Accessible Active Video Game Controllers

Active video games (AVGs), a category of video games that require whole body movements, hold promise for promoting higher levels of physical activity, weight management, and fitness among youths. However, many current AVGs are inaccessible or offer limited play options for youths who are unable to stand, have balance issues, poor motor control, or cannot use their lower body to perform game required movements.  To read more about the study purpose and design, click here or check out the information for D1 under the tab “Projects”.

RecTech has partnered with UAB School of Engeneering and developed the following adaptations:

Wii Mat

Barriers that were identified with the Wii Mat in Phase I had to do with sensitivity, spread of buttons, and safety for children with balance and/or coordination difficulties.  The adapted Wii Mat system is similar in design to the standard mats currently available on the market (below) in that it includes eight low profile buttons that correlate to the buttons of the Wii handheld controller.  The adaptions allow gameplay with both hands and feet and provide increased sensitivity through the use of piezoresistive sensors and an integrated microcontroller – an example of the sensor configuration and a similar DIY sensor are shown below.  The system has eight separate buttons that are spatially reconfigurable so as to give the user the ability to place the buttons in any configuration to better facilitate their specific preferences.

Wii Fit Board

Problems encountered with the Wii Fit Board during Phase I included lack of accessibility for wheelchair users as well as being too small for users with balance problems.  The adapted Wii Fit Board provides a stable controller platform for users that are seated in a wheelchair. By incorporating all existing Wii Fit Board electronics into a larger, more stable platform, the adapted controller will provide a more responsive, reliable, and safer experience for the user.  The existing board uses four rudimentary load cells – one positioned at each corner – to identify and track the user’s center of gravity.  The load cells were repositioned to each of the corners of a larger custom built platform as seen below.  Adaptive features of the new Wii Fit Board include:  

1. Easy Ramp access to get on and off the board
2. Lighted grids help to align the wheels
3. Sensitivity adjustment helps to play the game according to the individuals functional capability.
4. Front guard and back guard protects the wheelchair from rolling over.
5. Front guard can adjust to different angles to accommodate different foot rests.
6. Height adjustable handrails that provide additional support/protection.
7. An easily reachable “Start Button”
8. Certain Wii Games such as “tight rope walk” requires users to jump off the board.  For wheelchair users this is made possible through pressing a button.

Fall Protection System for a Modified Wii-gaming Board

The World Health Organization (WHO) declares disability as any impairment, activity limitation, or participation restriction.¹  Mobility disability is the most common disability type within the United States; it affects about 1 in every 8 adults,² and includes people who are wheelchair bound or people with balance difficulties due to stroke, Parkinson’s, multiple sclerosis, old age, or other debilitating circumstance. The team at UAB’s Engineering Technology Innovation & Development (EITD) redesigned a Wii Balance Board which provides a way for individuals with congenital or acquired balance limitations to exercise; however, there is insufficient safety mechanisms in place to catch a user should they lose their balance while playing. Therefore, a Biomedical Engineering (BME) capstone team has designed a fall protection exergaming frame that will allow the user to freely enjoy gameplay and exercise without fear of falling.

The design consists of four main parts: a frame base, back expansion legs; side poles, and a rope and harness system. The base of the machine is made out of 6061 Aluminum square tubing with poles that extend out to add extra support to the base and prevent tipping. Two vertical side poles slide into the base. A bungee rope system is attached to the frame through the use of pins on the side poles. The rope can be secured to differing heights of eyebolts to accommodate for different heights of people. The bungee rope system is then clipped onto a D-ring on the player’s shoulder blades via a torso harness. The entire base is on four locking casters which lock to keep the frame from moving during use but allow it to be easily transportable. The frame is also semi-collapsible in that the side poles can come off of the base and the base can be turned on its side for storage against a wall or in a closet.

The Fall-Protection system will be used in conjunction with the redesigned Wii Balance Board at the Lakeshore Foundation. Lakeshore clients will be able to use our frame to safely exercise while on the redesigned Wii Balance Board. The frame may also be used with treadmills or other common exercise equipment.

