scholarly journals Usability of a Fall Risk mHealth App for People With Multiple Sclerosis: Mixed Methods Study

10.2196/25604 ◽  
2021 ◽  
Vol 8 (1) ◽  
pp. e25604 ◽  
Author(s):  
Katherine Hsieh ◽  
Jason Fanning ◽  
Mikaela Frechette ◽  
Jacob Sosnoff
Keyword(s):  
Quality Of Life ◽  
Multiple Sclerosis ◽  
Risk Score ◽  
Fall Risk ◽  
Risk Of Falling ◽  
System Usability Scale ◽  
System Usability ◽  
Mhealth Apps ◽  
User Centered

Background Multiple sclerosis (MS) is a chronic, neurodegenerative disease that causes a range of motor, sensory, and cognitive symptoms. Due to these symptoms, people with MS are at a high risk for falls, fall-related injuries, and reductions in quality of life. There is no cure for MS, and managing symptoms and disease progression is important to maintain a high quality of life. Mobile health (mHealth) apps are commonly used by people with MS to help manage their health. However, there are limited health apps for people with MS designed to evaluate fall risk. A fall risk app can increase access to fall risk assessments and improve self-management. When designing mHealth apps, a user-centered approach is critical for improving use and adoption. Objective The purpose of this study is to undergo a user-centered approach to test and refine the usability of the app through an iterative design process. Methods The fall risk app Steady-MS is an extension of Steady, a fall risk app for older adults. Steady-MS consists of 2 components: a 25-item questionnaire about demographics and MS symptoms and 5 standing balance tasks. Data from the questionnaire and balance tasks were inputted into an algorithm to compute a fall risk score. Two iterations of semistructured interviews (n=5 participants per iteration) were performed to evaluate usability. People with MS used Steady-MS on a smartphone, thinking out loud. Interviews were recorded, transcribed, and developed into codes and themes. People with MS also completed the System Usability Scale. Results A total of 3 themes were identified: intuitive navigation, efficiency of use, and perceived value. Overall, the participants found Steady-MS efficient to use and useful to learn their fall risk score. There were challenges related to cognitive overload during the balance tasks. Modifications were made, and after the second iteration, people with MS reported that the app was intuitive and efficient. Average System Usability Scale scores were 95.5 in both iterations, representing excellent usability. Conclusions Steady-MS is the first mHealth app for people with MS to assess their overall risk of falling and is usable by a subset of people with MS. People with MS found Steady-MS to be usable and useful for understanding their risk of falling. When developing future mHealth apps for people with MS, it is important to prevent cognitive overload through simple and clear instructions and present scores that are understood and interpreted correctly through visuals and text. These findings underscore the importance of user-centered design and provide a foundation for the future development of tools to assess and prevent scalable falls for people with MS. Future steps include understanding the validity of the fall risk algorithm and evaluating the clinical utility of the app.

scholarly journals Usability of a Fall Risk Mobile Health Application for People with Multiple Sclerosis (Preprint)

2020 ◽  
Author(s):  
Katherine Hsieh ◽  
Jason Fanning ◽  
Mikaela Frechette ◽  
Jacob Sosnoff
Keyword(s):  
Quality Of Life ◽  
Multiple Sclerosis ◽  
Risk Score ◽  
Mobile Health ◽  
Fall Risk ◽  
Risk Of Falling ◽  
Health Apps ◽  
System Usability Scale ◽  
Cognitive Overload

