CnámhAR: Augmented reality exergames for people with osteoporosis

Osteoporosis is a progressive bone disease that lowers bone mass and raises the risk of fracture. Osteoporosis affects more than 200 million people globally. Physical exercise helps maintain bone and muscle strength, reducing fracture risk; however, adherence is a challenge. In recent years, virtual rehabilitation, using augmented reality (AR), an immersive technology enhancing the real-world with virtual artefacts, has emerged as a viable solution for improving motivation and participation. However, studies of AR-based rehabilitation in Osteoporosis remain under-explored. This thesis investigates the potential of AR-exergames to support physical rehabilitation for older adults with Osteoporosis. It examines their effectiveness in reducing the likelihood of falls and fractures among older adults with Osteoporosis, through the design, development, and evaluation of the CnámhAR system: a set of four exergames developed in collaboration with social and medical experts (i.e., Rheumatologists, Occupational Therapist and Physiotherapist) and refined through participatory action research with the study’s participants. A Clinical trial including a Run-in session to assess the acceptance and safety of the technology, followed by a six-week training programme (Phase 1) and a discussion of post-intervention results (Phase 2) was organised with 41 participants, aged 60 to 86 years old. Participants were divided into two groups; one engaged in traditional training (Control group) while the other practiced with the CnámhAR system (Intervention group). The findings of this thesis demonstrate that AR-exergames, and specifically the CnámhAR system, enable measurable improvements in both physical (e.g., muscle strength, flexibility, balance) and affective (pain, fear of falling, confidence) outcomes in older adults diagnosed with Osteoporosis. The AR-exergames showed improvement comparable to traditional training with additional benefits, such as enhanced engagement, a greater sense of independence and increased motivation. This thesis contributes to understanding technology acceptance, adherence and design preference for AR-based virtual rehabilitation among older adults with Osteoporosis. While this PhD did not assess clinical significance, Professor John J. Carey (Rheumatologist and Clinical lead in DXA, Osteoporosis and Fracture Liaison Services at the University Hospital Galway) notes that the strong acceptability and engagement results justify conducting longer studies (six to twelve months) where clinically meaningful outcomes can be evaluated.

Funder

Science Foundation Ireland

Publisher

University of Galway

Rights

CC BY-NC-ND

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Collections

University of Galway Theses (PhD Theses)