COCARE

An international project funded by AAL (Active Assistive Living Programme) with a total of 4 project partners is dedicated to the topic of exergame-based telerhabilitation in old age. As one of the partners, the group "Motor Control & Learning" of the Institute of Human Movement and Sport at ETH Zurich is the mainly responsible for guiding the project's resesarch process.

As commonly known, a steep growth of the number of people aged 60 years and over is expected until the end of the 21st century. Consequently, there is an increased need for long-term care which challenges the health-care system financially due to a lack of resources (time and personnel). Therefore, conventional rehabilitation is not able to provide interventions delivered long enough to ensure full recovery.

Advances in information and communication technologies (ICTs) present new, cost-effective solutions to the increased demands on health services as they enable - among others - telerehabilitation, thus the provision of rehabilitation services ove distance. It comprises home-based training as well as a digital centralized remote management. Currently, the topic telerehabilitation is of particular relevance due to the COVID-19 pandemic.

The COCARE-system developed by Dividat (Schindellegi, Switzerland) is an advanced example for a comprehensive ICT-based telerehabilitation tool. It comprises the following components (s. figure below):

(1) Technological devices for motor-cognitive training in clinics (Dividat Senso, a stepping platform with force sensors) and at home (Dividat SensoFlex, a foldable senso-based mat).
(2) An assessment system measuring physical and cognitive functions and providing training recommendations based on these measurements.
(3) A web-based management system (rehabilitation-cockpit) to support the entire rehabilitation process.

Training on Dividat Senso and SensoFlex is performed with the help of so-called exergames. Exergames are interactive digital games which combine physical and cognitive exercises with video games - a combination which has proven to be particularly effective. The exergames show a whole range of positive effects starting from improved physical functions such as balance, gait and mobility, to improved emotional well-being and an enhanced quality of life in older people. Besides, increased motivation through the game elements plays a major role as well.   

Thus, the COCARE-system allows to continuously accompany older adults during the entire rehabilitation process - starting in (rehabilitation)clinics followed by a remotely monitored training at home.

However, parts of the COCARE-system only exist as prototypes and final versions are yet to be developed and validated. This is why the COCARE-project was launched. The project is an international Research&Development project involving partners from 3 trial sites: ETH Zürich (Switzerland), Materia AgeCare (Cyprus), and Fondazione DonGnocchi (Italy). Its overarching aim is the development and validation of the COCARE-system and the demonstration of its effectiveness. Thereby, a so-called "User-Centered Design" (UCD) is applied shaping the entire project. Typically, projects based on a UCD-approach involve end-users, respectively future main users of a system (here seniors and healthcare professionals), in the whole developmental process in order to integrate their wishes and needs. This ensures their acceptance and the system's usability, feasibility,  functionality, and effectiveness.

Following this User-Centered-Design, three studies were planned and were, respectively will be conducted at each of the three trial site: 

1. So-called "focus groups" - discussion rounds in which seniors and healthcare professionals could express all their wishes, opinions, needs and concerns regarding the system. These groups have already been conducted in summer 2021 and delivered valuable information for further adaptations of the COCARE-system.
   
2. The second study was a usability study testing usability, acceptability and enjoyment of the COCARE-system. Therefore, the whole system was presented to and practically tested older adults as well as healthcare-professionals.
   
3. Currently, the COCARE system is further validated in a larger study, namely a randomized controlled trial (RCT) investigating the system's feasibility and effectiveness. For this purpose, participants older than 60 years are using the system for an independent 10-week, home-based training program, whereby health-care professionals will remotley control and manage the intervention. We are still searching older adults who are interested in participating in this study. For more information, please contact Julia Seinsche () 

For further information about the COCARE project, please have a look at the COCARE external page homepage