BACKGROUND Multiple Sclerosis (MS) is a chronic, neurogenerative disease that causes a range of motor, sensory, and cognitive symptoms. Because of these symptoms, people with MS (pwMS) are at a high risk for falls, fall related injuries, and reductions in quality of life. There is no cure for MS, and managing symptoms and disease progression is important to maintain high quality of life. Mobile health applications (apps) are commonly used by people with MS (pwMS) to help manage their health. However, there are limited health apps for pwMS designed to evaluate fall risk. A fall risk app can increase access to fall risk assessment and improve self-management. When designing health apps, a user-centered approach is critical to improve usage and adoption. OBJECTIVE The purpose of this study was to develop a fall risk app for pwMS and to test the usability of the app through an iterative design process. METHODS The fall risk app, Steady-MS, consists of two components: a 25-item questionnaire about demographics and MS symptoms, and 5 standing balance tasks. Data from the questionnaire and balance tasks are inputted into an algorithm to compute a fall risk score. Two iterations of semi-structed interviews (n=5/iteration) were performed to evaluate usability. PwMS used Steady-MS on a smartphone, thinking their thoughts aloud. Interviews were recorded, transcribed, and developed into codes and themes. PwMS also completed the System Usability Scale (SUS). RESULTS Three themes were identified: 1) intuitive navigation; 2) efficiency of use; and 3) perceived value. Overall, participants found Steady-MS efficient to use and found it useful to learn their fall risk score. There were challenges related to cognitive overload during the balance tasks. Modifications were made, and after the second iteration, pwMS reported that the app was intuitive and efficient to use. Average SUS scores were 95.5 in both iterations, representing “excellent” usability. CONCLUSIONS Steady-MS is the first health app for pwMS asses their overall risk of falling and can help pwMS manage their fall risk. PwMS found Steady-MS to be usable and useful to understand their risk of falling. When developing future mobile health apps for pwMS, it is important to: 1) prevent cognitive overload through simple and clear instructions, and 2) present scores that are understood and interpreted correctly through visuals and text. These findings underscore the importance of user-center design and provide a foundation for the future development of scalable falls assessment and prevention tools for pwMS.

Health-related quality of life in relation to mobility and fall risk in 85-year-old people: a population study in Sweden

2015 ◽  
Vol 36 (9) ◽  
pp. 1982-1997 ◽  
Author(s):  
EVA TÖRNVALL ◽  
JAN MARCUSSON ◽  
EWA WRESSLE
Keyword(s):  
Quality Of Life ◽  
Body Mass Index ◽  
Fall Risk ◽  
Health Related Quality ◽  
Risk Of Falling ◽  
Old People ◽  
Related Quality ◽  
Health Related ◽  
Lower Hrqol

ABSTRACTOptimal mobility is fundamental for healthy ageing and quality of life. This study is part of a cross-sectional population-based study of 85-year-old people residing in Linköping municipality, Sweden. The purpose was to describe 85-year-old peoples' health-related quality of life (HRQoL) in relation to mobility and fall risk while adjusting for gender and body mass index. Data collection included a postal questionnaire, a home visit and a reception visit. HRQoL was assessed with EQ-5D-3L, mobility with the Timed Up and Go test (TUG) and fall risk with the Downton Fall Risk Index (DFRI). All those who completed the DFRI, TUG and EQ-5D-3L were included in the present study (N = 327). Lower HRQoL was associated with longer time taken to complete TUG and higher fall risk in both genders but not with body mass index. Women had higher risk of falling, took a longer time to complete TUG and reported less physical activity compared with men. Health-care professionals should address mobility capacity and fall risk in order to maintain quality of life in elderly people. This is of utmost importance, especially for elderly women because impaired mobility, high risk of falling and occurrence of pain are common among women, and related to lower HRQoL.

scholarly journals Fatigue, Physical Activity, Quality of Life, and Fall Risk in People with Multiple Sclerosis

2017 ◽  
Vol 19 (2) ◽  
pp. 91-98 ◽  
Author(s):  
Eva Vister ◽  
Mylou E. Tijsma ◽  
Phu D. Hoang ◽  
Stephen R. Lord
Keyword(s):  
Quality Of Life ◽  
Multiple Sclerosis ◽  
Fall Risk ◽  
Fear Of Falling ◽  
Risk Scores ◽  
Activity Levels ◽  
Physiological Profile ◽  
Walking Activity ◽  
Physiological Profile Assessment