References
[1] World Health Organization, International Classification of Functioning, Disability and Health (ICF). Geneva: 2001, WHO.
[2] Centers for Disease Control and Prevention, Key Findings: Prevalence of Disability and Disability Type among Adults, United States – 2013. Disability and Health, 20 August 2015.

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AIMS – Activity Inclusion Mapping System

Visit http://aims.rectech.org/reports to access the product!

What is AIMS?  Why was it developed?

AIMS is a newly developed online system designed to promote accessible physical activity by enabling the public to search for inclusive fitness opportunities through it’s online directory.  The system provides a comprehensive directory of fitness and recreational facitlities located in Jefferson and Shelby County that previously did not exist.  Each location has been evaluated with the online survey which includes an in-depth accessibility analysis of the facility, the staff, and the individual activities offered by the facility.  AIMS is a unique system because the information collected through the survey allows us to map available accessible facilities in Jefferson and Shelby County as well as the inclusive adaptations offered by those facilities.

How does AIMS work?

The search features of AIMS are designed to be user friendly, allowing people to quickly and easily discover if:  a) facilities are accessible, b) what activities they offer, and c) if these activities offer inclusive adaptations.  To do this, from the home page, users select their fitness activity of choice from greater than 55 different fitness ativities currently found in the AIMS directory.  Users can further filter thier searches (see above pictures) by location or specific building features they desire (ex: accessible doors, accessible bathroom stall, accessible pool, etc).  From here, AIMS will map all facilities that meet the search criteria.  We encourage users to click through each facility listed to see the detailed analysis of each location in order to make informed decisions.  Our desire to be transparent and thorough in order to maximize user information is apparent in the information shared on each facility’s page.  The analysis will include several things that can all be noted in the Oak Mountain State Park example below:

1. A list of all fitness activities  offered at the facility and if they are Wheelchair Accessible (highlighted in green)
2. Accessible features of the facility (Parking, entrance, information, restrooms, etc.)
3. Detailed Accessibility Information (Inclusive adaptations offered for each activity, details on facility accessibility)
4. Pictures of the facility and basic facility information (directions, hours, telephone number, basic cost information)
5. Links to their Website, Social Media pages, and External reviews.

How is AIMS being developed and who can submit a report?

We currently have a team of UAB DPT and OT students that have evaluated and submitted reports as we developed the system.  As AIMS goes forward we have several goals.  First, we hope to receive comments about personal experiences with our already existing facilities as well as any facility updates that may have occurred since the evaluation.  Next, we encourage users to use the online survey to submit new resources to be used in our directory.  Upon submission, we will review the information and supplement areas if needed before being published in the directory.  Lastly, we hope to extend the reach of AIMS to other counties in order to provide a more profound impact on the public through the directory of inclusive activities and accessible facilities.

Check out AIMS at http://aims.rectech.org/reports!

AIMFREE – Accessibility Instruments Measuring Fitness and Recreation Environments

The AIMFREE instruments were developed to measure the accessibility of fitness and recreation facilities as it pertains to persons with mobility impairments (e.g., persons using wheelchairs or other assistive devices). The AIMFREE instrument, developed by Rectech and funded by NIDRR, contains about 400 questions and 15 sections. Efforts were also made to include items that were relevant to persons with other disabling conditions, including individuals with sensory impairments (e.g., size of print on facility signage).  Instrument development occurred in three phases: (1) setting selection, which involved identifying the types of fitness and recreation facilities of greatest interest to persons with disabilities; (2) item development; and (3) instrument piloting.

An Advanced Virtual Environment Exercise Device (AVE2D) for Promoting Socially Engaging Physical Activity in People with Disabilities

RecTech in partnership with PushProduct Design, LLC has developed successful prototype of AVE2D. This phase effort has developed and constructed an advanced control system to act as the foundation to enable AVE2D to provide exercise conditioning for users with asymmetric capabilities. This effort has been specifically focused on addressing key gaps in the market that current equipment often does not address, e.g., allowing the user’s “weak” side or limb axis to be properly conditioned.

