Skip to main content
Top
Published in: Journal of NeuroEngineering and Rehabilitation 1/2019

Open Access 01-12-2019 | Alzheimer's Disease | Research

An augmented reality approach for ADL support in Alzheimer’s disease: a crossover trial

Authors: Nina Rohrbach, Philipp Gulde, Alan Robert Armstrong, Linda Hartig, Anas Abdelrazeq, Stefan Schröder, Johanne Neuse, Timo Grimmer, Janine Diehl-Schmid, Joachim Hermsdörfer

Published in: Journal of NeuroEngineering and Rehabilitation | Issue 1/2019

Login to get access

Abstract

Background

Dementia of the Alzheimer’s type can impair the performance of activities of daily living and therefore severely impact independent living. Assistive technologies can support such patients when carrying out daily tasks.

Methods

In this crossover study, we used an augmented reality approach using a Microsoft HoloLens to support patients in a tea making task. During task execution, subjects received three-dimensional dynamic holograms of the sub-steps necessary to complete the task. Ten patients suffering from Alzheimer’s disease were tested and post-hoc semi-structured interviews were conducted to assess usability.

Results

The patients committed errors when executing the task with and without holographic assistance. No differences in success rates or error frequencies were observed (psuccess = .250, perrors = .887). Patients revealed prolonged trial durations (Glass’ Δ = 1.475) when wearing the augmented reality headset. A model of multiple linear regression (R2adjusted = .958) revealed an influence of the errors in the control condition and a moderation by the errors in the experimental condition. Patients with more severe problems in the natural performance of the task showed lower increases in trial durations when wearing the HoloLens.

Conclusions

We assume that the application was a secondary task requesting its own resources and impairing performance on its own. The regression suggests however that the given assistance was compensating these additional costs in patients with stronger needs of support. Interview data on usability revealed an overall positive feedback towards the application although the hardware was considered uncomfortable and too large. We conclude that the approach proved feasible and the acceptability was overall high, although advances in hardware and the patient-interface are necessary to assist patients suffering from Alzheimer’s disease in daily activities.

