Digital Therapeutic Exercises Using Augmented Reality Glasses for Frailty Prevention among Older Adults / 대한의료정보학회지

Objectives@#The objective of this study was to investigate the effects of a digital therapeutic exercise platform for pre-frail or frail elderly individuals using augmented reality (AR) technology accessed through glasses. A tablet-based exercise program was utilized for the control group, and a non-inferiority assessment was employed. @*Methods@#The participants included older adult women aged 65 years and older residing in Incheon, South Korea. A digital therapeutic exercise program involving AR glasses or tablet-based exercise was administered twice a week for 12 weeks, with gradually increasing exercise duration. Statistical analysis was conducted using the t-test and Wilcoxon rank sum test for non-inferiority assessment. @*Results@#In theprimary efficacy assessment, regarding the change in lower limb strength, a non-inferior result was observed for the intervention group (mean change, 5.46) relative to the control group (mean change, 4.83), with a mean difference of 0.63 between groups (95% confidence interval, –2.33 to 3.58). Changes in body composition and physical fitness-related variables differed non-significantly between the groups. However, the intervention group demonstrated a significantly greater increase in cardiorespiratory endurance (p < 0.005) and a significantly larger decrease in the frailty index (p < 0.001). @*Conclusions@#An AR-based digital therapeutic program significantly and positively contributed to the improvement of cardiovascular endurance and the reduction of indicators of aging among older adults. These findings underscore the value of digital therapeutics in mitigating the effects of aging.

Exploring the Category and Use Cases on Digital Therapeutic Methodologies / 대한의료정보학회지

Objectives@#As the Fourth Industrial Revolution advances, there is a growing interest in digital technology. In particular, the use of digital therapeutics (DTx) in healthcare is anticipated to reduce medical expenses. However, analytical research on DTx is still insufficient to fuel momentum for future DTx development. The purpose of this article is to analyze representative cases of different types of DTx from around the world and to propose a classification system. @*Methods@#In this exploratory study examining DTx interaction types and representative cases, we conducted a literature review and selected seven interaction types that were utilized in a large number of cases. Then, we evaluated the specific characteristics of each DTx mechanism by reviewing the relevant literature, analyzing their indications and treatment components. A representative case for each mechanism was provided. @*Results@#Cognitive behavioral therapy, distraction therapy, graded exposure therapy, reminiscence therapy, art therapy, therapeutic exercise, and gamification are the seven categories of DTx interaction types. Illustrative examples of each variety are provided. @*Conclusions@#Efforts from both the government and private sector are crucial for success, as standardization can decrease both the expense and the time required for government-led DTx development. The private sector should partner with medical facilities to stimulate potential demand, carry out clinical research, and produce scholarly evidence.

User Experience of Augmented Reality Glasses-based Tele-Exercise in Elderly Women / 대한의료정보학회지

Objectives@#The purpose of this study was to identify any difference in user experience between tablet- and augmented reality (AR) glasses-based tele-exercise programs in elderly women. @*Methods@#Participants in the AR group (n = 14) connected Nreal glasses with smartphones to display a pre-recorded exercise program, while each member of the tablet group (n = 13) participated in the same exercise program using an all-in-one personal computer. The program included sitting or standing on a chair, bare-handed calisthenics, and muscle strengthening using an elastic band. The exercise movements were presented first for the upper and then the lower extremities, and the total exercise time was 40 minutes (5 minutes of warm-up exercises, 30 minutes of main exercises, and 5 minutes of cool-down exercises). To evaluate the user experience, a questionnaire consisting of a 7-point Likert scale was used as a measurement tool. In addition, the Wilcoxon rank-sum test was used to assess differences between the two groups. @*Results@#Of the six user experience scales, attractiveness (p = 0.114), stimulation (p = 0.534), and novelty (p = 0.916) did not differ significantly between the groups. However, efficiency (p = 0.006), perspicuity (p = 0.008), and dependability (p = 0.049) did vary significantly between groups. @*Conclusions@#When developing an AR glasses-based exercise program for the elderly, the efficiency, clarity, and stability of the program must be considered to meet the participants’ needs.

Augmented Reality to Localize Individual Organ in Surgical Procedure / 대한의료정보학회지

OBJECTIVES: Augmented reality (AR) technology has become rapidly available and is suitable for various medical applications since it can provide effective visualization of intricate anatomical structures inside the human body. This paper describes the procedure to develop an AR app with Unity3D and Vuforia software development kit and publish it to a smartphone for the localization of critical tissues or organs that cannot be seen easily by the naked eye during surgery. METHODS: In this study, Vuforia version 6.5 integrated with the Unity Editor was installed on a desktop computer and configured to develop the Android AR app for the visualization of internal organs. Three-dimensional segmented human organs were extracted from a computerized tomography file using Seg3D software, and overlaid on a target body surface through the developed app with an artificial marker. RESULTS: To aid beginners in using the AR technology for medical applications, a 3D model of the thyroid and surrounding structures was created from a thyroid cancer patient's DICOM file, and was visualized on the neck of a medical training mannequin through the developed AR app. The individual organs, including the thyroid, trachea, carotid artery, jugular vein, and esophagus were localized by the surgeon's Android smartphone. CONCLUSIONS: Vuforia software can help even researchers, students, or surgeons who do not possess computer vision expertise to easily develop an AR app in a user-friendly manner and use it to visualize and localize critical internal organs without incision. It could allow AR technology to be extensively utilized for various medical applications.

Customer Discovery as the First Essential Step for Successful Health Information Technology System Development / 대한의료정보학회지

OBJECTIVES: Customer discovery (CD) is a method to determine if there are actual customers for a product/service and what they would want before actually developing the product/service. This concept, however, is rather new to health information technology (IT) systems. Therefore, the aim of this paper was to demonstrate how to use the CD method in developing a comprehensive health IT service for patients with knee/leg pain. METHODS: We participated in a 6-week I-Corps program to perform CD, in which we interviewed 55 people in person, by phone, or by video conference within 6 weeks: 4 weeks in the United States and 2 weeks in Korea. The interviewees included orthopedic doctors, physical therapists, physical trainers, physicians, researchers, pharmacists, vendors, and patients. By analyzing the interview data, the aim was to revise our business model accordingly. RESULTS: Using the CD approach enabled us to understand the customer segments and identify value propositions. We concluded that a facilitating tele-rehabilitation system is needed the most and that the most suitable customer segment is early stage arthritis patients. We identified a new design concept for the customer segment. Furthermore, CD is required to identify value propositions in detail. CONCLUSIONS: CD is crucial to determine a more desirable direction in developing health IT systems, and it can be a powerful tool to increase the potential for successful commercialization in the health IT field.