Abstract
This column aims to describe the characteristics of current cyberpsychology research in Europe. In particular, CyberEurope aims at describing the leading research groups and projects running on the other side of the Ocean.
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It focuses on prevention by conducting food intake measurements and personalized metabolic control, providing exergames to stimulate social interaction, and defining cognitive training programs within the framework of a pilot study. All in all, DOREMI resorts to multidisciplinary research in the fields of serious games, social networking, wireless sensor network, activity recognition, and contextualization, as well as behavioral pattern analysis.
“By recording and monitoring information about the use of the adopted lifestyle protocols, it is possible to track the user's performance over long periods, providing a potential alert for signs of malnutrition or physical and cognitive deterioration,” says Prof. Oberdan Parodi, coordinator of the project. “The close collaboration between healthcare representatives and experienced technological partners enabled us to release a set of prototypes to be validated in the pilot study.”
Networked Apps and Devices
The DOREMI system involves four core technologies and three apps. The technologies include the “Smart Carpet”—a Wii-based balance board for daily weight assessment, an Android tablet containing all apps, a bracelet collecting patient metrics and sending it to a centralized home-based station, and about 10 environmental sensors installed in patients' homes to check their habits and measure their level of socialization.
Each app focuses on a specific aging-related issue: fitness, cognition via a series of games, and diet. “Thanks to a visual approach the user can fill in a personal food diary, selecting food types and portions by means of images. Medical doctors will remotely check the diary and, if necessary, modify the participant's diet to promote healthy nutrition according to the general guidelines promoted by DOREMI,” Prof. Parodi explains.
All collected data, be they from the serious games or other apps and devices, are integrated and displayed on the physicians' dashboards, which allow for remote inspection and control of the devices, as well as providing information about each patient's status. This all implies the set-up of a dedicated server in the patient's home.
“Each single installation has its own specific plan, and devices are linked to their actual position in the HOMER database,” Prof. Parodi says. “This installation information, which is anonymous for privacy reasons, is also very important for the interpretation of the acquired data: Think of what would happen if the caloric consumption of an individual is mixed with the food intake of another by mistake!”
Successful Trials
The DOREMI system has been tested extensively for two and a half years. Thirty-two older people between 65 and 80 years of age were involved in 3 month trials taking place in the UK and Italy.
“Subjects were characterized at baseline in terms of physical activity (SPPB, PASE test, daily steps/meters, 6MWT), hemodynamic and biochemical parameters (blood pressure, HR, lipid profile, glycemia, etc.), dietary habits (caloric intake) and balance assessment (BERG scale). They were stimulated to perform an indoor physical activity protocol (exergame on a tablet); monitored by the DOREMI bracelet; invited to fill in a diet e-diary to receive nutritional advice provided by an expert; and tested for balance (DOREMI smart balance board). At the end of trial, users underwent the same test battery of baseline,” Prof. Parodi points out.
The UK trials ended in April 2016, and 15 people >65 years of age were enrolled to participate in the validation phase in three different villages. The first reports from the UK trials have been received, while the data from Italy are undergoing deeper evaluation.
Patients evaluated the DOREMI solutions as being excellent. “Residents at ExtraCare and Accord in the UK have formed friendships in a group of residents who otherwise might not have got the chance, while encouraging a healthy lifestyle and active mind,” Prof. Parodi says.
In both test sites, the DOREMI population saw an overall increase in physical activity and a significant improvement in hemodynamics (decrease in blood pressure following a six-minute walking test) and in test scores for increased short physical performance. Changes in dietary habits also produced remarkable effects on blood markers and somatometric parameters.
Toward Use in Real-Life Situations
While the consortium does not have commercialization plans yet, there are plans for applying a subset of the DOREMI system to a real-life situation in Pisa, Italy. The Pisa Municipality started a project where a subset of the DOREMI system will be used to monitor the behavior of elderly people and to improve their mobility thanks to the exergame.
Equally, some subsets of the DOREMI system are ready to go to market. “We consider the possible exploitation of the social and gamified environment, the monitoring environment and the context-aware smart system,” Prof. Parodi says. The reference market for DOREMI technologies includes hospitals, social care providers, end users, local authorities, insurance companies, general practitioners, and social housing.