Shepherd Center Tests Wearable Technologies to Help with Memory Problems and Stress Reduction

There’s no doubt that wearable technologies, such as smartglasses and smartwatches, are cool. But can they be useful to people with serious medical challenges, such as acquired brain injury or post-traumatic stress disorder (PTSD)? Researchers at Shepherd Center are testing this idea with two applications – EyeRemember and Breathe Well – they have developed for Google Glass.

Glass is worn on the head just like regular eyeglasses. It has just one display on the right side, with a track-pad and natural language voice input for control, as well as a bone-conducting speaker for audio output.

At Shepherd Center, researchers, who received a Glass Accessibility Award, developed EyeRemember to assist people who have an acquired brain injury in compensating for memory difficulties that often accompany these injuries. Putting names to faces can be troublesome for anyone at times, but for someone with a brain injury, it can be a nearly constant struggle. Long-term memories often stay intact while new ones slip away in a moment.

“In addition to being difficult for the patient, this can substantially increase the burden on others because it means they require more help,” explained Tracey Wallace, a speech-language pathologist and researcher at Shepherd Center.

Patients with memory difficulties sometimes get help from using memory notebooks and smartphones. But Wallace, alongside clinical research scientist John Morris, Ph.D., and software engineer Scott Bradshaw, wanted to see if wearable technologies like Google Glass could assist.

They tested their idea with five clients enrolled in the brain injury day program at Shepherd Pathways, Shepherd Center’s post-acute brain injury rehabilitation facility in nearby Decatur, Ga.

“Each person has a team of therapists – an occupational therapist, physical therapist, speech therapist, recreational therapist, a counselor and case manager,” Dr. Morris explained. “That’s a lot of people to keep track of. The core question we had is, ‘Does our solution improve their recollection of names and details of their therapy team?’”

Patients normally receive a sheet of paper with the name, type of therapist and the therapist’s location in the clinic. “That’s very helpful, and the patients benefit from seeing it repeatedly,” Wallace noted. “The drawback is they have to initiate looking at it, and sometimes they don’t remember that they have it.”

So the research team developed EyeRemember to display the therapist’s photo, name and location in the clinic when the client gets within 3 feet of the therapist.

Each client used the app for two to four weeks. At the end, every participant was able to recall all of the targeted information with complete accuracy. All but one participant also showed significant increases in recall of this information even after they had stopped using the app, researchers reported.

“We weren’t sure that people with significant memory impairments could learn to use Google Glass, a very different sort of device. It turns out they can,” Wallace said.

In addition, she said, the benefit of using wearable technology is that the information can be provided without patients having to remember to pull the phone out.

Meanwhile, with support from the Rehabilitation Engineering Research Center for Wireless Technologies (Wireless RERC), the research team is also developing BreatheWell, a Google Glass app to help people use breathing therapy to reduce stress. Working with Shepherd Center’s SHARE Military Initiative, a comprehensive rehabilitation program for service men and women who have sustained mild to moderate traumatic brain injury and/or PTSD in post-9/11 conflicts, researchers aim to see if a wearable device might encourage greater use of breathing therapy than smartphones currently do.

When people endure stress, they experience the fight-or-flight response. Their heart rate increases, and breathing becomes shallow, exacerbating anxiety. Slowing their breathing, particularly when exhaling, helps calm them.

People often forget to practice breathing therapy and were saying it seemed like it would be effective, but they couldn’t remember how to do it when they were under stress. The team – including Wallace, Dr. Morris, Bradshaw and SHARE clinical psychologist Corissa Callahan, Ph.D., ABPP – created an app for Glass to allow users to program reminders to practice and if there might be other benefits to using a wearable to aid relaxation breathing.

Putting the app on a wearable was also attractive because it could remind patients to do something without them having to bury their head in a phone.

“People often like to stay aware of what’s going on in their environment,” Wallace explained. “If they’re staring at their phone, they’re not able to see what’s going on. Wearing Glass, you can be in the moment and look at the screen, but in your peripheral vision, you still are aware of people around you.”

Breathe Well is still in development, but researchers say it will work much like apps on smartphones, with a visual guide that allows users to determine the duration of each breath.

Researchers are adding key features, like the ability to set reminders to practice the technique with the app during periods of low stress, with the aim of making it easier for the user to perform relaxation breathing when it is truly needed. Plus, the app allows the user to upload their own calming pictures and music, and it allows clients to customize the device’s voice guidance system, changing from a male voice to a female voice or muting the voice guidance altogether.

“We want people to have options, because they’re more likely to use it if it’s adjustable to their comfort and needs,” Wallace said.

The research team expects to have results by the end of 2015. They will be presenting preliminary findings to date in a session at the upcoming 92nd Annual Conference of the American Congress of Rehabilitation Medicine in October.

Although Glass is being redesigned by Google, the team says the results from these studies can be applicable to other wearables, such as smartwatches, as well as devices that are still just a gleam in an inventor’s eye.

Written by David Terraso
Photos by Louie Favorite
EyeRemember Video Produced by Louie Favorite