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BackgroundComputer based gaming systems, such as the Microsoft Kinect (Kinect), can facilitate complex task practice, enhance sensory feedback and action observation in novel, relevant and motivating modes of exercise which can be difficult to achieve with standard physiotherapy for people with Parkinson’s disease (PD). However, there is a current need for safe, feasible and effective exercise games that are appropriate for PD rehabilitation. The aims of this study were to i) develop a computer game to rehabilitate dynamic postural control for people with PD using the Kinect; and ii) pilot test the game’s safety and feasibility in a group of people with PD.MethodsA rehabilitation game aimed at training dynamic postural control was developed through an iterative process with input from a design workshop of people with PD. The game trains dynamic postural control through multi-directional reaching and stepping tasks, with increasing complexity across 12 levels of difficulty. Nine people with PD pilot tested the game for one session. Participant feedback to identify issues relating to safety and feasibility were collected using semi-structured interviews.ResultsParticipants reported that they felt safe whilst playing the game. In addition, there were no adverse events whilst playing. In general, the participants stated that they enjoyed the game and seven of the nine participants said they could imagine themselves using the game at home, especially if they felt it would improve their balance. The Flow State Scale indicated participants were immersed in the gameplay and enjoyed the experience. However, some participants reported that they found it difficult to discriminate between different types and orientations of visual objects in the game and some also had difficulty with the stepping tasks, especially when performed at the same time as the reaching tasks.ConclusionComputer-based rehabilitation games using the Kinect are safe and feasible for people with PD although intervention trials are needed to test their safety, feasibility and efficacy in the home.

Design and digital technologies to support a sense of self and human relationships for people living with dementia are both urgently needed. We present an enquiry into design for dementia facilitated by a public art commission for an adult mental health unit in a hospital in the UK. The interactive art piece was informed by the notion of personhood in dementia that foregrounds the person's social being and interpersonal relationships as sites where self is maintained and constructed. How clients, clients' family members and staff used the piece is reported and insights related to the notions of home, intimacy, possessions and self are presented. The art piece served as window on both dementia and the institution leading to a number of insights and implications for design.

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Parkinson's is a complex and multifaceted condition with a myriad of symptoms, thus, designing for and with this user group requires careful consideration. We reflect upon two studies, employing different design methodologies, relating to the design of rehabilitative exergames in Parkinson's. The first explored the concept of designing 'for' People with Parkinson's (PwP) and focused on specifications outlined by clinical stakeholders. The second used a designing 'with' approach and modified a pre-established participatory design method for use with PwP. We call attention to the importance of carrying out design work with PwP and contribute; an empathic understanding of living with Parkinson's, a set of recommendations for how to design with PwP and a set of wider considerations for developing rehabilitative exergames for PwP.