Using new technologies for the prevention of falls and promotion of exercise for older people in care homes: feasibility, usability and acceptability of therapy based kinect exergames

Fall related injuries are the largest cause of accidental death in older people across Europe with 30% of people aged 65 and older and 50% of people aged 80 and over falling at least once per year. Those at greatest risk for falls and hip fractures are residents of long-term care facilities, accounting for more than 25% of all hip fractures due to falls, and 52% of all fall-related hospital admissions. There is a robust body of evidence that demonstrates that specific strength/balance exercises can reduce falls (Gillespie et. al. 2012). Traditional care delivery restricts efficacy of treatment regimes for older people due to resource implications.

This feasibility study proposes to explore issues concerning the introduction of strength/balance Kinect exergames (exercise and computer games that use body movements as controls) developed to improve function, prevent falls and increase exercise adherence for older people in the care home setting.

This PhD incorporates postural stability exergames that have been developed at UoM with users and industry (MIRA Rehab Ltd), based on best evidence strength and balance exercises (OTAGO and Postural Stability) currently used by therapists, safe for older patients in a care home setting. Residents and staff at two care homes in the Northwest will be asked about their views before and after introduction of the exergame therapy. Researchers will observe usual practice in the care home settings to identify best ways of introducing the exergame therapy. A pilot study will follow where eligible residents will receive 24 weeks supported exergame therapy with the frequency, duration and levels of difficulty set according to individual needs and adjustments made as required to enable progression. Assessments will be completed at baseline, 6, 12, 18 and 24 weeks. Participants will undergo physical checks and complete questionnaires to identify history of falls, co-morbidities, levels of function, physical activity levels, use of medication, pain, fatigue, fear of falling and adherence.

Staff and therapists will be interviewed to give their views of the exergame therapy, how it fitted within the usual routines of the care home, usability of the games, whether they enjoyed the exergames and if they felt any benefits or otherwise. Costs of treatment will also be identified. Service user involvement will be continuously monitored to inform planning for future studies.

The proposed Kinect exergames are the first of their kind internationally, that also incorporate a patient statistics platform to monitor ability and adherence and the previous development work has leveraged substantial funding and awards. Uptake of the exergames could result in more older people able to undertake therapy in the care home setting and potentially overcome some of the barriers that prevent patients from adhering to exercise programmes (lack of resources, low motivation, not liking group classes).

The project will span the Schools of Computer Science and Nursing, Midwifery and Social Work. Support will be offered within the Advanced Interfaces Research Group led by Steve Pettifer, whose research focuses on virtual environments, collaborative visualisation systems, and computer vision. The study will also employ cross cutting skills in computer science, health informatics and clinical trial development.

This 4-year full-time studentship forms one of our PhD opportunities within the MRC Doctoral Training Partnership (MRC DTP) scheme. Funding provides full support for tuition fees, annual tax-free stipend at Research Council UK rates (currently £13, 863) and conference/travel allowance. The project is due to commence October 2015 and is open to UK/EU nationals only due to the nature of the funding.

Applicants should hold (or expect to obtain) a minimum upper-second honours degree (or equivalent) in bioinformatics, computer/information science, public health, nursing or related health sciences. A Masters qualification in a similar area would be an advantage.

Please direct applications in the following format to Dr Stephen Pettifer ([Email Address Removed]):

• Academic CV
• Official academic transcripts
• Contact details for two suitable referees
• A personal statement (750 words maximum) outlining your suitability for the study, what you hope to achieve from the PhD and your research experience to date.

Any enquiries relating to the project and/or suitability should be directed to Dr Pettifer. Applications are invited up to and including 26 November 2014.

Further details on the MRC DTP scheme, shortlisting/interview process and additional PhD project opportunities can be found on our website: www.mhs.manchester.ac.uk/mrcdtp

http://www.cs.manchester.ac.uk/about-us/staff/profile/?ea=steve.pettifer

www.mhs.manchester.ac.uk/mrcdtp
http://www.mhs.manchester.ac.uk/postgraduate/mhs-graduate-school/