leverage real-time crowdsourcing (RTC) to process complex therapeutic conversational tasks for social robotics. To fill this gap, we developed Crowd of Oz (CoZ), an open-source system that allows Softbank's Pepper robot to support such conversational tasks. To demonstrate the potential implications of this crowd-powered approach, we investigated how effectively, crowd workers recruited in real-time can teleoperate the robot's speech, in situations when the robot needs to act as a life coach. We systematically varied the number of workers who simultaneously handle the speech of the robot (N = 1, 2, 4, 8) and investigated the concomitant effects for enabling RTC for social robotics. Additionally, we present Pavilion, a novel and open-source algorithm for managing the workers' queue so that a required number of workers are engaged or waiting. Based on our findings, we discuss salient parameters that such crowd-powered systems must adhere to, so as to enhance their performance in response latency and dialogue quality.

Formal representation of ambulatory assessment protocols in HTML5 for human readability and computer execution.

Ambulatory assessment (AA) is a research method that aims to collect longitudinal biopsychosocial data in groups of individuals. AA studies are commonly conducted via mobile devices such as smartphones. Researchers tend to communicate their AA protocols to the community in natural language by describing step-by-step procedures operating on a set of materials. However, natural language requires effort to transcribe onto and from the software systems used for data collection, and may be ambiguous, thereby making it harder to reproduce a study. Though AA protocols may also be written as code in a programming language, most programming languages are not easily read by most researchers. Thus, the quality of scientific discourse on AA stands to gain from protocol descriptions that are easy to read, yet remain formal and readily executable by computers. This paper makes the case for using the HyperText Markup Language (HTML) to achieve this. While HTML can suitably describe AA materials, it cannot describe AA procedures. To resolve this, and taking away lessons from previous efforts with protocol implementations in a system called TEMPEST, we offer a set of custom HTML5 elements that help treat HTML documents as executable programs that can both render AA materials, and effect AA procedures on computational platforms.

Interactive wearable systems for upper body rehabilitation: a systematic review.

BACKGROUND: The development of interactive rehabilitation technologies which rely on wearable-sensing for upper body rehabilitation is attracting increasing research interest. This paper reviews related research with the aim: 1) To inventory and classify interactive wearable systems for movement and posture monitoring during upper body rehabilitation, regarding the sensing technology, system measurements and feedback conditions; 2) To gauge the wearability of the wearable systems; 3) To inventory the availability of clinical evidence supporting the effectiveness of related technologies. METHOD: A systematic literature search was conducted in the following search engines: PubMed, ACM, Scopus and IEEE (January 2010-April 2016). RESULTS: Forty-five papers were included and discussed in a new cuboid taxonomy which consists of 3 dimensions: sensing technology, feedback modalities and system measurements. Wearable sensor systems were developed for persons in: 1) Neuro-rehabilitation: stroke (n = 21), spinal cord injury (n = 1), cerebral palsy (n = 2), Alzheimer (n = 1); 2) Musculoskeletal impairment: ligament rehabilitation (n = 1), arthritis (n = 1), frozen shoulder (n = 1), bones trauma (n = 1); 3) Others: chronic pulmonary obstructive disease (n = 1), chronic pain rehabilitation (n = 1) and other general rehabilitation (n = 14). Accelerometers and inertial measurement units (IMU) are the most frequently used technologies (84% of the papers). They are mostly used in multiple sensor configurations to measure upper limb kinematics and/or trunk posture. Sensors are placed mostly on the trunk, upper arm, the forearm, the wrist, and the finger. Typically sensors are attachable rather than embedded in wearable devices and garments; although studies that embed and integrate sensors are increasing in the last 4 years. 16 studies applied knowledge of result (KR) feedback, 14 studies applied knowledge of performance (KP) feedback and 15 studies applied both in various modalities. 16 studies have conducted their evaluation with patients and reported usability tests, while only three of them conducted clinical trials including one randomized clinical trial. CONCLUSIONS: This review has shown that wearable systems are used mostly for the monitoring and provision of feedback on posture and upper extremity movements in stroke rehabilitation. The results indicated that accelerometers and IMUs are the most frequently used sensors, in most cases attached to the body through ad hoc contraptions for the purpose of improving range of motion and movement performance during upper body rehabilitation. Systems featuring sensors embedded in wearable appliances or garments are only beginning to emerge. Similarly, clinical evaluations are scarce and are further needed to provide evidence on effectiveness and pave the path towards implementation in clinical settings.

Motor Control Training for the Shoulder with Smart Garments.

