A haptic home-based exercise system
for elderly people: evaluating acceptance
and performance
SUBMITTED IN PARTIAL FULLFILLMENT FOR THE DEGREE OF MASTER
OF SCIENCE
ANTOINE HOGENBOOM
10666141
M
ASTER
I
NFORMATION
S
TUDIES
H
UMAN-
C
ENTERED
M
ULTIMEDIA
F
ACULTY OF
S
CIENCE
U
NIVERSITY OF
A
MSTERDAM
July 6, 2015
1
stSupervisor
2
ndSupervisor
Prof. dr. ir. Ben Kröse
Saskia Robben Msc.
Universiteit van Amsterdam
Hogeschool van Amsterdam
A haptic home-based exercise system for elderly people:
evaluating acceptance and performance
Antoine Hogenboom
Msc student Information Sciences
Science Park 904
University of Amsterdam
10666141@student.uva.nl
ABSTRACT
A minimum of thirty minutes of physical activity a day is good for maintaining muscle strength and staying fit, especially for people over 60 years of age. However, this minimum amount of thirty minutes is not reached by everyone. To make it easier to reach, researchers of the University of Applied Sciences Amsterdam have proposed a digital home-based exercise system. In this research we propose the addition of vibration stimuli in the form of a vibrating wristband to this exercise system. The aim of our research was to find out the attitudes of elderly towards haptic feedback and whether elderly will accept it. Also we have investigated the understanding of vibration stimuli. Lastly we investigated whether being pressured in performing the exercises influenced the acceptance of the home-based training system. Results show that being forced to follow the tempo of the system negatively influences the recognition of the stimuli. Other outcomes are that, although not all participants indicated that they needed the system right now, elderly are generally positive about the haptic home-based exercise system.
General Terms
Design, Experimentation, Human Factors
Keywords
Haptic feedback, physical activity, elderly, UTAUT, user acceptance, vibration stimuli
1. INTRODUCTION
For people over 60 years of age it is very important to keep moving. Daily movement ensures that elderly stay fit longer, maintain their muscle strength and can function independently for a longer time [26]. Due to an increase in sedentary lifestyles, chronic diseases such as obesity and diabetes increase, especially in people on a higher age [11]. It is therefore important to minimize or prevent an inactive lifestyle among the elderly.
1.1 Exercise program for elderly
Meer Bewegen voor Ouderen (MBvO - More physical activity for elderly people) is a Dutch organization that organizes group lessons for elderly people where they can do exercises together. These group lessons are organized all over the country of the Netherlands and are accessible for everyone who wants to join. MBvO focuses on the physical, mental and social functioning of the elderly. However, the frequency of one time per week is not sufficient to affect fitness, (perceived) health and daily functioning [10]. A minimum of thirty minutes of physical activity is recommended. To reach the thirty minute goal, it is important to move more often than the MBVO lessons once a week.
1.2 Functional Training
TNO has developed Functionele Training Ouderen (FTO - Functional training for elderly people). It is an evidence-based exercise intervention developed for older people with functional limitations. The program is aimed at maintaining or obtaining an active lifestyle and improve overall daily functioning. FTO trains activities that older people find meaningful and functional [27]. The FTO program is divided in five categories, each focused on improving muscle strength, flexibility, balance and coördination and stamina. There is a total of 17 exercises [7]. All those exercises are related to activities of daily living, which means no special equipment is required to perform the exercises. The exercises can be done within the home situation.
1.3 Digital home-based exercise system
To make it easier for elderly to achieve the minimum amount of thirty minutes of movement a day, a digital home training program, based on the FTO exercises, will be developed within the project VITAMINE at the University of Applied Sciences Amsterdam. Home-based training systems are not new. There are various digital devices that support older people to stay in motion in a home situation, making use of, for example, a mobile phone [17, 5].
1.4 Stimulate through vibration
Most existing applications use audio and video technologies to stimulate physical activity among elderly people. Literature study shows that the processing of audiovisual feedback in some situations can be problematic [21], especially when attention is focused on several things [18]. The use of the haptic modality is proven to be a good alternative for auditive and visual information [23]. In modern sport watches and fitness trackers vibration stimuli are already used to motivate and stimulate physical activity among athletes [8]. Therefore, we believe that haptic feedback can be a valuable addition to a digital home-based exercise system for elderly people.
