An augmented reality app for lower limb exercise- A focus group study

Although exercises improve the outcome of patients with osteoarthritis, patient compliance is poor. Behaviour modification and measuring compliance remain the Holy Grail of healthcare professionals. The responses of a focus group of 20 volunteers to a novel automatic compliance recording augmented reality exercise app were studied. Full compliance was achieved in all cases and was measured and recorded by the app. Overall, the app itself received favorable responses regarding the user interface and user experience. Introduction Physiotherapy and exercise are accepted as being beneficial for both prehab and postoperative/post injury rehabilitation. The benefits include pain reduction and delaying or removing the need for surgery (Fransen et al, 2015). Studies show that up to 70% of patients do not do their exercises as prescribed, (Szöts, K. 2015). The reasons include a lack of understanding or forgetting to how or how often to do them, pressures of work or social life and simply finding them boring. Behaviour modification and measuring compliance remain the Holy Grail of healthcare professionals. Increasing demands on reducing healthcare resources have made this a priority for governments across the globe. There is, however, a gap in the literature showing automatic measurement of compliance by stand-alone mobile apps. Gamification has been seen as an adjunct to behaviour modification and a means of sustaining the interest of the target patient population (Edney et al, 2017). The widespread availability and increasing processing power of smartphones have facilitated the development of augmented reality Health Sciences EPiC Series in Health Sciences Volume 2, 2018, Pages 183–186 CAOS 2018. The 18th Annual Meeting of the International Society for Computer Assisted Orthopaedic Surgery W. Zhan and F. Rodriguez Y Baena (eds.), CAOS 2018 (EPiC Series in Health Sciences, vol. 2), pp. 183–186 apps. The distribution of smartphone processing power, however, tends to correlate with the underlying operating system, age, income and social demographics. Therefore, for an app to maximise its reach, it must have the ability to function effectively across this current wide spectrum of available technologies and demographic groups. Above all, the app should be easy to use. The purpose of this study was to made an initial determination of patient acceptability and the opportunity for behaviour modification with regard to using Quads AR for lower limb exercises. Quads AR is an augmented reality app for lower limb exercise. It encourages the user to perform variations of lower limb movements through gamification (Figure 1). The games were designed to encourage slow steady muscle contractions (holding mode) and fast twitch muscle contractions (hitting mode) to activate the Type I and Type II muscles fibres respectively Moreover, the app automatically measures and records compliance. The user has the option to share the data and screenshots by email to health care professionals or on social media. Figure 1. Screen shot showing the interaction of the user’s foot with virtual objects and reward system. The core functionality is the ability to interact with a variety of augmented reality objects using the interaction of the user’s foot with virtual objects superimposed on a live real world visual field. There are two options for foot tracking. The markerless option uses computer vision and is suitable for higher end smartphones with faster processors. The marker option uses a marker stuck on the user’s sock or shoe. It is suitable for the still larger number of older smartphones with slower processors. An augmented reality app for lower limb exerciseA focus group study S. Sampath et al.