Background: Fatigue, inactivity, and falls are major health issues for people with multiple sclerosis (MS). We examined the extent to which fatigue and low walking activity are associated with quality of life and increased fall risk in people with MS. Methods: People with MS (N = 210, aged 21–74 years) were categorized as having either high or low reported fatigue and walking activity levels and were then followed up for falls using monthly fall diaries for 6 months. Results: A high level of fatigue was significantly associated with higher MS Disease Steps scores, worse balance, high composite physiological (Physiological Profile Assessment) fall risk scores, greater fear of falling, lower World Health Organization Disability Assessment Schedule (WHODAS) quality of life scores, and more prospectively recorded falls. Low walking activity was significantly associated with higher MS Disease Steps scores, reduced proprioception, worse standing and leaning balance, slow stepping, slow gait speed, worse fine motor control, high Physiological Profile Assessment fall risk scores, more fear of falling, and lower WHODAS quality of life scores. Conclusions: Increased fatigue and low walking activity levels were significantly associated with increased fall risk and lower quality of life in people with MS. Interventions aimed at addressing fatigue and inactivity may have multiple benefits for this group.

scholarly journals User-centred assistive SystEm for arm Functions in neUromuscuLar subjects (USEFUL): a randomized controlled study

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Valeria Longatelli ◽  
Alberto Antonietti ◽  
Emilia Biffi ◽  
Eleonora Diella ◽  
Maria Grazia D’Angelo ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Upper Limb ◽  
Assistive Devices ◽  
Active Device ◽  
Randomized Controlled ◽  
Passive Devices ◽  
System Usability Scale ◽  
System Usability ◽  
Friedman's Test

Abstract Background Upper limb assistive devices can compensate for muscular weakness and empower the user in the execution of daily activities. Multiple devices have been recently proposed but there is still a lack in the scientific comparison of their efficacy. Methods We conducted a cross-over multi-centric randomized controlled trial to assess the functional improvement at the upper limb level of two arms supports on 36 patients with muscular dystrophy. Participants tested a passive device (i.e., Wrex by Jaeco) and a semi-active solution for gravity compensation (i.e., Armon Ayura). We evaluated devices’ effectiveness with an externally-assessed scale (i.e., Performance of the Upper Limb-PUL-module), a self-perceived scale (i.e., Abilhand questionnaire), and a usability scale (i.e., System Usability Scale). Friedman’s test was used to assess significant functional gain for PUL module and Abilhand questionnaire. Moreover, PUL changes were compared by means of the Friedman’s test. Results Most of the patients improved upper limb function with the use of arm supports (median PUL scores increase of 1–3 points). However, the effectiveness of each device was related to the level of residual ability of the end-user. Slightly impaired patients maintained the same independence without and with assistive devices, even if they reported reduced muscular fatigue for both devices. Moderately impaired patients enhanced their arm functionality with both devices, and they obtained higher improvements with the semi-active one (median PUL scores increase of 9 points). Finally, severely impaired subjects benefited only from the semi-active device (median PUL scores increase of 12 points). Inadequate strength was recognized as a barrier to passive devices. The usability, measured by the System Usability Scale, was evaluated by end-users “good” (70/100 points) for the passive, and “excellent” (80/100 points) for the semi-active device. Conclusions This study demonstrated that assistive devices can improve the quality of life of people suffering from muscular dystrophy. The use of passive devices, despite being low cost and easy to use, shows limitations in the efficacy of the assistance to daily tasks, limiting the assistance to a predefined horizontal plane. The addition of one active degree of freedom improves efficacy and usability especially for medium to severe patients. Further investigations are needed to increase the evidence on the effect of arm supports on quality of life and diseases’ progression in subjects with degenerative disorders. Trial registration clinicaltrials.gov, NCT03127241, Registered 25th April 2017. The clinical trial was also registered as a post-market study at the Italian Ministry of Health.

scholarly journals Title Immersive Virtual Reality and Vestibular Rehabilitation in Multiple Sclerosis: Case Report (Preprint)

