Pharaon: Some preliminary conclusions from AdSysCo and Christiane Grünloh

Last year Christiane Grünloh was interviewed by Dirk Winkel, Manager of Marketing, Communication & Sales at AdSysCo to talk about the Pharaon project. Below is a repost of this interview (https://adsysco.nl/pharaon-enkele-voorlopige-conclusies/).

 

In early 2020, at the initiative of the European Commission, the Pharaon project started. Pharaon aimed to explore the extent to which digital technologies can support the lives of older people. In Pharaon, AdSysCo participates with the RegiCare customer portal. A higher quality of life with digital discoveries, that's what it's all about.

The Pharaon study will be completed at the end of 2024. So it's too early for final conclusions, but there are already some preliminary. This is evident from a conversation we had with Dr. Christiane Grünloh, senior researcher at RRD and responsible for the smooth running of the six Pharaon pilots. Christiane has long been researching the adoption of technology solutions in healthcare. 

In these six pilots in five countries, all sorts of different technologies are being tried ranging from sensors that monitor people's safety to various forms of video calling via TV. In some care organizations, robots are being tested. In the Netherlands, the emphasis is on social contact around the outings of the PlusBussen of the National Fund for the Elderly. The RegiCare customer portal supports these social activities with digital contact. 

Just after Pharaon started, the COVID-19 pandemic erupted. "This risk was not foreseen in any project plan," said Christiane, "Due to the new measures, our target group (older adults who may be vulnerable) was almost immediately inaccessible to researchers in all countries, at least physically, while the research requires a lot of interaction with the target group." Delay was not an option for the EU, after all, everyone had committed to the program. Besides, Pharaon is all about information and communication technology, so researchers and designers are also creative to explore other ways to interact with people.

The kick-off meeting was still held in-person in Pisa, but after that Pharaon played out behind (boring) computer screens for two years. Due to the pandemic, the recruitment of older adults for the study got off to a slow start. All in all, the Pharaon study has to make do with a limited number of participants, and this applies to all pilots. For quantitative research, this presents a challenge, so more effort has also been put into qualitative research such as interviews. "Of course it is not great to have fewer participants than promised in the research proposal. But there is also an opportunity to go more into depth. Why do people participate or not? What challenges do they run into in their daily lives when they have to start using technology. These insights are super important," Christiane says.

 

Development for and with users

People in healthcare and welfare also had a high workload during the pandemic and hardly any additional capacities available. In addition to the pandemic, doubts against the use of technologies also played a role in many places. "I don't know it", "it doesn't work", "I don't get it" and "what's in it for me?". In Pharaon, we came across all kinds of arguments to not use a solution, and they were all justified. 

Technology can improve care and also make it more efficient and cheaper, Christiane knows, but it has to be developed for and with the users to take their needs into account, and that's often the crux of the matter. "I don't know it", "it doesn't work", "I don't get it" and "what's in it for me?" is well known. Close end-user involvement in the design and step-by-step building and testing of a digital solution for care and well-being is necessary to reduce these problems. "If we develop technology together with the target group and thereby ensure that it really connects with users' needs and values, we can increase acceptance, stimulate use and ultimately have effect and impact," Christiane has learned from her many research projects.

 

Development of RegiCare

AdSysCo recognizes this well. New developments in the RegiCare suite, such as the mobile applications and the customer portal, are developed for and with users. This also applies to the implementation: active involvement and ownership of users is a key success factor. Simply making a nice solution with lots of functionality available without actively involving the end-user in the how, the what and the why misses the mark. "Not the technical solution but the user experience determines success" says Christiane. "It does take more time, but do you want a cheap solution that doesn't work or a slightly more expensive solution that does?" she says smiling.

Once the research is complete, there will be a follow-up conversation between AdSysCo and Christiane.

The start of TREAT: Transforming healthcare through semantic interoperability and patient self-efficacy

Written by: Erik Prinsen

We are excited to be a partner in the newly started ITEA-project called TREAT. The TREAT project aims to increase patient self-efficacy in managing non-communicable disorders including diabetes, cardiac events and osteoarthritis by integrating data from wearables, journals and medical records. Through that, we aim to move healthcare access from the clinic into the patient’s daily life. In addition we aim to improve the health management skills of the patient. The project will develop novel wearables and software-based solutions to improve patient self-efficacy while driving clinical efficiencies.