Wearable technologies for posture monitoring and posture correction are emerging as a way to support and enhance physical therapy treatment, e.g., for motor control training in neurological disorders or for treating musculoskeletal disorders, such as shoulder, neck, or lower back pain. Among the various technological options for posture monitoring, wearable systems offer potential advantages regarding mobility, use in different contexts and sustained tracking in daily life. We describe the design of a smart garment named Zishi to monitor compensatory movements and evaluate its applicability for shoulder motor control training in a clinical setting. Five physiotherapists and eight patients with musculoskeletal shoulder pain participated in the study. The attitudes of patients and therapists towards the system were measured using standardized survey instruments. The results indicate that patients and their therapists consider Zishi a credible aid for rehabilitation and patients expect it will help towards their recovery. The system was perceived as highly usable and patients were motivated to train with the system. Future research efforts on the improvement of the customization of feedback location and modality, and on the evaluation of Zishi as support for motor learning in shoulder patients, should be made.

TagTrainer: supporting exercise variability and tailoring in technology supported upper limb training.

BACKGROUND: Rehabilitation technology for upper limb training can potentially increase the amount, duration, and quality of therapy offered to patients by targeting the needs of individual patients. Empirical evaluations of such technologies focus on clinical effectiveness; however, little is known regarding the implications of their implementation in daily practice. Tailoring training content to patients requires active participation by therapists, and requires an extension of their role to include authoring and modifying exercises. It is not yet known whether this is feasible, and the socio-technical requirements that will make it successful in practice have not yet been explored. The current study investigates the extent to which therapists can take the role of authoring patient-specific training content and whether effort savings can be achieved by sharing the created content. METHOD: We present TagTrainer: an interactive tabletop system for rehabilitation that can be operated by manipulating every day physical objects in order to carry out exercises that simulate daily living tasks. TagTrainer supports therapists in creating their own exercises that fit individual patient needs, in adjusting existing exercises, and in putting together personalized exercise programs for and with patients. Four therapists in stroke- and paraplegia-rehabilitation have used TagTrainer for three weeks. Semi-structured interviews were conducted with the therapists, questionnaires were administered to them, and observation notes and usage logs were collected. RESULTS: A total of 20 exercises were created from scratch, while another three exercises were created as variations of the existing ones. Importantly, all these exercises were created to address specific needs that patients expressed. The patients found the exercises motivating and these exercises were integrated into their regular training. CONCLUSIONS: TagTrainer can support arm-hand rehabilitation training by increasing therapy variability and tailoring. Therapists consider TagTrainer most suited for group sessions where they supervise many patients at once. Therapists are motivated and are able to, with minimal training, create and tailor exercises for patients fitting individual needs and capabilities. Future research will examine the socio-technical conditions that will encourage therapists to contribute and share training content, and provide the peer support needed for the adoption of a new technology.

"Not Sure Sharing Does Anything Extra for Me": Understanding How People with Cardiovascular Disease Conceptualize Sharing Personal Health Data with Peers.

As people deal with cardiovascular disease (CVD), they are to self-monitor routinely and be aware of complications and the corresponding course of action. Engaging in these self-care behaviors is conducive to gaining knowledge of health status. Even so, knowledge of the self may be insufficient in making sense of chronic conditions. In constructing a new normal after health-related life disruptions, people often turn to peers (others facing similar health issues) and share personal health information with each other. Although health information-sharing behavior is well-documented, it remains underexplored what attitudes individuals with chronic conditions, such as CVD, have toward disclosing personal health data to peers and exploring those of others with similar conditions. We surveyed 39 people who reported being diagnosed with CVD to understand how they conceptualize sharing personal health data with their peers. By analyzing qualitative survey data thematically, we found that respondents expressed themselves as uncertain about the benefits of interacting with peers in such a manner. At the same time, they recognized an opportunity to learn new ideas to enhance CVD self-care in mutual data sharing. We also report participants' analytical orientation toward this sort of data sharing herein and elaborate on what sharing a range of personal health data could mean. In light of the existing literature, this study unpacks the notion of sharing in a different population/pathology and with more nuance, particularly by distinguishing between disclosing one's data and exploring others'.

Exploration of Contributory Factors to an Unpleasant Bracing Experience of Adolescent Idiopathic Scoliosis Patients a Quantitative and Qualitative Research.

