Objective:To assess the feasibility of conducting a randomised controlled trial of a home-based virtual reality system for rehabilitation of the arm following stroke.Design:Two group feasibility randomised controlled trial of intervention versus usual care.Setting:Patients’ homes.Participants:Patients aged 18 or over, with residual arm dysfunction following stroke and no longer receiving any other intensive rehabilitation.Interventions:Eight weeks’ use of a low cost home-based virtual reality system employing infra-red capture to translate the position of the hand into game play or usual care.Main measures:The primary objective was to collect information on the feasibility of a trial, including recruitment, collection of outcome measures and staff support required. Patients were assessed at three time points using the Wolf Motor Function Test, Nine-Hole Peg Test, Motor Activity Log and Nottingham Extended Activities of Daily Living.Results:Over 15 months only 47 people were referred to the team. Twenty seven were randomised and 18 (67%) of those completed final outcome measures. Sample size calculation based on data from the Wolf Motor Function Test indicated a requirement for 38 per group. There was a significantly greater change from baseline in the intervention group on midpoint Wolf Grip strength and two subscales of the final Motor Activity Log. Training in the use of the equipment took a median of 230 minutes per patient.Conclusions:To achieve the required sample size, a definitive home-based trial would require additional strategies to boost recruitment rates and adequate resources for patient support.
Level of use is variable and can fall far short of recommendations. Competing commitments were a barrier to use of the equipment, but participants reported that the intervention was flexible and motivating. It will not suit everyone, but some participants recorded high levels of use. Implications for practice are discussed.
The research reported here is part of a larger project which seeks to combine serious games (or games based learning) with location based services to help people with intellectual disability and additional sensory impairments to develop work based skills. Specifically this paper reports on where these approaches are combined to scaffold the learning of new routes and ultimately independent travel to new work and educational opportunities. A phased development methodology is applied in a user sensitive manner, to ensure that user feedback drives the ongoing development process. Methods to structure this include group feedback on conceptual storyboards, expert review of prototypes using usability heuristics relating to the main system goals, and finally co-discovery methods with student pairs exploring all three modes of the system in real world contexts. Aspects of developmental and cognitive psychological theories are also reviewed and it is suggested that combining games based learning approaches with location based services is an appropriate combination of technologies for an application specifically designed to scaffold route learning for this target audience.
Objective African‐Caribbean men in the United Kingdom in comparison with other ethnicities have the highest incidence rate of prostate cancer. Psychosocial aspects related to screening and presentation impact on men's behavior, with previous studies indicating a range of barriers. This study explores one such barrier, the digital rectal examination (DRE), due to its prominence within UK African‐Caribbean men's accounts. Methods African‐Caribbean men with prostate cancer (n = 10) and without cancer (n = 10) were interviewed about their perceptions of DRE. A synthetic discursive approach was employed to analyze the data. Results Findings illustrate that an interpretative repertoire of homophobia in relation to the DRE is constructed as having an impact upon African‐Caribbean men's uptake of prostate cancer screening. However, the discursive focus on footing and accountability highlight deviations from this repertoire that are built up as pragmatic and orient to changing perceptions within the community. Conclusions Health promotion interventions need to address the fear of homophobia and are best designed in collaboration with the community.
lindsay.evett@ntu.ac.uk, superski@sky.com, steven.battersby@ntu.ac.uk, david.brown@ntu.ac.uk *To whom correspondence should be addressed Brief biography for Dr Lindsay EvettLindsay is a lecturer in the Computing & Technology Team. Her research is on accessibility and assistive technology, especially with respect to Serious Games, and webbased content. She is a lecturer in Artificial Intelligence, and a member of Nottingham Trent University's working group on accessibility. She is a co-investigator on the GOET European project on serious educational games to develop prevocational skills in people with learning difficulties. Brief biography for Steven BattersbySteven is a software design engineer for the Interactive Systems Research group and has worked on numerous projects concerned with Serious Games and assistive technology. Steven is currently completing a PhD on adaptive, assistive technology. Brief biography for Allan RidleyAllan was recently awarded an MRes with distinction in Computer Science by Nottingham Trent University. He is just starting a PhD on accessible interactive systems. He has worked as an assistive technology trainer. Brief biography for Professor David BrownDavid was promoted from Reader to Professor of Interactive Systems for Social Inclusion in 2007. His research focuses on the application of virtual environments for the education of people with an intellectual impairment and for rehabilitation. His research on virtual environments for people with learning disabilities has been funded by a range of government agencies, by EPSRC and the EU. He is consortium leader for "Game on", to develop 3D role play games for the education and personal development of prisoners and those at risk of offending. He is the principle investigator for the GOET European project on serious educational games to develop prevocational skills in people with learning difficulties. Acknowledgements: This underlying research in games supports EU Leonardo Project GOAL.NET (UK/07/LLP-LdV/TOI-009)An interface to virtual environments for people who are blind using Wii technology -mental models and navigation ABSTRACT Accessible games, both for serious and for entertainment purposes, would allow inclusion and participation for those with disabilities. Research into the development of accessible games, and accessible virtual environments, is discussed. Research into accessible Virtual Environments has demonstrated great potential for allowing people who are blind to explore new spaces, reducing their reliance on guides, and aiding development of more efficient spatial maps and strategies. Importantly, Mioduser (2005, 2008) have demonstrated that, when exploring virtual spaces, people who are blind use more and different strategies than when exploring real physical spaces, and develop relatively accurate spatial representations of them. The present paper describes the design, development and evaluation of a system in which a virtual environment may be explored by people who are blind using Nintendo Wii devices, with au...
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