Within ITEA-projects national use cases exist that work together under a common framework. The Dutch use case will focus on the development of a wearable and feedback system for individuals with diabetes mellitus that also suffer from osteoarthritis. This system will focus on stimulating healthy movement behavior in the target population. RRD will be involved in the end-user engagement, definition of the patient journey and the evaluation of the developed system.

After an exciting kick-off in Canmore, Canada, and the national kick-off in the beautiful city of Den Bosch we are ready to start improving the healthcare for individuals with diabetes mellitus and osteoarthritis!

Interested to read more about this project? Read more on the website: ITEA 4 - Project - 22022 TREAT

 

FOTO ERIC BRINKHORST
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Erik Prinsen

Erik Prinsen

Email: e.prinsen@rrd.nl

Tel: 088 087 5761

 

Writing a new project proposal: engaging with the target audience before you start

Written by: Eline te Braake and Marian Hurmuz

When writing a new project proposal, end-users are often not included. This can be due to various reasons, such as time pressure, procedures or not having access to the right end-users. As a result, the project proposal is often written by researchers only and they also mostly shape the intended goals of the project. The end-user is then involved once the project is approved. A disadvantage of involving end-users at a later stage, is that the intended purpose of the project proposal does not fit with the end-users’ actual needs. To try to avoid this problem, and thus better match end-users' needs, we collected input from end-users before writing the project proposal. In this news post, we tell you what this brought us.

 

Set-up of end-user meeting

With two researchers and panel members, we took a first step towards this 'new' way of working. On the 15th of February, they met and a focus group on medication adherence took place. The aim of the focus group was to find out what the facilitators and barriers are for being compliant. During the meeting, we went through the following 6 main categories:

  • Patient-related factors
  • Disease-related factors
  • Treatment-related factors
  • Healthcare and system related factors
  • Social and cultural factors
  • Logistical and financial factors

For each category, panel members were given time to write down their experiences and share them with the group. In addition to these categories, there was also an option at the end to name other factors that they perceived as promoting or hindering, but did not fit under any of the previous categories.

 

Results end-user meeting

During the meeting, the group was able to discuss with each other the different factors. During the discussion, we noticed that many factors recurred under several categories. One frequently recurring factor that hindered medication adherence was cost. The examples mentioned were:

  • Costs for explanation about the medication at the pharmacy
  • Costs for typing a label (which is more expensive than the medication itself)
  • Parking costs for picking up the medication from the pharmacy
  • Paying the deductible excess (related to Dutch health insurance)

Other examples of barriers they experienced were the different intake times of medication, limited availability of the medication and, with this, often the long delivery time of a medicine at the pharmacy. With regard to intake times, this mainly concerns intake before/during/after a meal. These meals do not always take place at the same time. Some medications are really only allowed to be taken after 24 hours, so there is often not enough time between taking them.

In addition to these barriers, panel members could also discuss factors that facilitate medication adherence. These factors, although fewer were mentioned, were all very relevant, for example:

  • Receiving sufficient information about the medication
  • Having good contact with the healthcare professional and good communication between the different healthcare professionals
  • Taking a medication where you notice the effect yourself

 

Are you curious to see the entire list of factors? These are available in Dutch. Click here to open it. Do you want to have this information in English? Contact the researchers below.

 

This kind of meeting was a very fun and instructive way of working, and it helped us to learn a lot about how the target group views the influencing factors in medication adherence. This 'new' approach allows us to include the target group's wishes in the project proposal in order to better meet their needs. Would you also like to hold a focus group to identify the needs of the target group in order to write a project proposal? Please contact us for the possibilities!

 

Eline te Braake
FOTO ERIC BRINKHORST

Eline te Braake

Email: e.tebraake@rrd.nl

Tel: 088 087 5734

 

Marian Hurmuz

Email: m.hurmuz@rrd.nl

Tel: 088 087 5771

 

SenSeeAct is now open-source: allowing digital health developers to benefit from and build on top of our software platform

Written by: Dennis Hofs

 

We have just released the first open-source version of SenSeeAct, our software platform that has driven many of our research projects and applications for more than ten years. During that time the platform has gone through several iterations, growing into a mature, flexible and secure backend with web portals and mobile apps.

The name SenSeeAct reflects the functionalities that the platform focuses on.

 

Sense: Collecting data through questionnaires, diaries, wearables, and smart home devices.

See: Presenting the data in user-friendly ways to both end users and health care professionals.

Act: Coaching users toward healthier behaviour with virtual agents, video exercises and gamification.