Trial registration

DRKS, DRKS00014870. Registered 11 June 2018 - Retrospectively registered, TrialID = DRKS00014870.
Literature
1.
go back to reference Reisberg B, Finkel S, Overall J, Schmidt-Gollas N, Kanowski S, Lehfeld H, et al. The Alzheimer's disease activities of daily living international scale (ADL-IS). Int Psychogeriatr. 2001;13(2).CrossRef Reisberg B, Finkel S, Overall J, Schmidt-Gollas N, Kanowski S, Lehfeld H, et al. The Alzheimer's disease activities of daily living international scale (ADL-IS). Int Psychogeriatr. 2001;13(2).CrossRef
2.
go back to reference Pedrosa H, De Sa A, Guerreiro M, Maroco J, Simoes M, Galasko D, et al. Functional evaluation distinguishes MCI patients from healthy elderly people - the ADCS/MCI/ADL scale. J Nutr Health Aging. 2010;14(8):703–9.CrossRef Pedrosa H, De Sa A, Guerreiro M, Maroco J, Simoes M, Galasko D, et al. Functional evaluation distinguishes MCI patients from healthy elderly people - the ADCS/MCI/ADL scale. J Nutr Health Aging. 2010;14(8):703–9.CrossRef
3.
go back to reference Perneczky R, Pohl C, Sorg C, Hartmann J, Tosic N, Grimmer T, et al. Impairment of activities of daily living requiring memory or complex reasoning as part of the MCI syndrome. Geriatric Psychiatry. 2006;21(2):158–62.CrossRef Perneczky R, Pohl C, Sorg C, Hartmann J, Tosic N, Grimmer T, et al. Impairment of activities of daily living requiring memory or complex reasoning as part of the MCI syndrome. Geriatric Psychiatry. 2006;21(2):158–62.CrossRef
4.
go back to reference Gulde P, Leippold K, Kohl S, Grimmer T, Diehl-Schmid J, Armstrong A, et al. Step by step: kinematics of the reciprocal trail making task predict slowness of ADL performance in Alzheimer's disease. Front Neurol. 2018. Gulde P, Leippold K, Kohl S, Grimmer T, Diehl-Schmid J, Armstrong A, et al. Step by step: kinematics of the reciprocal trail making task predict slowness of ADL performance in Alzheimer's disease. Front Neurol. 2018.
5.
go back to reference Navia B, Jordan B, Price R. The AUDS dementia complex: I. clinical features. Anals of Neurology. 1986;19(6):517–24.CrossRef Navia B, Jordan B, Price R. The AUDS dementia complex: I. clinical features. Anals of Neurology. 1986;19(6):517–24.CrossRef
6.
go back to reference Neary D, Brun A, Englund B, Gustafon L, Passant U, Mann D, et al. Clinical and neuropathological criteria for frontotemporal dementia. J Neurol Neurosurg Psychiatry. 1994;57(4):416–8.CrossRef Neary D, Brun A, Englund B, Gustafon L, Passant U, Mann D, et al. Clinical and neuropathological criteria for frontotemporal dementia. J Neurol Neurosurg Psychiatry. 1994;57(4):416–8.CrossRef
7.
go back to reference Ochipa C, Rothi L, Heilman K. Conceptual apraxia in Alzheimer's disease. Brain. 1992;115(4):1061–71.CrossRef Ochipa C, Rothi L, Heilman K. Conceptual apraxia in Alzheimer's disease. Brain. 1992;115(4):1061–71.CrossRef
8.
go back to reference Rapcsak S, Croswell S, Rubens A. Apraxia in Alzheimer's disease. Neurology. 1989;39(5):664.CrossRef Rapcsak S, Croswell S, Rubens A. Apraxia in Alzheimer's disease. Neurology. 1989;39(5):664.CrossRef
9.
go back to reference Ienca M, Fabrice J, Elger B, Caon M, Scoccia Pappagallo A, Kressig R, et al. Intelligent assistive Technology for Alzheimer's disease and other dementias: a systematic review. J Alzheimers Dis. 2017;56:1301–40.CrossRef Ienca M, Fabrice J, Elger B, Caon M, Scoccia Pappagallo A, Kressig R, et al. Intelligent assistive Technology for Alzheimer's disease and other dementias: a systematic review. J Alzheimers Dis. 2017;56:1301–40.CrossRef
10.
go back to reference Asghar I, Cang S, Yu H. Assitive technology for people with dementia: an overview and bibliometric study. Health Inf Libr J. 2017;34(1):5–19.CrossRef Asghar I, Cang S, Yu H. Assitive technology for people with dementia: an overview and bibliometric study. Health Inf Libr J. 2017;34(1):5–19.CrossRef
11.
go back to reference Perez C, Kaizer F, Archambault P, Fung J. A novel approach to integrate VR exer-games for stroke rehabilitation: evaluating the implementation of a 'games room'. Virtual Rehabil (ICVR). 2017. Perez C, Kaizer F, Archambault P, Fung J. A novel approach to integrate VR exer-games for stroke rehabilitation: evaluating the implementation of a 'games room'. Virtual Rehabil (ICVR). 2017.
12.