BACKGROUND: To obtain a better understanding of the wearing habits and preferences of Adolescent Idiopathic Scoliosis (AIS) patients undergoing rigid brace treatment, we examine what factors contribute to patients' perceived discomfort during the treatment. METHODS: Seventeen AIS patients treated with a rigid brace were recruited. We asked them to complete a questionnaire and participate in an interview study. Finally, we measure the interface corrective force and perceived discomfort with the participants for different positions and assess the correlation. RESULTS: Our survey reveals that participants scored the lowest in the domains of environmental factors, psycho-spiritual factors, satisfaction, and self-image. Appearance anxiety, physical and psychological discomfort and inconvenience were the three most frequently mentioned problems in the interviews on participants' daily bracing experiences. A significant, moderately positive relationship between corrective force and discomfort level was found only when participants were lying on their left side, but not in any of the other positions. No significant correlation between treatment length and perceived discomfort was found. CONCLUSIONS: Future work should focus on reducing the psychological burden and the inconvenience of wearing a brace, rather than on reducing physical discomfort resulting from the corrective force.

Development of an AI-Enabled System for Pain Monitoring Using Skin Conductance Sensoring in Socks.

Background: Where self-report is unfeasible or observations are difficult, physiological estimates of pain are needed. Methods: Pain-data from 30 healthy adults were gathered to create a database of physiological pain responses. A model was then developed, to analyze pain-data and visualize the AI-estimated level of pain on a mobile app. Results: The initial low precision and F1-score of the pain classification algorithm were resolved by interpolating a percentage of similar data. Discussion: This system presents a novel approach to assess pain in noncommunicative people with the use of a sensor sock, AI predictor and mobile app. Performance analysis and the limitations of the AI algorithm are discussed.

Exploring Peoples' Perception of Autonomy and Reactance in Everyday AI Interactions.

Applications using Artificial Intelligence (AI) have become commonplace and embedded in our daily lives. Much of our communication has transitioned from human-human interaction to human-technology or technology-mediated interaction. As technology is handed over control and streamlines choices and decision-making in different contexts, people are increasingly concerned about a potential threat to their autonomy. In this paper, we explore autonomy perception when interacting with AI-based applications in everyday contexts using a design fiction-based survey with 328 participants. We probed if providing users with explanations on "why" an application made certain choices or decisions influenced their perception of autonomy or reactance regarding the interaction with the applications. We also looked at changes in perception when users are aware of AI's presence in an application. In the social media context, we found that people perceived a greater reactance and lower sense of autonomy perhaps owing to the personal and identity-sensitive nature of the application context. Providing explanations on "why" in the navigation context, contributed to enhancing their autonomy perception, and reducing reactance since it influenced the users' subsequent actions based on the recommendation. We discuss our findings and the implications it has for the future development of everyday AI applications that respect human autonomy.

Personalizing HRI in Musical Instrument Practicing: The Influence of Robot Roles (Evaluative Versus Nonevaluative) on the Child's Motivation for Children in Different Learning Stages.

Learning to play a musical instrument involves skill learning and requires long-term practicing to reach expert levels. Research has already proven that the assistance of a robot can improve children's motivation and performance during practice. In an earlier study, we showed that the specific role (evaluative role versus nonevaluative role) the robot plays can determine children's motivation and performance. In the current study, we argue that the role of the robot has to be different for children in different learning stages (musical instrument expertise levels). Therefore, this study investigated whether children in different learning stages would have higher motivation when assisted by a robot in different supporting roles (i.e., evaluative role versus nonevaluative role). We conducted an empirical study in a real practice room of a music school with 31 children who were at different learning stages (i.e., beginners, developing players, and advanced players). In this study, every child practiced for three sessions: practicing alone, assisted by the evaluative robot, or assisted by the nonevaluative robot (in a random order). We measured motivation by using a questionnaire and analyzing video data. Results showed a significant interaction between condition (i.e., alone, evaluative robot, and nonevaluative robot) and learning stage groups indicating that children in different learning stage groups had different levels of motivation when practicing alone or with an evaluative or nonevaluative robot. More specifically, beginners had higher persistence when practicing with the nonevaluative robot, while advanced players expressed higher motivation after practicing with a robot than alone, but no difference was found between the two robot roles. Exploratory results also indicated that gender might have an interaction effect with the robot roles on child's motivation in music practice with social robots. This study offers more insight into the child-robot interaction and robot role design in musical instrument learning. Specifically, our findings shed light on personalization in HRI, that is, from adapting the role of the robot to the characteristics and the development level of the user.

Assessing the Influence of Physical Activity Upon the Experience Sampling Response Rate on Wrist-Worn Devices.