 

We now published the SenSeeAct backend as open-source software to help stimulate health technology innovation and collaboration. It facilitates the development of new applications by third parties, and enables organizations to take full control of their data ownership and access.

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We are continuously improving the platform. Some of the new features that we anticipate in the near future are:

  • Enhanced support to author your own questionnaires and use them in our mobile app with your own backend.
  • Improved security with two-factor authentication.
  • A web interface to download your data or the data of your research participants.
  • A major update of our iOS app bringing it to the same level as the Android app.
  • Extending our earlier announced collaboration with DialogueBranch toolkit by Fruit Tree Labs.
  • More documentation and guides to help you get started with the open-source backend.

Read more about it at https://www.senseeact.com/?lng=nl

 

FOTO ERIC BRINKHORST

Dennis Hofs

Email: d.hofs@rrd.nl

Tel: 088 087 5763

 

Major research starts to tackle osteoarthritis on a tailor-made basis

By 2040, osteoarthritis is likely to be the most common chronic disease in the Netherlands. Currently, almost 1.5 million people in our country have osteoarthritis. The nature and extent of the symptoms may vary, but they always have an impact on people’s daily life. Osteoarthritis progresses differently for everyone, which requires tailor-made treatment. In order to be able to offer this as good as possible, insight is needed into the characteristics of the person and the disease process. Until now, that insight has been lacking. But this is about to change thanks to the funded research efforts of a unique partnership.

In November, researchers from the Interdisciplinary Consortium for Clinical Movement Sciences & Technology (ICMS) will start with the TopTreat project. They will follow 500 people with osteoarthritis over the next five years and will comprehensively map their characteristics. The aim is to gain insight into who qualifies for which treatment. The reason for this is because universal treatment is not effective for everyone due to the fact that the diversity among people with osteoarthritis is quite large.

 

Measuring and knowing precisely with a unique technology platform

This is the first time that the various manifestations of osteoarthritis are being measured with advanced technology and collected in a platform. The aim is to map extremely accurately how people with osteoarthritis feel, how they move, how their disease develops and which medicine is most effective for whom. Because physical, psychological and social factors all play a role in health, researchers are looking at the whole spectrum, from cell to well-being, and are conducting the study in consultation with the patients themselves. The insights from the study make it possible to optimally tailor treatment to the person with osteoarthritis. 

The promise of improvement

The research includes existing technologies such as 'joint-on-a-chip', accurate measurements of substances in the body that are indicative of the disease (biomarkers), analysis of movement with sensors, and making computer models of joint movement and load on cartilage. In doing so, the researchers aim to understand and capture specific characteristics of people with osteoarthritis. Based on these insights, practitioners can determine the most promising treatment for their patient.

Broad inclusion

Besides people with advanced osteoarthritis, two groups with an increased risk of osteoarthritis formation will also participate in the study. These are people with a broken or removed meniscus or with a leg amputation.

Moving forward together

TopTreat has a significant relevance for the progress of care of people with osteoarthritis. Moreover, the project is expected to develop a technology platform that is patent-worthy, and can be quickly translated into more healthcare applications. With this ambitious project, ICMS aims to maximise clinical and societal progress.

About ICMS

The Interdisciplinary Consortium for Clinical Movement Sciences & Technology (ICMS) is a unique partnership between RadboudUMC, Sint Maartenskliniek, Roessingh Research and Development and the TechMed Centre of the University of Twente. In TopTreat, these partners work together with ReumaNederland, the companies ATRO Medical and Moveshelf, the Rheumatism Foundation Sint Maartenskliniek, the Twente Graduate School and the Dutch Ministry of Defence. Together with funding from the Top Consortium for Knowledge and Innovation High-tech Systems & Materials, the project involves about EUR 4.8 million.

Reeping what you sow: final plenary meeting LEAVES project

Written by: Lena Brandl

36 months, nine consortium partners, three countries, one common goal: supporting older adults after spousal bereavement. Loss is a common occurrence in life and grief is a normal and healthy reaction to loss. Yet, grief is overwhelming at times and one can find oneself feeling lost. Together with eight international partners in Portugal, Switzerland and in the Netherlands, RRD has spent the last three years developing an online service for older mourners to support them in processing the loss of their partner.

It has been an exciting journey, including many many hours discussing, creating and evaluating, together with older adults, grief professionals and our fellow consortium partners.