Figure 1. Latest prototype with advanced control system including asymmetric upper axis resistance control and augmented power to leg axis.

Figure 2. Programmable control system detail.

This control system has the ability to provide specific right and left side resistance and cadence-related settings “tuned”for specific conditions. The control system can also provide supplemental power to the leg axis for individuals with a range of potential exercise needs (e.g. incomplete SCI who could benefit from leg-related exercise in a recumbent or standing position).

Figure 3. Below are example screens and diagrams showing how resistance on the right and left sides of the body can be adjusted both manually and with algorithms to control relative resistance on each side to achieve uniform RPM/cadence.

Figure 4. Conceptual image of prototype CAD taken from animation showing ultimate mass production design.

Push PD, LLC filed provisional patent with US Patent Office (based on Push’s experience with securing intellectual property for corporate clients) to create maximum value for potential strategic commercialization partners

What is EE_estimator?

EE_estimator is a computer application designed for estimating energy expenditure of manual wheelchair users with spinal cord injury (SCI) using the commercial activity monitor SenseWear armband (Bodymedia, Inc., Pittsburgh, PA). This application uses the personal information (e.g., height and weight) of a manual wheelchair user with SCI, along with the raw data collected by the SenseWear armband to provide a more accurate estimate of his/her energy expenditure as compared to the default outputs from the SenseWear armband. In order to use this application, you should have access to the raw data collected by the SenseWear armband typically through the SenseWear Professional Software.

Why is EE_estimator developed?

The SenseWear armband was originally designed for estimating physical activity and energy expenditure of the ambulatory population. Research has shown that the SenseWear armband is not accurate at tracking physical activity and energy expenditure in manual wheelchair users with SCI (1, 2). Therefore, our research team has created this application that uses custom models for manual wheelchair users with SCI derived from our research (3) to enable people who are interested in using SenseWear armbands for wheelchair users to obtain an accurate estimate of energy expenditure.

How was this application developed?

Our research team has developed two types of custom energy expenditure models, i.e. the general and the activity-specific models. The general model can be used when you do not have a log of activities performed by the wheelchair user. The activity-specific model can be used for four activities including resting while seated, light-weight deskwork (e.g., computer operation, reading etc.), wheelchair propulsion, and arm-ergometry exercise. Both models were developed using data collected from 45 manual wheelchair users with SCI. Participants were asked to wear a SenseWear armband and a portable metabolic cart (gas analyzer) while performing the four activities mentioned above in the laboratory setting. More details about the modeling process can be found in (3).

How accurate is this application?

We evaluated the two custom models with another group of 45 manual wheelchair users with spinal cord injury who performed a wide range of lifestyle and sporting based activities in both laboratory and home/community settings. Eighteen out of the 45 wheelchair users have participated in our previous study mentioned above. Overall, the general model has an average percent error of -2.8±26.1%, while the activity-specific model has an average percent error of -4.8±25.4% when compared to the portable metabolic cart readings. More information on the validity study can be found in (4, 5). It should be noted that both models were developed and tested among manual wheelchair users with SCI. We do not know how the models will perform when they are applied to manual wheelchair users with other diagnoses.

For more information on activity monitors for physical asssessment of wheelchair users, check out the projects page.

Contact Information

If you are interested in using the EE_estimator application, please share your project information as well as your contact information with us. We will follow up with you and send you the application. If you have any questions about using this application, please free feel to contact the Project Director Dr. Dan Ding at dad5@pitt.edu. This work is supported by the RERC on Interactive Exercise Technologies and Exercise Physiology for Persons with Disabilities (#H133E120005) funded by the National Institute on Disability and Rehabilitation Research (NIDRR). The work is also supported by the Human Engineering Research Laboratories, VA Pittsburgh Healthcare System. The contents do not represent the views of the Department of Veterans Affairs or the United States Government.