1.5 Guide versus push
In sports, the goal for the athlete is to perform better and improve himself [8]. In the case of elderly people, the purpose is to move more often and reach the thirty minute goal. This means that the role of the coach -regardless of whether this coach is digital or a real living person- is different, depending on the situation. In the case of the athlete, a coach pushes his pupil to improve, whereas in the case of an older person the coach would act more as a guide. The degree to which someone wish to be pushed is different for each person [8]. In this research we want to find out whether being pushed influences acceptance of the system and the understanding of the vibration stimuli.
1.6 Goal of this research
We believe that adding vibration stimuli to a home-based exercise system can stimulate elderly to exercise more often and to perform better. In order for such a system to work it is necessary that elderly understand vibration stimuli and see the added value. Will elderly accept the system and will they be willing to use it? Do they understand the vibration stimuli? And does the type of guidance influence how well they understand them? In this research we will try to find an answer to those questions using semi-structured interviews and experimental research.
2. RELATED WORK
In this paragraph we will look at related work in the field of digital interventions for increasing physical activity of the elderly and in the field of haptic devices that encourage people to move more (often).
2.1 Digital interventions for increasing physical
activity
Digital interventions that aim to stimulate elderly to move more already exist for a long time. For example, a home-based videotaped strength training program, specifically aimed at non-disabled older people was done in 1996 [16]. Also, telecommunication and tv training was used before the year of 2000 [12, 15].
More recently, accelerometers have been used to monitor the physical activity and stimulate movement. Although most research does not have a specified age in the target group, some research projects are specifically focused on elderly people [6]. An example is Flowie, an application that uses a pedometer with a built-in accelerometer and a screen displaying a flower that alters its emotions to the performance of its wearer [2]. Also more playful persuasion concepts are used to motivate elderly. Like The
Activator, an interactive leaflet that reminds elderly in retirement
homes of upcoming events to stimulate them to be more active. [25].
Fig 1. A pedometer used to track activity of elderly [2].
In a literature study to technologies that enable tele-rehabilitation, Rogante et al found out that most applications use audio and video technologies [24], which is not in all cases the best solution, since processing audiovisual signals can be difficult [21]. Research shows that the haptic modality is a good alternative for visual and auditive information [23]. Therefore, in the next section we will discuss several devices that use haptic feedback to stimulate movement.
2.2 Haptic devices that encourage people to move
In commercial sports products there are many examples of devices that use vibration to stimulate athletes to exercise more. Examples are fitness trackers like Fitbit, Jawbone and Withings [8].Figure 2 shows an overview of these devices.These activity trackers track the amount of movement of it’s wearer and stimulates to move more and perform better by giving short vibration stimuli. For example, the Jawbone Up wristband vibrates after a long sedentary period or a long period of inactivity. In scientific literature also many examples exists of the use of vibration for stimulating physical exercise. For example in mobile phones [13]. In modern sport watches and fitness trackers vibration feedback is already used to stimulate athletes to move more or to run or cycle faster. We suppose that a haptic device can also encourage / motivate elderly people to move more often.2.3 Acceptance of vibration stimuli
Not much research is done in the field of measuring acceptance of vibration stimuli. Prior et al mention that the acceptance of a Myoelectric hand, a hand prosthesis, is related to its price [22]. In a study to haptic feedback in a remote pointing device, Krol et al found that none of the respondents preferred a pointing device with haptic feedback over a device with visual or aural feedback [19].