 

At DOMUSDELA, Eindhoven, The Netherlands, the consortium of AAL project LEAVES (Project No. AAL-2019-6-168-CP) gathered to streamline its recent efforts one final time, including:

  • discussing the progress of the evaluation study of LEAVES in Switzerland;
  • documenting the insights from the evaluation studies conducted in Portugal and the Netherlands in the second half of 2022 and preparing these results for (scientific) publication; and
  • finalizing a business case for future exploitation of the LEAVES intervention for spousal bereavement.

 

We also took some time to look back to where LEAVES began, including:

  • how we transformed a purely text-based grief intervention to a more dynamic, dialogue-based format, combined with readings, writing exercises and activity suggestions to foster self-care;
  • How we developed an algorithm to detect and communicate when LEAVES users might be better off involving offline support in their grieving process; and
  • how Luisa, our initial peer virtual coach for LEAVES, became Sun, the final sun-shaped virtual coach in the service. The virtual coach introduces the content of the application to LEAVES-users. During the project, we learned that for some older adults a virtual coach designed as a peer (an older adult who has lost their partner) is confusing. Some older adults who participated in early prototype tests of LEAVES were misled to think that Luisa is a real person which is why we ultimately abandoned the idea of a peer virtual coach.
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AAL project LEAVES has entered its final stage of reporting and tying up loose ends and RRD fondly looks back to three years of fruitful collaboration with our LEAVES consortium partners. Now we look ahead to the final review of the project in April 2023.

Lena Brandl

Lena Brandl

Email: l.brandl@rrd.nl

Tel: 088 087 5768

Making advances in technology for healthy ageing matter: RRD at Ageing Well Week 2022

Written by: Lena Brandl

More than 40 parallel workshops, 30 poster presentations, and 50 exhibitors from industry, science, and communities dedicated to making healthy ageing possible gave rise to the Ageing Well Week 2022 in Gdańsk, Poland. Gdańsk is a buzzling city with a rich history, including its key role in the solidarity and oppositionist movements. It has therefore only been natural for the city to host the Ageing Well Week 2022, according to the city’s mayor, Aleksandra Dulkiewicz. The challenges that a rapidly ageing world population poses can only be met by a unified and solidary world community.

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The next step to making technology for healthy ageing matter


After 14 years of practice-oriented research about health technologies for the increasingly ageing world population, the most important topic of this final edition of the Ageing Well Week was how the community can accomplish the transition of health technologies to the market. Put differently, how can we ensure that the repertoire of evidence-based health technologies gets into the hands of those to whom we dedicated our efforts: the ageing population?

Since this is a question RRD cares about deeply, we joined the event and the ongoing discussions about enabling ageing well. RRD presented two posters about our work in the AAL project LEAVES (Project No. AAL-2019-6-168-CP). Within the LEAVES project, together with 8 consortium partners, RRD has developed an online grief intervention to support older adults in processing the loss of their spouse:

  • The first poster, by Stephanie Jansen-Kosterink, demonstrated the preliminary results about technology acceptance and potential health effects of the LEAVES service.
  • The second poster, by Lena Brandl, discussed older adults’ use and appreciation of a monitoring system to guide users of LEAVES to offline support (if their situation deteriorates while working with the online grief service).
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Our presented work was met with curiosity and praise for giving attention to a common, yet unfortunately, largely unrecognized aspect of healthy ageing: processing the loss of loved ones.

Do you want to take a look at our work presented at the Ageing Well Week 2022? You can find the poster about technology acceptance and potential health effects (preliminary results) of LEAVES here and the poster about older adults’ use and appreciation of a monitoring system here.

Do you have thoughts or ideas about how the health technology community can achieve their goals towards solving the challenges of the ageing world population through digital health solutions? We are happy to discuss, exchange ideas and collaborate to bring healthy ageing within everyone’s grasp!

Lena Brandl

Lena Brandl

Email: l.brandl@rrd.nl

Tel: 088 087 5768

RE-SAMPLE: First meeting with all partners in the Netherlands

Written by: Marian Hurmuz

After a year and a half, the time had come: the ten European partners in the RE-SAMPLE project met together in the Netherlands at the University of Twente's DesignLab. This meeting was organized for three main reasons:

  1. Sharing knowledge with the various project partners.
  2. Brainstorming on topics the project will focus on over the next six months.
  3. Working on the team spirit within the project! So that we all have our noses in the same direction.

Everyone was very happy that this could take place face-to-face. This way, we were able to organize many interactive group sessions.