References

1. Hiremath S, Ding D. Evalution of activity monitors in manual wheelchair users with paraplegia. Journal of Spinal Cord Medicine. 2011;34(1):110-7. doi: 10.1179/107902610X12911165975142.
2. Hiremath SV, Ding D, Evaluation of Activity Monitors in Estimating Energy Expenditure in Manual Wheelchair Users. RESNA Annual Conference; 2010; Las Vegas, Nevada.
3. Hiremath S, Ding D, Farringdon J, Cooper RA. Predicting Energy Expenditure of Manual Wheelchair Users with Spinal Cord Injury Using a Multisensor-Based Activity Monitor. Achives of Physical Medicine and Rehabilitation. 2012;93(11):1937-43. doi: 10.1016/j.ampr.2012.05.004.
4. Tsang KL, Hiremath SV, Ding D. Evaluating the Energy Expenditure Prediction Models for Manual Wheelchair Users with Spinal Cord Injuries.  RESNA Annual Conference; Indianopolis, Indiana2014.
5. Tsang KL, Hiremath SV, Ding D. Evaluation of the Energy Expenditure Prediction Models for Tracking Physical Activity in Manual Wheelchair Users. Journal of Rehabilitation Research & Development. 2014; In Review.

Para-Percussion: Rhythmic Exercise for the Body and Mind

Exercise is recognized as one of the most important behaviors in maintaining overall health and reducing the risks of chronic diseases,1,2 as well as protecting against secondary conditions.3  For persons with disabilities, studies have demonstrated that exercise improves functional performance,4 and quality of life.5  Musical performance is an art form that has shown to be a highly effective method for increasing the amount of physical activity one performs each day.6 With a lack of resources able to accommodate the high demand for personal musician trainers, it is often difficult or impossible for users to advance their skills.
Para-percussion technology approaches this problem with automated systems and unique assemblies to accommodate users of all kinds.  The idea is simple – give users a system that allows for interactive and instructional rhythmic content, while keeping the system easy to follow and universally accessible. The current model of Para-percussion integrates Arduino microcontroller systems with an adjustable percussion rack unit (examples shown below), currently allowing for simple patterns and rudiments to be learned and practiced.

Example of microcontroller used, and initial assembly

Features of this model include time mapping algorithms for forgiving pattern recognition, complete adaptability for users with varying ranges of movement and ability, 3D printed circuitry enclosures for unique and sturdy assembly, lighted drums for aesthetically pleasing visual recognition, and wireless communication with vibrating modules to allow haptic feedback for users with little to no sight.

References
1. U.S. Department of Health and Human Services. (1996). Physical Activity and Health: A Report of the Surgeon General. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion.
2. U.S. Department of Health and Human Services. (2000). Healthy People 2010. Washington, DC: U.S. Department of Health and Human Services.
3. Paffenbarger RS, Morris JN, Haskell WL, Thompson PD, Lee I-M. (2004). An intro-duction to the Journal of Physical Activity and Health. J Phys Activity Health, 1:1–3.
4. Romberg A, Virtanen A, Ruutiainen J, Aunola S, Karppi SL, Vaara M, Surakka J,Pohjolainen T, Seppanen A. (2004). Effects of a 6-month exercise program on patients with multiple sclerosis: a randomized study. Neurology, 63(11):2034–2038.
5. Patti F, Ciancio MR, Reggio E, Lopes R, Palermo F, Cacopardo M, Reggio A. (2002). The impact of outpatient rehabilitation on quality of life in multiple sclerosis. J Neurol, 249(8):1027–1033.
6. University of Chichester, “The Clem Burke Drumming project,” July 2008. Web.
http://www.clemburkedrummingproject.com/Research.html.

What is TExT-ME?

TExT-ME (Telehealth Exercise Training for Monitoring and Evaluation of Home-Based Exercise in People with Neuromuscular Disability) is an exercise training and monitoring system using a customized platform to conduct high-fidelity, safe and effective training studies. The platform consists of a “coach’s station” website that connects to a customized application on an Android tablet operating system. This allows the coach and participant to communicate via live-time video conferencing as well as text message. Additionally, TExT-ME utilizes a BioharnessTM 3 physiological monitor that sends live heart rate and respiratory rate data to the tablet and coach’s station to allow for safe and effective monitoring of the exercise session. Each training session is stored on the website and can be exported for further data analysis. Exercise protocols and participant and coach information is also stored on the coach’s website.