2.4 Understanding of vibration stimuli
Vibration stimuli are proven to be an effective way of communicating. The best example is the vibration motor in mobile phones. The mobile phone shortly vibrates to make its owner aware of an incoming call or message. This is a very basic interaction with a small amount of information that is transmitted. Brewster and Brown discovered that using tactile icons richer information can be transmitted via touch [3]. By manipulating frequency, amplitude, waveform, duration and rhythm richer messages can be transmitted. Mostly, the meaning of these messages should be learned [4]. However, Lylykangas et al. argue that haptic feedback also can be intuitive [20]. In their research interpretations of vibration stimuli were compared between two participant groups. Both groups had to evaluate tactile stimulations. Ascending, constant and descending vibration stimuli represented three instructions: increase speed, keep speed constant and decrease speed. One group was taught the meaning of the stimuli, whereas the other group was not. The stimuli were evaluated nearly equally, which means that intuitive easy-to-understand feedback can be delivered by vibration stimuli.
2.5 Literature Conclusion
The conclusions that can be drawn from the literature study are that many examples exist of digital interventions to stimulate movement. Most applications use the visual and auditive modality to stimulate movement. However, the haptic modality is proven to be a very effective way of communicating and stimulating physical exercise. Not much research has been done to the acceptance of vibration stimuli.
3. RESEARCH QUESTION
As showed in the previous section, lots of examples exist of devices and applications that help (elderly) people live more active and healthier. Some of them use haptic feedback to make users aware of achieved goals, or lack of activity. Haptic feedback in the form of vibration stimuli is proven to be an effective way to stimulate or improve an active lifestyle, as well as an effective way of communicating. We see haptic feedback as a powerful and useful addition to the digital home-based exercise system that was proposed within the VITAMINE project. We believe that a vibrating wristband can guide and stimulate elderly people to perform the FTO exercises better and as such act as a digital coach. This digital coach is able to guide elderly when performing exercises. This guidance may take various forms. Like in real life a coach can be relaxed and serene, but it can also be aggressive and pressing.
The questions we wanted to answer in this research were whether this haptic addition is seen as valuable by its potential users. Will elderly be willing to use a haptic home-based training system? Moreover, we were interested in whether elderly will understand vibration stimuli in a training setting. Lastly, we were interested in whether being pressured by the digital coach influences the acceptance of the system and understanding of vibration stimuli.
Therefore three research questions were defined:
1. What is the acceptance of a haptic home-based exercise system among elderly?
2. Are vibration stimuli understood by the elderly during the execution of the exercises?
3. Does the type of guidance influence the understanding of vibration stimuli and acceptance of the system?
In the following section we will discuss how each research question was approached.
4. METHODOLOGY
The research aimed at obtaining qualitative data using semi-structures interviews and experimental research. This section provides an overview on how each question was dealt with.
4.1 User acceptance
The first research question was1. What is the acceptance of a haptic home-based exercise system among elderly?
To answer this question we have conducted semi-structured interviews with elderly people above 65 who participate in the MBVO lessons. To make them feel at ease and comfortable, the interviews and experiments were conducted with two or three participants at one time. To measure acceptance we have used the UTAUT model.
4.1.1 Unified Theory of Acceptance and Use of
Technology (UTAUT)
To measure the acceptance we have used the Unified Theory of Acceptance and Use of Technology (UTAUT) model that was presented by Venkatesh et al [28]. Using UTAUT one can explain user intentions to use an information system. It is based on the constructs of eight earlier developed models that explain usage intention [28]. UTAUT consists of eight constructs. Three key constructs in the model are direct determinants of behavior intention. These are performance expectancy, effort expectancy and social influence. The facilitating conditions construct is a direct determinant of use behavior.
Fig 3. The UTAUT model and it’s constructs [14].
4.1.2 Constructs of UTAUT
For each construct of the UTAUT model, we will clarify its meaning in the following paragraph [9].
Performance expectancy is defined as the degree to which an
individual believes that using the system will help him or her to attain gains in job performance
Effort expectancy is the degree of ease associated with the use of
the system.
Social Influence is the degree to which an individual perceives
that important others believe he or she should use the new system.
Facilitating conditions is defined as the degree to which an
individual believes that an organizational and technical infrastructure exists to support use of the system.
Behavioral intention is the degree to which a person has
formulated conscious plans to perform or not perform some specified future behavior.
4.1.3 Use of UTAUT in a qualitative setting
UTAUT is an acceptance model used in a quantitative setting, usually using questionnaires. In this research we have been conducting semi-structured interviews. In this paragraph we
explain how we have converted the UTAUT model to a qualitative setting.