go back to reference Meiland F, Innes A, Mountain G, Robinson L, van der Roest H, García-Casal JA, et al. Technologies to support community-dwelling persons with dementia: a position paper on issues regarding development, usability, effectiveness and cost-effectiveness, deployment, and ethics. JMIR Rehabil Assist Technol. 2017;4(1).CrossRef Meiland F, Innes A, Mountain G, Robinson L, van der Roest H, García-Casal JA, et al. Technologies to support community-dwelling persons with dementia: a position paper on issues regarding development, usability, effectiveness and cost-effectiveness, deployment, and ethics. JMIR Rehabil Assist Technol. 2017;4(1).CrossRef
14.
go back to reference Ostlund U, Kidd L, Wengstrom Y, Rowa-Dewar N. Combining qualitative and quantitative research within mixed method research designs: a methodological review. Int J Nurs Stud. 2011;48(3):369–83.CrossRef Ostlund U, Kidd L, Wengstrom Y, Rowa-Dewar N. Combining qualitative and quantitative research within mixed method research designs: a methodological review. Int J Nurs Stud. 2011;48(3):369–83.CrossRef
15.
go back to reference Bienkiewicz MM, Brandi ML, Hughes C, Voitl A, Hermsdorfer J. The complexity of the relationship between neuropsychological deficits and impairment in everyday tasks after stroke. Brain Behav. 2015;5(10):e00371.CrossRef Bienkiewicz MM, Brandi ML, Hughes C, Voitl A, Hermsdorfer J. The complexity of the relationship between neuropsychological deficits and impairment in everyday tasks after stroke. Brain Behav. 2015;5(10):e00371.CrossRef
16.
go back to reference Hughes CML, Baber C, Bienkiewicz M, Worthington A, Hazell A, Hermsdörfer J. The application of SHERPA (systematic human error reduction and prediction approach) in the development of compensatory cognitive rehabilitation strategies for stroke patients with left and right brain damage. Ergonomics. 2015;58(1):75–95.CrossRef Hughes CML, Baber C, Bienkiewicz M, Worthington A, Hazell A, Hermsdörfer J. The application of SHERPA (systematic human error reduction and prediction approach) in the development of compensatory cognitive rehabilitation strategies for stroke patients with left and right brain damage. Ergonomics. 2015;58(1):75–95.CrossRef
18.
go back to reference Rohrbach N, Armstrong A, Hermsdörfer J. Therapy Lens – Stakeholder Analyse zur Nutzung von Augmented Reality in der Neurorehabilitation. 2 Forschungssymposium Physiotherapie; 2017 16–17 November; Hochschule Osnabrück. Osnabrück: Selbstverlag. Rohrbach N, Armstrong A, Hermsdörfer J. Therapy Lens – Stakeholder Analyse zur Nutzung von Augmented Reality in der Neurorehabilitation. 2 Forschungssymposium Physiotherapie; 2017 16–17 November; Hochschule Osnabrück. Osnabrück: Selbstverlag.
19.
go back to reference Rohrbach N, Armstrong A, Abdelrazeq A, Gödel A, Leippold K, Hermsdörfer J. “Can you find the kettle?” using augmented reality to support patients in their activities of daily living – first opinion on the Therapy Lens app. Innovation & Technologie im Sport; 13-15 September 2017; Munich: Hamburg: Czwalina. ISBN 978-3-88020-655-7. Rohrbach N, Armstrong A, Abdelrazeq A, Gödel A, Leippold K, Hermsdörfer J. “Can you find the kettle?” using augmented reality to support patients in their activities of daily living – first opinion on the Therapy Lens app. Innovation & Technologie im Sport; 13-15 September 2017; Munich: Hamburg: Czwalina. ISBN 978-3-88020-655-7.
20.
go back to reference Kuckartz U. Qualitative text analysis. Thousand oaks (CA): Sage Publications; 2016. Kuckartz U. Qualitative text analysis. Thousand oaks (CA): Sage Publications; 2016.
21.
go back to reference Meiland FJ, Bouman AI, Sävenstedt S, Bentvelzen S, Davies RJ, Mulvenna MD, et al. Usability of a new electronic assistive device for community-dwelling persons with mild dementia. Aging Ment Health. 2012;16(5):584–91.CrossRef Meiland FJ, Bouman AI, Sävenstedt S, Bentvelzen S, Davies RJ, Mulvenna MD, et al. Usability of a new electronic assistive device for community-dwelling persons with mild dementia. Aging Ment Health. 2012;16(5):584–91.CrossRef
Metadata
Title
An augmented reality approach for ADL support in Alzheimer’s disease: a crossover trial
Authors
Nina Rohrbach
Philipp Gulde
Alan Robert Armstrong
Linda Hartig
Anas Abdelrazeq
Stefan Schröder
Johanne Neuse
Timo Grimmer
Janine Diehl-Schmid
Joachim Hermsdörfer
Publication date
01-12-2019
Publisher
BioMed Central
Published in
Journal of NeuroEngineering and Rehabilitation / Issue 1/2019
Electronic ISSN: 1743-0003
DOI
https://doi.org/10.1186/s12984-019-0530-z

Other articles of this Issue 1/2019

Journal of NeuroEngineering and Rehabilitation 1/2019 Go to the issue