Design and Implementation of a Web-based Tailored Gymnasium to Enhance Self-management of Fibromyalgia
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Abstract
Background: This paper describes the design and development of an online gymnasium that proposes personalized exercise videos to users affected by fibromyalgia. Fibromyalgia syndrome is a chronic condition characterized by widespread pain in muscles, ligaments and tendons, usually associated with sleep disorders and fatigue. Physical exercise is considered as an important component of non-pharmacological treatments of this pathology and internet is praised as a powerful resource to promote and improve physical exercise. Yet, while online personalization of health interventions to consumers must be grounded on empirically based guidelines, guidelines for fibromyalgia-targeted exercises are scanty.
Objective: Our objective was to create an online application that could select and display to users affected by fibromyalgia exercise videos that best fit their personal needs and preferences. More specifically we intended, firstly, to define the variables that are needed to personalize the exercise videos and, secondly, to design an appropriate technological framework based on these variables.
Methods: The investigation of the variables was grounded on previous research on fibromyalgia and focused on the general characteristics of the syndrome, its management strategies and existing indications. Alongside this review, we collected original data through interviews with a team of experts and patients, where we applied the technique of ‘knowledge acquisition’. The general framework of the program is a revised version of the ‘tailoring’ approach proposed by Kreuter and colleagues (2000).
Results: The achievements presented in this paper are twofold. Firstly, we illustrate how we reached definition of the relevant factors for tailoring exercise videos in relation to fibromyalgia. For reasons that will be clarified in the paper, eight variables were included in the application’s extraction algorithms, namely: the available time, the level of pain, the time of day (predictor of the level of fatigue), the available training tools, the localization of the pain, the preferred level of difficulty, the previous experiences with the application and the judgments formerly expressed by the user. Secondly, we explain the general framework of the application that is composed by an assessment module (that investigates the determinant values of a specific user), a feedback module (presenting the tailored set of exercises) and a tracking component (used to monitor users’ interactions with the website). The personalized sets of exercises are automatically retrieved through a set of algorithms that will be illustrated and discussed. These algorithms use the data retrieved from the assessment module and from previous uses of the site in order to rank the available exercises according to their relevance to a specific user’s conditions and needs. Exercises are then extracted according to their category of belonging (e.g. relaxation, mobilization and so forth). The distribution in categories is influenced by the moment of the day when the exercise is performed and the level of pain of the patient.
Conclusions: This study led to the definition of relevant determinants and to the implementation of an algorithm to tailor physical exercises to fibromyalgia affected patients. However, the knowledge acquisition approach does not guarantee exhaustiveness in the identification of this variables; moreover, although we collected preliminary data from the use of the tool, a comprehensive evaluation is still missing.
Objective: Our objective was to create an online application that could select and display to users affected by fibromyalgia exercise videos that best fit their personal needs and preferences. More specifically we intended, firstly, to define the variables that are needed to personalize the exercise videos and, secondly, to design an appropriate technological framework based on these variables.
Methods: The investigation of the variables was grounded on previous research on fibromyalgia and focused on the general characteristics of the syndrome, its management strategies and existing indications. Alongside this review, we collected original data through interviews with a team of experts and patients, where we applied the technique of ‘knowledge acquisition’. The general framework of the program is a revised version of the ‘tailoring’ approach proposed by Kreuter and colleagues (2000).
Results: The achievements presented in this paper are twofold. Firstly, we illustrate how we reached definition of the relevant factors for tailoring exercise videos in relation to fibromyalgia. For reasons that will be clarified in the paper, eight variables were included in the application’s extraction algorithms, namely: the available time, the level of pain, the time of day (predictor of the level of fatigue), the available training tools, the localization of the pain, the preferred level of difficulty, the previous experiences with the application and the judgments formerly expressed by the user. Secondly, we explain the general framework of the application that is composed by an assessment module (that investigates the determinant values of a specific user), a feedback module (presenting the tailored set of exercises) and a tracking component (used to monitor users’ interactions with the website). The personalized sets of exercises are automatically retrieved through a set of algorithms that will be illustrated and discussed. These algorithms use the data retrieved from the assessment module and from previous uses of the site in order to rank the available exercises according to their relevance to a specific user’s conditions and needs. Exercises are then extracted according to their category of belonging (e.g. relaxation, mobilization and so forth). The distribution in categories is influenced by the moment of the day when the exercise is performed and the level of pain of the patient.
Conclusions: This study led to the definition of relevant determinants and to the implementation of an algorithm to tailor physical exercises to fibromyalgia affected patients. However, the knowledge acquisition approach does not guarantee exhaustiveness in the identification of this variables; moreover, although we collected preliminary data from the use of the tool, a comprehensive evaluation is still missing.
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