Based on the original UTAUT questionnaire that was presented by Venkatesh, we created interview questions. Each question was labeled with a UTAUT construct. After having transcribed the interviews, we then filtered and parsed all answers based on the construct label. For each construct of UTAUT we have listed the corresponding answers. We then have merged equivalent answers. Based on these answers statements were made on factors influencing the intention to use the exercise system.
4.2 Understanding of vibration stimuli
The second research question was:2. Are vibration stimuli understood by the elderly during the execution of the exercises?
An experiment was done with 12 people aged above 65 who also participated in the interviews. The participants were asked to perform one FTO-exercise while wearing a vibrating wristband. Specifically designed vibration patterns that corresponded to commands that can be expected while performing the exercise (like ‘Get out of the chair and have a seat again) were presented. It was the participant’s task to act according to the given command. The goal was to find out whether the vibration stimuli were understood and whether the stimuli were perceived as pleasant or annoying.
The participants were observed by the researcher while performing. The researcher carefully watched the participant and judged whether the command was executed well. All observations were written down. After the experiment a short semi-structured interview was conducted about the experiences of the respondents and their opinions on the vibration stimuli.
4.2.1 FTO exercise used in experiment
The exercise that was performed by the participants during the experiment was ‘Getting out of a chair’. It was chosen because for elderly it is relatively easy to perform. It does not require knowledge of the researcher of kinesiology and therefore the experiment could be performed without supervision of a sports scientist. Secondly, the instructions given during the regular exercises were easy to ‘translate’ to vibration stimuli. The exercise 'get out of a chair' belongs to the FTO category 'switching between a lying, sitting and standing position' and its goal is to improve and maintain muscle strength of the lower body and improving balance and coördination [7].
The exercise has different levels, based on the experience of the performer. Exercises can be made more difficult by either increasing the number of repetitions, increasing the intensity in which the exercise is performed, and by adding a second task or attribute to the exercise. An example would be wearing a tray when getting out of a chair.
4.3 Influence of type of guidance
The third research question was:3. Does the type of guidance influence the understanding and acceptance of the system?
To find out the elderly’s preferences for the type of guidance, the group of participants in the experiment -the same experiment as we mentioned in the previous paragraph- was divided in two groups: one group that was ‘forced’ by the vibrating wristband and one group that was not. Forcing means that the wristband did not take into account the speed in which elderly perform the exercise.
In the ‘not-forced group’, the participants received a command to perform an action. The system then waited until this action was performed before the next command was given. In the ‘forced group’, however, the system did not wait for the participant to finish the action. In this case, a next command was given while the participant was still executing the previous command. In other words, in the forced group, participants could not influence the tempo in which the exercise was performed.
After the experiment, in a semi-structured interview we asked both groups their opinion about having used the wristband.
5. EXPERIMENT
In this section we will further describe the goal of the experiment, what materials we have used and how the set-up was.
5.1 Goal
The goal of the experiment was to get insight into the acceptance of elderly people towards a haptic home-based exercise system and how they experience and handle vibration stimuli.
5.2 Participants
All participants were at least 65 years old. The youngest one was 69 the, whereas the oldest one was 87. All interviewees participated in the MBVO (Meer Bewegen Voor Ouderen) program once a week. More demographic information about the participants can be found in Table 1.
Table 1. Demographics of the participants (n = 12) Age (years) Mean 79 SD 6.39 Range 69 to 87 Gender Male 0 Female 12 Location Paganinihof 2 De Marckeburgh 7 De Serreburgh 3 Physical complications None 7 Yes 5
5.3 Experiment set-up
The study was divided into seven parts.
- Introduction to the research, explanation of FTO exercises and
the haptic home-based exercise system
- Showing a video that demonstrates the system
- Semi-structured interview focused at finding out the acceptance
using UTAUT
- Explanation of functionality of the vibrating wristband - Getting acquainted with the vibration stimuli
- Experiment aimed at finding out the understanding of the
vibration stimuli
- Short interview about the experiences of the experiment
5.3.1 Description of experiment parts
In the following section we will describe each part separately.
