Bita Imam*, Rehabilitation Sciences, University of British Columbia, Vancouver, Canada William C Miller, Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, Canada Ian M Mitchell, Computer Science Department, University of British Columbia, Vancouver, Canada Heather Finlayson, Division of Physical Medicine and Rehabilitation, University of British Columbia, Vancouver, Canada Janice J Eng, Department of Physical Therapy, University of British Columbia, Vancouver, Canada Tal Jarus, Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, Canada Track: Research Presentation Topic: Human-Computer Interface (HCI) Design Presentation Type: Oral presentation Submission Type: Single Presentation Building: Sol Principe Room: C - Almudaina Date: 2014-10-10 11:50 AM – 12:35 PM Last modified: 2014-09-10

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Background: The number of older adults with lower limb amputation (LLA) who require rehabilitation for improving their walking and mobility is growing. Existing rehabilitation practices are experiencing difficulty meeting this demand. Furthermore, transition towards outpatient rehabilitation, coupled with community inaccessibility and transportation barriers, impose challenges for clients, particularly those in rural/remote areas, to attend face-to-face clinic appointments. In-home telehealth is an innovative and emerging approach to provide rehabilitation through technologies and telecommunication. Nintendo Wii FitTM is a commercial gaming technology that shows promise as an in-home rehabilitation tool. Our team, consisting of researchers, clinicians and computer scientists, developed WiinWalk; a tablet-enabled in-home telehealth group intervention to improve walking in older adults with LLA.

Methods: Developmental Phase: consisted of trialing various tablets, connectivity types, videoconferencing software, and wireless headphones combinations. The main variables of interest included: simplicity and user friendliness of tablet interface; compatibility of the tablet with videoconferencing software and wireless headphones; reliability of the software to support secured group videoconferencing with high video/audio qualities; software features to enable the Trainer to monitor the sessions; and quality of wireless headphones (comfort, noise/echo cancelling, ease of pairing with the tablet, good battery life). Piloting Phase: prior to conducting a multi-site randomized controlled trial, WiinWalk was piloted with 3 older adults with LLA (72, 67, and 62 years old). Users’ feedback about the selected technologies was collected.

Results: WiinWalk was refined through an iterative approach based on our observations and participants’ feedback. After trialing different software, VidyoMobile was chosen because of its reliability to handle group videoconferencing with high video/audio qualities as well as having moderating features. Apple iPads (wifi + cellular) were selected over Android tablets because of their user-friendly interface as well as better compatibility with VidyoMobile. To simplify access to VidyoMobile, and to limit the iPad to a single use, we tested iPad’s “guided access” which allows locking down the iPad to one app only. We decided to not use this option, however, because: 1) the guided access is automatically inactivated in case the iPad runs out of battery and dies; and 2) it restricts access to iPad’s settings which is needed in the event iPad’s connectivity with the headphones is lost. Therefore we created a custom launcher to easily access VidyoMobile - which only requires participants to enter their name in order to connect with the Trainer. Access to other available apps was restricted through iPad’s settings. Kinivo bluetooth headphones were selected because of their excellent battery life and echo cancellation. WiinWalk appeared to be feasible. Users’ feedback revealed general positive experiences with the selected technologies.

Conclusions: WiinWalk presents a promising in-home telehealth intervention which may have useful applications for clients with no/limited access to rehabilitation. The pilot study revealed encouraging results regarding the feasibility of WiinWalk in older adults with LLA. In the next phase, Wiinwalk will be evaluated in a multi-site randomized controlled trial with 72 participants.