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Interactive Vision-Based 3D Augmented Reality System for In-Home Rehabilitation in Older Adults Following Total Joint
Adriana C Salvia1, Siona Phadke1, Manuela Kunz2
1School of Rehabilitation Therapy, Queen's University, Louise D Acton Building, 31 George Street, Kingston, ON, K7L 3N6, Canada, 1 6135336000 ext 77893.
Background:
Completing home exercise programs remains a significant challenge for older adults after total joint replacement (TJR), often resulting in suboptimal rehabilitation outcomes. Augmented reality (AR) technologies offer a promising approach to addressing limitations associated with traditional paper-based home exercise programs.
Objective:
This study aimed to identify priorities for design features and practical or logistical considerations to inform the future design of a 3D AR system (3D ARS) to support home-based rehabilitation for older adults following TJR.
Methods:
A cross-sectional online survey was administered via Qualtrics. The survey included items across four domains: sociodemographic and clinical characteristics, proposed design features, practical considerations, and logistical details, and potential barriers to access and use of the 3D ARS. Descriptive statistics (frequencies and percentages) were computed, and the Mann-Whitney U test was used to examine differences in feature preferences between older adults and service providers.
Results:
A total of 145 participants (56 older adults with TJR and 89 service providers) completed the survey (response rate 88.4%). Older adults and service providers shared similar priorities for several design features of the 3D ARS, including embedding individualized exercise programs, providing customized feedback on exercise progress, and including background music during exercise (all P>.05). However, significant differences emerged for other features. Older adults ranked the ability to receive positive, encouraging messages during exercises (U=1525, P<.001), voice activation prompts (U=1145, P<.001), and the ability to pause and resume exercises at any time (U=1843.50, P=.01) as higher priorities than service providers. Most older adults preferred real-time visual prompts to guide joint range of motion during exercise (42/56, 75%), whereas most service providers preferred chart-based progress reports (63/89, 71%). Participants further recommended accessing the system through physiotherapy clinics, initiating use within the first month following surgery, and maintaining access for 6-12 months.
Conclusions:
Findings identify key user-informed priorities for the design of AR-based rehabilitation technologies for older adults following TJR, including personalized exercise programming, accessible system interfaces, and timely feedback mechanisms. Incorporating these priorities into future system development may support scalable models of home-based rehabilitation that complement conventional physiotherapy care.