5.3.1.1 Introduction to the research
First, the participants were told the procedure of the next hour. We gave an explanation of the research project, the FTO exercises and the VITAMINE project.
5.3.1.2 Showing video
Then we showed them a video that explained the haptic home-based exercise system. The video shows an actor that demonstrates the functionality and possibilities of the system. An example FTO-exercise was performed in the video.
5.3.1.3 Semi-structured interview about acceptance
After the researcher had ensured that the participants did not have any questions, the interview started. In the interview we first asked about the demographics of the participants and their motivation for participating in the MBVO lessons. We asked about their home situation and their affinity with computer, laptops and mobile technology. Then we asked their opinion and view on what they had seen in the video. What was their opinion about the value of the system? And how much did they think it took to use it?
5.3.1.4 Explanation of the experiment
After the interview, the second part of the study started. We presented the vibrating wristband, explained the functionalities and the way it was controlled. Also we explained the procedure of the experiment.
5.3.1.5 Getting to know the stimuli
One participant was put on the wristband and the researcher presented the four stimuli. The other respondent did not have to do a thing at this time. The researcher sat next to the active participant at a table. After having confirmed that he or she understood what was expected, the exercise started.
5.3.1.6 Experiment
The participant was asked to perform the FTO exercise ‘get out of a chair’. In random order, the researcher presented stimuli to the participant. After a certain command was given, the participant had to act accordingly (“do what you think the device is asking you to”). In the not-forced group, the researcher waited until the participant had executed the task before the next stimulus was presented. In the forced group however, stimuli were also given while the participants were still executing the previous task. The researcher wrote down his observations.
5.3.1.7 Semi-structured interview about stimuli experiences
After both participants had done the experiments, another short interview followed. The participants were asked their opinion about what they had experienced and how they had perceived the stimuli. Also they were asked whether their opinion about the system they saw earlier in the video changed after having experienced it in real life.
Fig 4: picture showing two participants of the research, of which one is wearing the haptic wristband.
5.4 Material
In our experiments, we used a custom made vibrating device. The device contains a regular vibration coin, a bluetooth low-energy module and a micro controller. This vibrating device was controlled by a Google Nexus 5 smartphone, running on Android 4.4. The software for the communication between the smartphone and the device was custom made as well. The researcher could control the output of the vibrating device on the smartphone. It was connected via bluetooth.
Fig 5: picture showing the Nexus 5 smartphone and the vibrating device
5.5 Vibration stimuli
In the experiment four vibration stimuli were presented to the participants. These stimuli corresponded to commands that would be given by a real-life coach when performing the exercise.
The commands and corresponding stimuli were:
- “Get out of the chair and have a seat again” (stimulus of 1000ms, constant intensity)
- “Increase the speed at which you get out of the chair” (stimulus of 300ms, repeated three times, constant intensity)
- “Decrease the speed at which you get out of the chair” (stimulus of 2000ms, decreasing intensity)
- “Stop, the exercise is finished” (stimulus of 4000ms, constant intensity)
The duration and intensity of each stimulus that was used in the experiment is visualized in figure 6.
Fig 6. Figure showing the stimuli’s duration and intensity
6. RESULTS
In this paragraph we will discuss the results. This section is divided into two parts. The first part will discuss the results of the interview about the acceptance of the haptic home-based exercise system. The second part will discuss the results of the experiment with vibration stimuli.
6.1 Interview results
All interviews took place in the city of Spijkenisse in the Netherlands. The interviews were held in retirement homes on three different locations within the city of Spijkenisse, namely: Paganinihof, De Marckeburgh and Serreburgh. The interviews lasted around 60 - 75 minutes. All twelve interviews were transcribed and coded.
6.1.1 Analysis of UTAUT constructs
For each factor of the UTAUT model we will discuss the outcomes of the interviews.