2021 ◽  
Author(s):  
María-Dolores Cortés-Vega ◽  
Cristina García-Muñoz ◽  
Juan-Carlos Hernández-Rodríguez ◽  
Lourdes M Fernández-Seguín ◽  
Isabel Escobio-Prieto ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Multiple Sclerosis ◽  
Virtual Reality ◽  
Vestibular Rehabilitation ◽  
Erector Spinae ◽  
Immersive Virtual Reality ◽  
Multiple Sclerosis Case ◽  
Muscular Tone ◽  
System Usability Scale

BACKGROUND Background: Dizziness and imbalance are common and disabling symptoms in multiple sclerosis (MS) patients caused by a central, peripheral or mixed vestibulopathy. Central vestibular disorder is the most frequent report in the MS population due to demyelination. Vestibular rehabilitation ameliorates these symptoms and its repercussions in quality of life. However, immersive virtual reality (VRi) is a growing tool in this fieldwork, but no previous research has been performed studying its effects in MS. OBJECTIVE Objective: To apply a VRi vestibular training protocol in a patient with MS and assess the effects induced by the experimental intervention. METHODS Methods: Case study of a 54-year-old woman with relapsing remitting multiple sclerosis (RRMS). We developed a standardized VRi exercise protocol for vestibular rehabilitation based on the gold standard vestibular training of Cawthorne-Cooksey. The 20 session intervention is formed of 10 initial sessions and 10 advanced sessions. Each 50 minute session will be performed 3 times per week for 8 weeks. Four evaluations were carried out over the study period: at baseline (T0), between the two intervention phases (T1), at the end of the intervention and at the one month follow-up (T3). The outcomes of the research were dizziness, balance, gait, impact of fatigue, quality of life, repercussions in muscular tone and usability of HMD. RESULTS Results: The patient improved DHI (T0=62 points/T2=4), BBS (T0=47/T2=54), iTUG (T0=8.35 sec/T2=5.57 sec), muscular tone of the erector spinae, rectus femoris and soleus, MFIS (T0=61/T2=37) and MSQoL-54 (T2 physical area=67.16%; T2 mental area= 33.56%) after receiving the VRi vestibular protocol. System Usability Scale reached 90% of usability and A grade. CONCLUSIONS Conclusions: This research provided evidence of the first VRi vestibular protocol in the MS population to improve dizziness, balance, gait, impact of fatigue and quality of life and muscular tone through an exergame intervention. This study may help to set a standardized VRi protocol for vestibular rehabilitation.

scholarly journals Contribution of the Built Environment towards Elderlies’ Quality of Life and Risk of Falling

2019 ◽  
Vol 4 (12) ◽  
pp. 101
Author(s):  
Nurul Liyana Hanapi ◽  
Sabarinah Sheikh Ahmad ◽  
Azli Abd Razak ◽  
Norhati Ibrahim
Keyword(s):  
Quality Of Life ◽  
Built Environment ◽  
Fall Risk ◽  
Publishing House ◽  
The Elderly ◽  
Risk Of Falling ◽  
International Publishing ◽  
Current Concerns ◽  
Open Access Article

Recent study trends on elderlies range from improving their quality of life to reducing the risk of falling. This paper investigates current concerns on the risk of any untoward fall or injury of elderly residents in public housing due to the rising number of the elderly population. This study aims to analyze published literature with a focus on finding a non-semantic relation on the built environment with the elderly quality of life and risk of falling. Results show that a pleasant environment could introduce social activities in which significantly improves the quality of life and reduce fall risk among the elderly population.Keywords: elderly; quality of life; fall risk; environment.eISSN: 2398-4287 © 2019. The Authors. Published for AMER ABRA cE-Bs by e-International Publishing House, Ltd., UK. This is an open-access article under the CC BYNC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). Peer–review under responsibility of AMER (Association of Malaysian Environment-Behaviour Researchers), ABRA (Association of Behavioural Researchers on Asians) and cE-Bs (Centre for Environment-Behaviour Studies), Faculty of Architecture, Planning & Surveying, Universiti Teknologi MARA, Malaysia.DOI: https://doi.org/10.21834/e-bpj.v4i12.1939