The Experience Sampling Method (ESM) is gaining ground for collecting self-reported data from human participants during daily routines. An important methodological challenge is to sustain sufficient response rates, especially when studies last longer than a few days. An obvious strategy is to deliver the experiential questions on a device that study participants can access easily at different times and contexts (e.g., a smartwatch). However, responses may still be hampered if the prompts are delivered at an inconvenient moment. Advances in context sensing create new opportunities for improving the timing of ESM prompts. Specifically, we explore how physiological sensing on commodity-level smartwatches can be utilized in triggering ESM prompts. We have created Experiencer, a novel ESM smartwatch platform that allows studying different prompting strategies. We ran a controlled experiment (N=71) on Experiencer to study the strengths and weaknesses of two sampling regimes. One group (N=34) received incoming notifications while resting (e.g., sedentary), and another group (N=37) received similar notifications while being active (e.g., running). We hypothesized that response rates would be higher when experiential questions are delivered during lower levels of physical activity. Contrary to our hypothesis, the response rates were found significantly higher in the active group, which demonstrates the relevance of studying dynamic forms of experience sampling that leverage better context-sensitive sampling regimes. Future research will seek to identify more refined strategies for context-sensitive ESM using smartwatches and further develop mechanisms that will enable researchers to easily adapt their prompting strategy to different contextual factors.

A Mobile App for Longterm Monitoring of Narcolepsy Symptoms: Design, Development, and Evaluation.

BACKGROUND: Narcolepsy is a chronic sleep disorder with a broad variety of symptoms. Although narcolepsy is primarily characterized by excessive daytime sleepiness and cataplexy (loss of muscle control triggered by emotions), patients may suffer from hypnagogic hallucinations, sleep paralysis, and fragmented night sleep. However, the spectrum of narcolepsy also includes symptoms not related to sleep, such as cognitive or psychiatric problems. Symptoms vary greatly among patients and day-to-day variance can be considerable. Available narcolepsy questionnaires do not cover the whole symptom spectrum and may not capture symptom variability. Therefore, there is a clinical need for tools to monitor narcolepsy symptoms over time to evaluate their burden and the effect of treatment. OBJECTIVE: This study aimed to describe the design, development, implementation, and evaluation of the Narcolepsy Monitor, a companion app for long-term symptom monitoring in narcolepsy patients. METHODS: After several iterations during which content, interaction design, data management, and security were critically evaluated, a complete version of the app was built. The Narcolepsy Monitor allows patients to report a broad spectrum of experienced symptoms and rate their severity based on the level of burden that each symptom imposes. The app emphasizes the reporting of changes in relative severity of the symptoms. A total of 7 patients with narcolepsy were recruited and asked to use the app for 30 days. Evaluation was done by using in-depth interviews and user experience questionnaire. RESULTS: We designed and developed a final version of the Narcolepsy Monitor after which user evaluation took place. Patients used the app on an average of 45.3 (SD 19.2) days. The app was opened on 35% of those days. Daytime sleepiness was the most dynamic symptom, with a mean number of changes of 5.5 (SD 3.7) per month, in contrast to feelings of anxiety or panic, which was only moved 0.3 (SD 0.7) times per month. Mean symptom scores were highest for daytime sleepiness (1.8 [SD 1.0]), followed by lack of energy (1.6 [SD 1.4]) and often awake at night (1.5 [SD 1.0]). The personal in-depth interviews revealed 3 major themes: (1) reasons to use, (2) usability, and (3) features. Overall, patients appreciated the concept of ranking symptoms on subjective burden and found the app easy to use. CONCLUSIONS: The Narcolepsy Monitor appears to be a helpful tool to gain more insight into the individual burden of narcolepsy symptoms over time and may serve as a patient-reported outcome measure for this debilitating disorder.

Effects of Robot Facial Characteristics and Gender in Persuasive Human-Robot Interaction.

The growing interest in social robotics makes it relevant to examine the potential of robots as persuasive agents and, more specifically, to examine how robot characteristics influence the way people experience such interactions and comply with the persuasive attempts by robots. The purpose of this research is to identify how the (ostensible) gender and the facial characteristics of a robot influence the extent to which people trust it and the psychological reactance they experience from its persuasive attempts. This paper reports a laboratory study where SociBot™, a robot capable of displaying different faces and dynamic social cues, delivered persuasive messages to participants while playing a game. In-game choice behavior was logged, and trust and reactance toward the advisor were measured using questionnaires. Results show that a robotic advisor with upturned eyebrows and lips (features that people tend to trust more in humans) is more persuasive, evokes more trust, and less psychological reactance compared to one displaying eyebrows pointing down and lips curled downwards at the edges (facial characteristics typically not trusted in humans). Gender of the robot did not affect trust, but participants experienced higher psychological reactance when interacting with a robot of the opposite gender. Remarkably, mediation analysis showed that liking of the robot fully mediates the influence of facial characteristics on trusting beliefs and psychological reactance. Also, psychological reactance was a strong and reliable predictor of trusting beliefs but not of trusting behavior. These results suggest robots that are intended to influence human behavior should be designed to have facial characteristics we trust in humans and could be personalized to have the same gender as the user. Furthermore, personalization and adaptation techniques designed to make people like the robot more may help ensure they will also trust the robot.