Performance expectancy
The reactions to the home-based training system were mixed. Almost all participants (11 out of 12) saw the added value of the system. They were positive about the possibility to be guided at home (4 out of 12) and to be corrected when not performing the exercise as supposed (6 out of 12). They saw the vibrating wristband as stimulating and as something that forced them in a positive way to workout regularly. They valued the system for being something that serves as a threat, but not in a negative way (3 out of 12). However, 50% of the participant said that they already do enough physical activity and therefore don’t need such a system.
Effort expectancy
Ten out of twelve participants indicated that they found the system easy to use after seeing the video. Three people’s opinion changed after having used the haptic wristband in the second part of the experiment. They found the vibration stimuli hard to understand, and therefore their overall opinion to the ease of use of the system became less positive.
Facilitating conditions
Three out of twelve participants had a physical complication. For them, recovering from their injury or keeping it under control was the most important reason for participating in the MBVO lessons. 60% of the people that have a physical complication intent to use the system.
11 out of 12 participants did have a mobile phone. 25% had a tablet and 58% had a computer. 50% of the people said that they enjoy using technology. 50% of the people who enjoy using technology intented to use the system. The other half was not indifferent, but in their opinion they did not need it for know. However, when their situation would change -they get injured for example- they intented to use the system as well.
Social Influence
11 out of 12 participants have indicated that their family or relative would be (very) positive when they would use the haptic home-based exercise system. One person indicated their family would not care. However, for only a few of them (5 out of 12) the opinion of family, friends and relatives will influence their decision to use the system or not.
Age
The age range was between 69 and 87. We have not found a relation between the age and the intention to use the system.
Gender
We can not say something about differences between men and women, because the group of participants consisted of females only. Therefore we cannot distinguish results for men an women.
Behavioral Intention
9 out of 12 people intented to use the system, as long as specific conditions were met. 25% of the participants wanted to use the system right away. They literally asked whether they could buy the wristband in store right now. The other six people wanted to use the system at the moment they thought they needed it. For now they had enough physical activity a day. In case that the amount of activity would decrease as a result of for example an injury or impaired mobility, they would intent to use the system. Research of Croteau and Vieru show that the perceived usefulness of an application is positively related to the intention to use the application [1]. In table 2 we present the perceived usefulness of the participants and the percentage of people that intent to use the system. The results show that 66% of people who find the system useful intent to use the system. The majority of people (87%) who think it is useful, although not for themselves, intent to use the system. Finally, all participants who found the system useless did not intent to use the system.
Table 2. The perceived usefulness and intention to use Perceived usefulness Intention to use
Useful 66%
Useful, but not for me 87%
Not useful 0%
6.2 Experiment results
In the following section we will discuss the results of the vibration stimuli experiment.
6.2.1 Recognition of vibration stimuli
The second part of the research consisted of an experiment where various vibration stimuli were presented to the participants. After having received a stimulus, the participants had to act accordingly. The actions of the participants were observed by the researcher. When the executed behavior was equal to the expected behavior the stimulus was labeled as correctly recognized. If the participant showed different behavior than was expected the stimulus was labeled as not correctly recognized. In Table 3 we show the overall results of the experiment and those divided per group of participants.
Table 3. Percentage of correctly recognized stimuli (n) Stimulus Total (12) Force (6) No force (6)
Get out of the chair
and have a seat again 83% 66% 100% Increase speed 83% 83% 83% Decrease speed 16% 16% 16% Exercise is finished 58% 33% 83%
Total 60% 50% 70%
Based on the results in Table 3 one can conclude that the group of participants that was not forced performed better in recognizing the vibration stimuli.
6.2.2 Opinions about the stimuli
Nine out of twelve people could not clearly distinguish all stimuli. To the question whether they understood the stimuli, only five out of twelve people indicated that they did not understand them. Two out of the twelve participants have indicated to find the vibration stimuli annoying and / or unpleasant. These are the two people that are not willing to use the system (see table 4). The people who found the vibration stimuli annoying did not intent to use the system. Table 4 also indicates that 100% of the participants who did not find the stimuli annoying intented to use the system. However we do not believe that this is the (only) reason people intent to use it. We see the vibrations to be pleasant as a requirement for people to intent to use the system.
