Abstract
Chronic (persistent) pain (CP) affects 1 in 10 adults; clinical resources are insufficient, and anxiety about activity restricts lives. Technological aids monitor activity but lack necessary psychological support. This article proposes a new sonification framework, Go-with-the-Flow, informed by physiotherapists and people with CP. The framework proposes articulation of user-defined sonified exercise spaces (SESs) tailored to psychological needs and physical capabilities that enhance body and movement awareness to rebuild confidence in physical activity. A smartphone-based wearable device and a Kinect-based device were designed based on the framework to track movement and breathing and sonify them during physical activity. In control studies conducted to evaluate the sonification strategies, people with CP reported increased performance, motivation, awareness of movement, and relaxation with sound feedback. Home studies, a focus group, and a survey of CP patients conducted at the end of a hospital pain management session provided an in-depth understanding of how different aspects of the SESs and their calibration can facilitate self-directed rehabilitation and how the wearable version of the device can facilitate transfer of gains from exercise to feared or demanding activities in real life. We conclude by discussing the implications of our findings on the design of technology for physical rehabilitation.
Highlights
Chronic pain (CP) is pain that persists for more than 3 months without a treatable cause (Turk & Rudy, 1987)
Nonparametric Friedman’s tests between the sound conditions and planned pairwise comparisons using Wilcoxon were performed for the non-normal data, whereas parametric analysis of variance with sound conditions as within-subject factor and planned pairwise t tests comparisons were performed for the normal data
In this article we proposed the Go-with-the-Flow sonification framework for defining Sonified Exercise Spaces (SESs) for physical rehabilitation in CP
Summary
Chronic pain (CP) is pain that persists for more than 3 months without a treatable cause (Turk & Rudy, 1987). An integrated biopsychosocial framework (Gatchel et al, 2007) attempts to represent the interaction of physical, psychological, and social factors in the pain experience, including the adverse impact on quality of life These changes apply across persistent pain with or without diagnosable cause, giving rise to the suggestion that CP may be a disease in its own right (Tracey & Bushnell, 2009). Cognitive content predominantly describes unhelpful beliefs about what pain means, interpreting it as threat and responding by withdrawal, escape, and avoidance Over time this leads to loss of range and extent of activity, impacting on work, family, and social life. Emotional difficulties associated with pain are mainly anxiety about the meaning and implications of pain, depression related to losses of lifestyle and planned future, and frustration with day-to-day difficulties and the shortcomings of medicine
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