Conceptions of sleep experience: a layman perspective.

OBJECTIVE: To date, there is little information on how lay people understand and discuss sleep in the context of daily life. Efforts to conceptualize sleep quality have been largely driven by clinical considerations of sleep disorders. As such, they are not necessarily of how normal sleepers without clinical expertise conceptualize sleep quality. A phenomenological approach was taken to understand the essence of the sleep experience and the concepts held by lay people without sleep disorders. A sentence completion questionnaire was developed and administered to a quota sample of 64 respondents who were selected aiming for sufficient representation of different gender, ages, and education levels. RESULTS: Significant sentences and meaningful units were derived inductively, resulting in a classification of nine categories. The major facets of sleep experience of lay people were 'daytime functioning', 'interruptions during the night' and 'before bed state'. This implies that the experienced sleep quality is not only depending on the progress of the night. These results can guide future research to provide suitable psychometric measures for normal sleepers, as well as the design of sleep data visualization applications in the context of health self-monitoring.

Stroke Patients' Acceptance of a Smart Garment for Supporting Upper Extremity Rehabilitation.

The objective is to evaluate to which extent that Zishi a garment equipped with sensors that can support posture monitoring can be used in upper extremity rehabilitation training of stroke patients. Seventeen stroke survivors (mean age: 55 years old, SD =13.5) were recruited in three hospitals in Shanghai. Patients performed 4 tasks (analytical shoulder flexion, functional shoulder flexion placing a cooking pot, analytical flexion in the scapular plane, and functional flexion in the scapular plane placing a bottle of water) with guided feedback on a tablet that was provided through inertial sensors embedded in the Zishi system at the scapula and the thoracic spine region. After performing the training tasks, patients completed four questionnaires for assessing their motivation, their acceptance of the system, its credibility, and usability. The study participants were highly motivated to train with Zishi and the system was rated high usability, while the subjects had moderate confidence with technology supported training in comparison with the training with therapists. The patients respond positively to using Zishi to support rehabilitation training in a clinical setting. Further developments need to address more on engaging and adaptive feedback. This paper paves the way for larger scale effectiveness studies.

Motivating arm-hand use for stroke patients by serious games.

We present a novel technology to support playful rehabilitation of arm-hand performance for stroke survivors. The system combines tangible tabletop interaction with wearable technology, to encourage stroke patients to train their arm-hand skills in a task-oriented manner, while a jacket supporting tilt-sensing and vibrotactile feedback guides patients regarding the correct execution of exercises and specifically to avoid compensatory movements. We present the iterative client centered development of this technology and its on going development.

Application of Wearable Systems in Upper Extremity Rehabilitation:Research and Practice (review) / 中国康复理论与实践

This paper reported a structured literature survey of research in wearable technology for upper-extremity rehabilitation. A keyword based search returned 61 papers related to this topic. Examination of the abstracts of these papers identified 18 articles describing distinct wearable systems aimed at upper extremity rehabilitation. They were classified in three categories depending on their functionality:posture and motion monitoring; monitoring and feedback systems that supported rehabilitation exercises; serious games for rehabilitation training. We characterized the state of the art considering respectively the reported performance of these technologies, availability of clinical evidence, or known clinical applications. Based on the insights from the review study, we proposed a smart rehabilitation garment system for variety of patient groups. The garment integrated with smart textiles and wearable electronics. It presented real-time feedback as a vibra-tion delivered through the garment, visual and audio instructions through Android-hand held device (smartphone or tablet).

Us'em: the user-centered design of a device for motivating stroke patients to use their impaired arm-hand in daily life activities.

Stroke leaves the majority of its survivors with an impairment of the upper extremity that affects their ability to live independently and their quality of life. Rehabilitation research shows that practice of everyday life activities in a natural context may sustain or even improve arm-hand performance, even during chronic stages after stroke. Based on this insight we designed, developed and evaluated Us'em; this consists of two watch-like accelerometry devices that provide feedback to stroke patients regarding the usage of their impaired versus their non-affected upper extremity. System usability and treatment credibility/expectancy were evaluated positively by therapists and patients.