Digital PhysioOT: a home digital physio and occupational therapy technology for reversing frailty and keeping people moving

Movement is at the core of maintaining independence reversing frailty and keeping healthy and well as we age. This project proposes the development of digitally-augmented occupational and physiotherapy practices that uses digital technology to tailor movement interventions for people living with frailty in their home environment. Half of people over 65 are frail, and it is predicted that the UK's population of older adults will double by 2041 therefore the number of people with frailty will rise considerably over the coming years. Frailty is the presence of weakness, slow walking speed, fatigue, rapid weight loss, and a very reduced level of activity. Frailtyaffects a person's ability to move and transition between postures keep moving and recover from everyday chores and activities. Frailty increases risks of illness, poor quality of life, falls, hospitalisation, dependency, disability, and death. A simple cold can reduce activity sufficiently to critically stop a person's ability to be independent. Health Care Rehabilitation Professionals delivering movement exercises can reverse frailty in about 40% of people for as long as 12 months saving 4 -4.5 billion a year in NHS spending. Physiotherapy can assess and prescribe personalised targeted exercises, and Occupational Therapy (OT) assesses and support an individual to be safe and independent in their home. But insufficient numbers and skills of Health Care Professionals have been highlighted as a critical global concern by the World Health Organisation

In this project will use available everyday devices to develop a novel technology to work with rehabilitation services that aims to help older people who are frail, with poor mobility, and at risk of falling or just avoiding movement because of being scared to move more and do exercises. This will likely include the ability for a relative/carer to go to the person's home whilst they are still in hospital and using a mobile phone app to walk around the home so that the phone creates a map of the person's home. The map will enable the physical therapists working with the older person to see where in the home they may need help or be most at risk of falling etc. It will take into account the person's size, way of moving (their gait), and preferences (e.g. likes to spend a lot of time in the kitchen) and will look at what solutions might be needed to keep them mobile in the home. The solutions might be quite a basic tech (e.g. walking frame) or something more innovative, but essentially we want to draw on free resources that are already developed and equip the person with keeping mobile. It may be that the app highlights that bits of the house need to be re-designed (e.g. bed now comes downstairs as stairs are not manageable; need to open up more space by the fridge as it's too tight and so increases the risk of falls). This all means that when the person goes home they have help with all these things right away, rather than waiting for different services to come (who takes ages/sometimes don't come at all). In addition, there will be technology to keep people moving when they are at home, e.g. a prescribed physiotherapy daily exercise program that adapts to how the individual is feeling and very simple reminder technologies to help people to remember to lift their feet every so often to strengthen their legs if seated for a long time or when they are standing by the sink. We will use affordable in-use technology and with novel engineering fuse the information together working with older frail people to design this technology so that it actually meets their needs and preferences. This will involve doing interviews with people and seeing them in their own homes etc to make sure that we fully understand their situation, needs, and preferences. We will co-create the digital technology system and check it is accurate and usable to help people with frailty to move more and participate in a personalised effective movement program.