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The four-year RE-SAMPLE project (Horizon 2020, grant agreement No. 965315) focuses on people with COPD and other chronic conditions. The goal of RE-SAMPLE is to develop a technology that supports patients and their caregivers.  

Workshops during the meeting

The meeting lasted two days during which energizing workshops were held by various partners. These workshops included:
  • The observational cohort within RE-SAMPLE. During this workshop, we had fun looking at how to involve more COPD experts in the cohort and reduce the burden on the COPD experts in the cohort.
  • Coaching. In this workshop, we went into groups to think about relevant coaching topics for the technology we are developing.
  • The Social Return on Investment (SROI) method. This workshop was organized by RRD. We worked with 4 groups to capture the main activities and outcomes of different stakeholders involved within RE-SAMPLE (click here for more information on the SROI method).
 

Social activities

In addition to these workshops, we also had time for social activities to get to know each other better. This started with a graffiti workshop!!! We were given a crash course in spraying graffiti and then we all got to create our own design. See below some examples of these designed. Afterwards a dinner was arranged at De Tropen in Enschede to close the evening with drinks and dishes. After 1.5 years of working online, it was really nice to meet the people in RE-SAMPLE in person.
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RE-SAMPLE: AI-powered care for patients with COPD and other chronic diseases

Written by Eline Te Braake and Christiane Grünloh

RE-SAMPLE is a European project targeting people with COPD and other chronic conditions. The goal of RE-SAMPLE is to develop a technology that supports patients and their caregivers. This technology will help patients manage their COPD and other chronic conditions. Along with 9 other partners, RRD is collaborating on this project to shape and develop the RE-SAMPLE technology. The project started in March 2021 and will run for a total of 4 years. RE-SAMPLE has received funding from Horizon (Grant agreement No. 965315).

USER-ORIENTED. When designing an eHealth intervention, it is important to consider the needs and desires of those who will use it. Ultimately, we want RE-SAMPLE to have an added value in practice for both people with COPD and their healthcare professionals. Of course, we also want that after the project, RE-SAMPLE is actually successfully implemented in the health care system. To do this, we need to learn from the attitudes, experiences, and needs of people with COPD and their caregivers. Since they are all experts in the field, they know best what is currently missing or what is already going very well. This information can help us develop a technology that is actually useful to them.

Since the inception of RE-SAMPLE, we have conducted many different surveys. We had the opportunity to talk to many people with COPD and caregivers to learn more about COPD, the experiences of living and coping with COPD, and preferences regarding COPD management. This provided a lot of useful information. This input helped us a lot in shaping the RE-SAMPLE technology. To give you an idea of what we have discovered so far, RRD has created a summary video with some highlights.

You can watch this video below!

Although much information is already being collected, we will also need ongoing input from both healthcare providers and people with COPD in the future! After hearing about RE-SAMPLE, would you like to join us and give us feedback?

Then feel free to contact us!

You can do this by sending an e-mail to Christiane Grünloh (c.grunloh@rrd.nl) or Eline te Braake (e.tebraake@rrd.nl)

HOLOBALANCE: HOLOgrams for personalized virtual coaching and motivation in an aging population with BALANCE disorders

Feasibility and effectiveness of the HOLOBALANCE telerehabilitation platform

88% of participants in the HOLOBALANCE interventions achieved at least the minimal clinically significant difference in the Functional Gait Assessment (which is used to assess postural stability and an individual's ability to perform multiple tasks while walking) scores vs. 55% for participants in the control group. Moreover, 82% of participants in the HOLOBALANCE interventions achieved at least the minimal clinically significant difference in Mini-BESTestest (which is a standard balance measure) scores vs. 52% for participants in the control group.

 

Balance disorders are very common in older adults and have wide ranging detrimental physical, cognitive/psychological and life quality sequelae. Early detailed individualized assessment and treatment interventions for older adults with balance disorders at risk of falls is recommended by several guidelines but is often not implemented into clinical practice due to lack of resources and specialist knowledge.

The HOLOBALANCE platform (https://holobalance.eu/ ) provides an advanced telerehabilitation solution that addresses the critical health needs of older adults with balance disorders. HOLOBALANCE features evidence-based exercises, cognitive and other gamified training, physical activity planning, and components that aim to improve motivation and compliance with the activities.

