Optimization of long-term care of neurological patients through internet- and mobile-based interventions with and without persuasive elements including gamification

Abstract

In a pilot study of 60 neurological long-term patients (degenerative cerebral microangiopathy with reduced sensorimotor stability), an initial assessment of the practicability of a specially developed concept was carried out focusing on the communication aspect of long-term medical treatment. Patient preferences, methods for increasing the patient's own activity and other factors determining adherence were analysed and optimised. In addition to communication and factual arguments, an affective-emotional, multi-layered message transmission is required, which adapts comprehensively and in real time to the recipient. Persuasion is the targeted addressing of behavioural patterns. Gamification transfers playful elements into a game-free context. Technology-based approaches offer an opportunity to optimize aspects of health, quality of life and positive disease management, e. g. through the use of internet- and mobile-based interventions (IMIs). Based on this information-theoretical and health-communicative background, a pilot study was conducted with 60 neurological long-term patients with symptomatic cerebral microangiopathy patients hospitalised for an existing sensorimotor incompetence. During the one-week inpatient stay, patients received an introduction to a standardized sensorimotor training therapy, which they then continued for six weeks after being discharged as a four-arm intervention study on an outpatient basis on the clinic campus or at home, each without and with gamification. Patients were examined at the beginning and end of the training phase with motor-functional procedures and test psychology. Thereafter, they were subjected to a standardised guideline interview. The most important results were as follows:- The training therapy was effective and was accepted by the patients. They attached particular importance to: high user-friendliness, high precision in reflecting their level of control of even subtle training elements, and personal progress evaluation in real time.- The domestic training results were better than those of the ambulance campus.- A comparison of the individual groups showed almost consistently better results under gamification, both at home and on an outpatient basis.