Why is TExT-ME being developed?

The TExT-ME system is being developed to provide a home-based exercise training option for people with spinal cord injury (SCI) and other conditions which could serve both therapy and research initiatives. The current exercise training literature on people with SCI is limited by small sample sizes, high dropout rates, under-dosed training programs, and selection bias associated with study participants who have transportation, are higher functioning, and are more motivated to devote time and energy traveling to and from an exercise site several days per week (1-3). Home-based telehealth holds promise as an effective method for conducting exercise trials on hard-to-reach populations by eliminating the barrier of transportation, offering participants the flexibility of exercising at their preferred time of day, and conserving energy and time associated with travel.

How is this system being developed and tested?

We worked with collaborators at Innovare Care and the University of Alabama at Huntsville to finalize the customized Android application and coach’s website. We then tested the usability of the system in three individuals with SCI during a single bout of aerobic exercise on the arm ergometer in a fitness facility.

TExT-ME will compare adherence rates, quantitative data, and qualitative data among 3 groups: 1) Remotely delivered exercise group with a telecoach  2) Exercise at home group without the coach 3) Exercising at a typical fitness facility without a coach.   All groups will exercise three times per week on an arm ergometer using the same progressive training protocol. Participants in the 2 home-based groups will be provided with an Android tablet, arm ergometer, and BioharnessTM.  Group 1 will be trained under the supervision of a remote telehealth coach, while Group 2 will be educated on the equipment and protocol but will not receive coaching during the exercise sessions.  Group 3 will have a 2 month paid membership to an accessible facility with the needed equipment.  All groups will undergo pre-post assessments including VO2 peak, fasting blood glucose, and 3 questionnaires (Quality of Life Index, Satisfaction with Life Scale, and the Physical Activity Scale for Individuals with Physical Disability). We hypothesize that participants in the home-based telehealth program with telecoaches will experience higher adherence to the exercise prescription and hence greater improvements in aerobic capacity compared to the onsite exercise group.

For more information on Telehealth Exercise Training, check out the projects page.

Contact Information

If you have any questions about the development or use of this system, please free feel to contact the Project Director Dr. C. Scott Bickel at bickel@uab.edu. This work is supported by the RERC on Interactive Exercise Technologies and Exercise Physiology for Persons with Disabilities (#H133E120005) funded by the National Institute on Disability and Rehabilitation Research (NIDRR).

References

1. Rimmer JH, Chen MD, McCubbin JA, Drum C, Peterson J. Exercise intervention research on persons with disabilities: what we know and where we need to go. American journal of physical medicine & rehabilitation / Association of Academic Physiatrists. 2010;89(3):249-63. Epub 2010/01/14. doi: 10.1097/PHM.0b013e3181c9fa9d. PubMed PMID: 20068432.
2. Ginis KA, Hicks AL. Exercise research issues in the spinal cord injured population. Exercise and sport sciences reviews. 2005;33(1):49-53. Epub 2005/01/11. PubMed PMID: 15640721.
3. Ginis KA, Hicks AL. Considerations for the development of a physical activity guide for Canadians with physical disabilities. Canadian journal of public health = Revue canadienne de sante publique. 2007;98 Suppl 2:S135-47. Epub 2008/01/25. PubMed PMID: 18213944.

Standard Test Method for Evaluating the Universal Design of Fitness Equipment for Inclusive Use by Persons with Functional Limitations and Impairments

ASTM F3021

https://www.astm.org/f3021-17.html

ASTM F3022

https://www.astm.org/f3022-16e01.html

The ASTM F3021/F3022 UDFE/IF Data Form will be used to collect data and report results on strength and aerobic equipment designed to meet the ASTM F3021 and F3022 standards for Universal Design of Fitness Equipment (UDFE)/Inclusive Fitness (IF).

http://www.rectech.org/wp-content/uploads/2014/09/UDFE.pdf