The proof-of-concept study, conducted from May 2019 to September 2021, with about 80 patients using HOLOBALANCE and 80 patients as controls, aimed to explore an advanced and more holistic approach to standard care. HOLOBALANCE is a tele-rehabilitation system which provides an individualized, prescribed program to be performed at home. The program has been originally designed by a specialist balance physiotherapist and is intended to be prescribed and regularly reviewed by a non-expert clinician. The system supports this by remotely monitoring task performance and providing the outcomes to the treating physiotherapist to review. The system comprises of a set of CE marked wearables (i.e., accelerometers, sensorized soles, smart bracelet), ambient sensors (motion capture sensor) and a head worn augmented reality display, which provide detailed movement and physiological data for the remote assessment of task performance (prescribed exercises, auditory tasks, and cognitive games).

The study recruited 145 older adults with falls/at risk of falls and middle aged or older individuals with a confirmed diagnosis of a vestibular disorder. Participants were randomized into one of two intervention groups. One group received the HOLOBALANCE/HOLOBOX intervention, i.e. the home-based or the clinic-based intervention, and the other received the standard clinical treatment i.e., the OTAGO Home Exercise Program (HEP) for 8 weeks. All participants were required to undertake a daily exercise program intended to improve their balance, with the program overseen by a physiotherapist.

Despite the huge challenges since the study was performed during the COVID-19 global pandemic, recruitment and retention rates were good, dropout rates were low, and the estimated sample size was achieved. The COVID-19 global pandemic inevitably led to continuous recruitment and intervention uncertainty due to the various government restrictions imposed across the three study sites of Athens, Freiburg, and London and imposed challenges for participants, researchers, and treating therapists. We anticipate that these measures of feasibility would be better under less adverse circumstances. Importantly, the absence of any adverse events during the study related to participant interventions or associated with functioning of the HOLOBALANCE system suggest that the program is safe to use in future studies and clinical applications.

The high rate of exercise compliance (83%) observed across all study sites, and the improved balance perceived by 73% of these older adults, and those with vestibular disorders adds further support for the feasibility of the HOLOBALANCE program implemented in this research. Furthermore, both the HOLOBOX and Home-based delivery of the systems appear to be feasible interventions, regardless of the age, sex, or education level of this study population.

Regarding effectiveness, for average baseline scores near normal or normal, 88% of all participants in the HOLOBALANCE interventions vs. 55% for participants in the control group improved their postural stability (measured with the Functional Gait Assessment scale - FGA). 82% of all participants in the HOLOBALANCE interventions vs. 52% for participants in the control group improved their balance (evaluated with the Mini-BESTestest). Importantly, an average improvement of 25% for FGA and of 36% for Mini-BESTest for those with abnormal scores at baseline and eventually trained with HOLOBOX. It is anticipated that in a client group with greater disability and lower scores, the pre-post treatment change would have been even greater.

A high dosage (>50 hours) of challenging balance exercises has been associated with a successful reduction in fall rates in older adults. Our findings though, indicate that a moderate dosage multisensory and multifactorial balance rehabilitation program may also have a significant effect on falls risk and intervention cost. The potential benefit for these multiple factors is therefore immense and must be confirmed in a full randomized controlled trial.

An additional beneficial finding was noted for social well-being. In all groups a decrease, in the average total number of days during which their balance difficulties affected their ability to perform daily activities, was observed. Participants in the HOLOBALANCE interventions combined, 87.5% achieved at least a 25% improvement in social well-being. Moreover, a decrease of 14.66 days per month during which the participants' balance impacted their lives in a negative way was demonstrated.

Further exciting findings were observed for cognitive function scores with significant pre-post improvements (8%) noted for visual memory and new learning and visual pattern recognition memory. It is well documented that falls risk is greater for those with cognitive impairment whereby all aspects of balance control deteriorate with increasing severity of cognitive impairment. This finding has significant implications for further studies in this area, particularly in individuals with cognitive impairment, and subsequently for clinical practice. Positive improvements in cognition, as those observed, may also contribute to the delay of onset for cognitive impairment and consequently prolong the active life of these older adults, with better quality of life, improved social wellbeing and reduced economic costs for their care.

The project involves 13 partners from across Europe and is coordinated by Prof. Dimitrios I. Fotiadis, who is Professor of Biomedical Engineering at the University of Ioannina.

If you would like more information about the project visit https://holobalance.eu/.

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HOLOBALANCE has received funding from the European Union's Horizon 2020 research and innovation programme under grant agreement No 769574.

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