Augmented Reality Rehabilitation for People with Osteoporosis: Squat exergame (a demo)

In Ireland, osteoporosis is one of the greatest societal and economic health challenges, affecting between 300,000 and 500,000 people [CJ23]. A 2019 European report noted that Ireland has one of the highest rates of fracture in Europe, while the costs associated with managing fractures was 7.2% of national healthcare [JA21, JA22]. Physical exercises are considered to be a powerful non-pharmacological strategy for people with osteoporosis and or those who are at risk of falling [Dio14]. Notwithstanding the positive impact of physical exercise, the participation in and adherence to an exercise regimen by older adults is often low due to inconvenience (i.e., lack of time, lack of motivation, accessibility issues), fear (i.e., falling, safety), cost and or boredom [OYWALSRDKV18]. Exergames are defined as games requiring the participant to be physically active; they can be delivered through augmented reality (AR) virtual reality (VR) [Oh10]. Despite the potential of AR task-oriented physical therapy training and exergames for people with osteoporosis, there is a notable paucity of research in this area [GNG20]. As part of our research, five physical therapy exercises targeting older adults with osteoporosis have been approved by a chartered physiotherapist, an occupational therapist and two Rheumatologist consultants at Galway University Hospital. We are currently in the process of mapping these physical therapy exercises into a set of five AR exergames. The design of these AR exergames is underpinned by a systematic literature review (in the final stages of publication) and existing guidelines. A formal investigation of the impact of AR exergames in improving balance and reducing the likelihood of falls for people with osteoporosis will take place next year, with control and intervention groups. Our demonstration is a first version of one of these AR exergames which reproduces a squat exercise. During this exergame, the player wears an AR headset (Microsoft Hololens 2). When they start the exergame, a menu of different levels is displayed. The player selects the level appropriate to their abilities, after which a series of clouds appear and move toward them. The goal is for the player to avoid the clouds using a squat movement. As they perform the exercise in a gamified context, the relevant biomechanical points will be checked to ensure correct alignment and the delivery of appropriate feedback. To check the status of the biomechanical points, this exergame uses a body tracking camera (Azure Kinect 2) to provide direct and real-time feedback. Ultimately, this squat exercise AR exergame will be incorporated into a series of exergames, which will adapt to the capabilities and preferences of the player with osteoporosis.