Mismatch of Subjective and Objective Risk of Falling in Patients with Dementia

2020 ◽  
Vol 78 (2) ◽  
pp. 557-572
Author(s):  
Klaus Hauer ◽  
Michael Schwenk ◽  
Stefan Englert ◽  
Rixt Zijlstra ◽  
Sabine Tuerner ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Fall Risk ◽  
Psychological Status ◽  
Risk Of Falling ◽  
Activity Avoidance ◽  
Mobility Assessment ◽  
Moderate Dementia ◽  
Objective Risk ◽  
Support Seeking

Background: Match or mismatch of objective physiological and subjectively perceived fall risk may have serious consequences in patients with dementia (PwD) while research is lacking. Objective: To analyze mismatch of objective and subjective fall risk and associated factors in PwD. Method: Cohort study in a geriatric rehabilitation center. Objective and subjective risk of falling were operationalized by Tinetti’s Performance Oriented Mobility Assessment and the Falls Efficacy Scale-International. Four sub-groups according to objective and subjective fall risk were classified. Subgroups were compared for differences in clinical, cognitive, psychological, and behavioral variables. Results: In geriatric rehab patients with mild to moderate dementia (n = 173), two-thirds showed a mismatch of subjective versus objective risk of falling, independently associated with previous falls. Underestimation of objective fall risk (37.6%) was determined by lower activity avoidance (OR 0.39), less concerns about falling due to previous falls (OR 0.25), and higher quality of life (OR 1.10), while overestimation (28.9%) was determined by higher rate of support seeking strategies (OR 50.3), activity avoidance (OR 15.2), better executive (OR 21.0) and memory functions (OR 21.5), and lower quality of life (OR.75) in multivariate logistic regression. Conclusion: The majority of patients showed a mismatch between objective and subjective falls risk. Underestimation as well as overestimation of fall risk was associated with specific profiles based on cognitive- and psychological status, falls and fall-related behavioral consequences which should be included in the comprehensive assessment of fall risk, and planning of individualized fall prevention programs for this population.

Problems and fall risk determinants of quality of life in older adults with increased risk of falling

2014 ◽  
Vol 15 (5) ◽  
pp. 579-587 ◽  
Author(s):  
Sang-I Lin ◽  
Ku-Chou Chang ◽  
Hsuei-Chen Lee ◽  
Yi-Ching Yang ◽  
Jau-Yih Tsauo
Keyword(s):  
Quality Of Life ◽  
Older Adults ◽  
Fall Risk ◽  
Risk Of Falling ◽  
Increased Risk ◽  
Risk Determinants

scholarly journals Possibility of Estimating the Risk of Falling at the Seat-Off Face While Rising Up from a Chair

2021 ◽  
Vol 4 (1) ◽  
Author(s):  
Hideo Hirai
Keyword(s):  
Quality Of Life ◽  
Motor Function ◽  
Fall Risk ◽  
Daily Life ◽  
The Elderly ◽  
Horizontal Distance ◽  
Risk Of Falling ◽  
The Stability ◽  
The Relationship

It is known that falls in the daily life of the elderly occur frequently during walking and rising up and greatly affect their quality of life. In the previous study we obtained the COG-heel horizontal distance and the COG horizontal velocity when the subjects performed rising up under the “fastest” or “slowest” velocity task. These seat-off parameters which were an indicator of the stability in rising from a chair were defined based on the relationship between them. In this experiment with healthy adults as subjects the seat-off parameters were found to become a different distribution because of the rising up strategies of each subject. Moreover, based on the relationship between the seat-off parameters and motor function, they could become an index expressing current fall risk and predicting future fall risk.

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