A motivational tool that utilizes the psychological, social and physical factors that provide and prevent motivation to create an assistive, in-home tool for use between office sessions while undergoing physical therapy

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Kimel, Janna C.
Chung, Wayne
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The physical body is the one thing we have with us from the day we enter life to the day we depart. Most of us take for granted the fact that our bodies and all the systems therein do what we expect them to without pain or discomfort. It is important to keep this vessel as functional as possible. In this society where independence and mobility are highly valued, it is often thought that the body needs to be in working order to take full advantage of the world around us. It is easier to live when the body is in complete working order since our society is one designed for those with independent mobility. Although it may be difficult to see directly after an injury, quality of life is enhanced when mobility is regained. Reduced functionality leads to physical and emotional debilitation. Reduced functionality may occur from an accident, disease, injury or genetic abnormalities. According to The Disability Statistics Rehabilitation Research and Training Center, the fourth most common condition (4.6% of all conditions) which causes individuals to limit activities, is the impairment of lower extremities, greatly effecting quality of life (Persoon, 2004 and Rikli, 2005) Among the lower extremities, impairments, knee joint injuries and chronic pain are common. A 2003 interview from ABC television quotes Scott Lephart, Ph.D. as saying, knee injuries are occurring in epidemic proportions. Knee injuries constitute only about 15% of all sports injuries but are 50% of visits to sports doctors, indicating that when they happen, they are usually significant. (McLaughlin) This project will focus on lower extremity injuries since it is the largest orthopedically limiting condition. Physical Therapy is one of the medical options used to regain normal functionality of an injured body part or to reduce chronic pain from a musculoskeletal condition. Patients are referred to PTs by a physician, orthopedist or surgeon after an injury. The referrals come after a physician has confirmed that a patient needs to regain functionality and reduce pain after surgery or the incident of chronic pain. Patients may be seen at a variety of locations including the hospital (both in-patient and out-patient), a private PT office, at home, in a nursing home, or in an athletic center. The profile of patients who see PTs is changing and growing. The population of the United States shows a breakdown of 49.1% and 50.1% males to females. (Hicks et al., 2004) In therapeutic settings, the genders are unequally represented with 44.2% of patients being male and 55.8% being female. It has been hypothesized that more women are participating in sports and suffering subsequent injuries (Brisette, 2004 and abclocal.go.com). Compared to their representation in the U.S. general population, middle aged (50-74) and older (74+) adults were overrepresented in the demographics of those seen by a physical therapist. Most frequently seen patients were middle-aged adults (50-74) and young adults (20-49). The population is living longer and, through modern medicine, are able to live with chronic and disabling conditions. These conditions require treatment possibly resulting in the rise of patient statistics weighted towards the older population (Brisette, 2004). A patient participating in a course of physical therapy has not only to contend with the physical ramifications of an injury, but also the psychological issues (Uppal, 2003). While bones, ligaments and cartilage are healing, patients are required to participate in a series of exercises both at home and in a therapists office. While rehabilitating at home, patients may find it difficult to remember, make time or feel motivated to do these exercises. These issues are a large obstacle on the path to wellness. The design solution presented in this thesis looks at the factors which influence motivation including community, positive and negative feedback, tracking and goals. The proposed solution will incorporate information from the fields of psychology, wearable technology and physical therapy. Pain and injury do not necessarily motivate individuals to participate in a course of a HEP (home exercise program) which can eventually lead to better health. Knowing a product will make you feel better does not make you use it. A goal is not enough. To further motivate individuals, aspects of fun, community, autonomy and competence can greatly improve a persons desire to heal (Uppal, 2003 and Deci-Ryan and Coleman, 1998). A customizable, networked solution is proposed where individuals may use one, two or all three parts of an integrated system to track daily and overall progress, work with a buddy and communicate with a therapist. It is hypothesized that with this system, patients will be more motivated to participate in at home physical therapy to regain full functionality. The research and design process took part in various stages. Processes moved from the general to the specific as research and interviews informed the work.
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