Table 4. Opinions about the feeling of the vibrations Feeling of the vibrations Intention to use
Annoying 0%
Pleasant / not annoying 100%
6.2.3 Guidance preference
Although the forced participants did not experience this pressure as such, results show that they performed less well in understanding the vibration stimuli (see Table 3). It has, however, no effect on the willingness to use the system. The two people who explicitly indicated not wanting to use the system belonged to the group that was forced. However, we do not have enough evidence to prove that this refusal was caused by being forced.
In Table 5 we show the differences in intention to use between the participants that were forced and those that were not. One-third of the forced group do intent to use the system right away, one-third do intent to use it but not now and one-third do not intent to use the system. In the group that was not forced the results are not evenly distributed. 17% of the participants that were not forced do intent to use the system right now. The majority (83%) of the not-forced group intent to use it in a later stadium and none of participants in the group that was not forced do not want to use the system.
Table 5. Intention to use the system, forced vs. not forced Intention to use Forced (n = 6) Not Forced (n = 6)
Yes 33% 17%
Yes, but not now 33% 83%
No 33% 0%
We asked the participants whether they felt being pushed during the experiment. Of the people that were indeed pushed, 50% indicated indeed that they felt pressure. One person who was not pushed, however, did feel as such. In total, 9 out of twelve people did not feel any pressure during the exercise. Someone stated “Yes of course you have to follow the orders of the wristband, but to me that feels like personal guidance. It helps me”. Some other reactions were “I realized that it wanted me to speed up, but I just ignored it. I want to do it in my own tempo”. In summary, we can say that most participants did not feel pressure or force. Being forced does not influence the intention to use the system.
7. DISCUSSION
In this paragraph we will discuss the results of the overall research.
7.1 Limitations of the study
Because all participants in the interviews and experiments were women, we can not say something about differences in intention to use between men and women. Also, because of the relative small amount of participants (n = 12) the conclusions are premature. Further research with a higher amount of participants should show whether the conclusions are valid.
Another thing that might have influenced the results is a lack of time for the participants in the experiment to learn the meaning of the vibration stimuli. Ten out of twelve participants have expressed the need for a longer period of getting used to the stimuli, after having done the experiment. In the experimentation setting, the stimuli were only presented once, or twice when the respondent explicitly requested so.
Finally, only one FTO exercise was included into the research. In this case, an exercise was chosen that fits well with the vibration stimuli. However, one can imagine an exercise with more
complicated commands. Commands that are harder to translate to vibration stimuli and therefore harder to understand. More complex commands might affect the understanding of the system and therefore negatively influence the effort expectancy of the system.
7.2 Future Work
Further research with a higher amount of participants should be done to find out more relationships between the separate UTAUT constructs. Participants should be able to learn the vibration stimuli before performing the exercise. And finally more FTO exercises should be taken into account in future research of the haptic home-based exercise system.
8. CONCLUSION
In this research we were interested in the acceptance and performance of elderly people towards a haptic home-based exercise system. We believed haptic feedback can be a valuable addition to the system. In general, almost all participants agree with us. They were positive about the haptic home-based exercise system. Although not all respondents wanted the system right now, ten out of twelve participants are willing to use the system when they -in their opinion- need to. Only two people have indicated not wanting to use the system, no matter what their situation is, or will be. The results of the understanding of given vibration stimuli were mixed. The majority of participants were able to correctly recognize two stimuli. They performed a lot worse in recognizing the other two. Most participants did not experience pressure in performing the exercise, although 50% of them were actually forced. Pressure does not appear to be recognized as such. To summarize, we believe that vibration feedback is a valuable addition to the home-based exercise system and will be greatly valued by its users.
9. ACKNOWLEDGMENTS
I would like to thank professor Ben Kröse for the supervision during my Masters thesis project. Iskander Smit of Info.nl and Tessa Dadema and Sumit Mehra of the University of Applied Sciences Amsterdam were very helpful as well with their advices. Also I would like to thank Joke van Poucke of SWO Spijkenisse. She has arranged meetings with all twelve MBVO participants. And lastly I would like to thank all people that have participated in the interviews and experiments.
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