Problem and Hypothesis
My father-in-law experienced a severe ischemic stroke in 2017. He underwent a wide variety of treatments and therapies with the goal of recovering as much physical and cognitive capability as possible. One of these treatments involved physical therapy through Virtual Reality, where the patient would wear a headset and use controllers to stretch and perform movements aligned with the content of the immersive experience, usually a simple game or a walkthrough in a particular scene. However, in the context of his recovery, issues with mobilization, costs, and time were permanent concerns.
This sparked my curiosity regarding how an immersive and gamified experience could enhance patients' well-being during usually-painful therapy sessions. As the pandemic started, I began contemplating how an interconnected platform could leverage this technology to help all stakeholders pursue physical therapy remotely.
My Role
As this project served as the capstone for an online master’s program, the requirement was to pursue it individually. Therefore, I assumed the roles of UX Researcher and Product Designer.
Background Research
I conducted extensive research on the technology itself, delving into the Human-Computer Interaction perspective. This involved exploring how emerging technologies like Extended Reality (XR) and Artificial Intelligence (AI) have increasingly expanded over the years, examining the various applications of Virtual Reality in different fields, and understanding the usability constraints when designing experiences for spatial design.
Design Process
1. Qualitative Research
Competitive Benchmark
I selected five solutions available in the market that were aligned with the problem space and evaluated them using the following criteria: market presence, platform capabilities, product accessibility, usability, and therapeutic value. XR Health emerged as the top solution, with a very appealing offering that includes easy access to hardware, an interconnected platform for therapists and patients, and a wide variety of third-party applications oriented towards physical and cognitive therapy.
User Interviews
I conducted semi-structured interviews with eight patients, two licensed physical therapists, and two UX designers experienced in Extended Reality (XR). Key findings included:
XR Designers: XR design challenges stem from unfamiliar constraints, impacting 2D patterns. The future involves experimenting with innovative approaches. XR applications show promise in healthcare.
Physical Therapists: Freelance therapists faced challenges in the pandemic, investing in home visits. Skepticism about VR effectiveness persists.
Physical Therapy Patients: Patients with varying lesions undergo different recovery programs. Cost and pain are concerns. The patient-therapist relationship influences enjoyability. Caregivers provide crucial support.
2. Analysis and Ideation
Personas
After the initial research, I was able to define the personas and potential roles interacting in this platform.
Patient: Someone with a mild, moderate, or severe lesion requiring physical therapy. All share concerns about costs, time investment, and potential pain. The more time invested, the less motivation and predisposition to complete the program is evident.
Therapists: They face logistical barriers, especially for mild lesions, experiencing additional costs often unrecognized in mobilizing, particularly during the pandemic.
Caregivers: Friends and family frequently provide emotional and logistical support.
Product Concept
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Every patient, lesion, and rehabilitation process is unique, with people prioritizing time, money, and convenience—elements that often conflict with the demands of therapy.
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As research indicated, physical therapy can be prescribed for individuals of any age and condition. Music can foster a positive attitude and divert attention from pain or discomfort. It also enables the product to scale and appeal to a diverse user base. A character would visually guide the patient through exercises, asking them to replicate movements. This promotes trust and concentration. VR doesn't require complexity to be impressive—simple controls and interactions allow patients of all capabilities to achieve their goals.
3. Design
User Flow and Concept Sketching
This product includes different roles and potential user flows per device. However, the project focuses on the use case of a physical therapy patient. The flow includes:
1. User accesses the VR application on a desktop or laptop computer.
2. Goes through the onboarding process.
3. Navigates the menu and accesses the pre-scheduled therapy session.
4. Navigates the menu and accesses an exercise session, defining the specs independently.
5. Goes through the session lobby to confirm session specs and select a musical genre.
6. Performs the therapy or exercise session.
7. Inspects therapy progress and session metrics.
8. Browses the support and FAQ modules.
9. Exits the application.
2. Goes through the onboarding process.
3. Navigates the menu and accesses the pre-scheduled therapy session.
4. Navigates the menu and accesses an exercise session, defining the specs independently.
5. Goes through the session lobby to confirm session specs and select a musical genre.
6. Performs the therapy or exercise session.
7. Inspects therapy progress and session metrics.
8. Browses the support and FAQ modules.
9. Exits the application.
Low-Fidelity Prototype
The low-fidelity prototype expanded on the core user flow and concept sketch to create a two-dimensional artifact used for testing. When designing this prototype, I began considering important design concepts, envisioning how a diverse audience, including seniors unfamiliar with virtual reality sessions, might use it. This is where key concepts from the background research surfaced. Ensuring good readability and comfortable body movement throughout the experience became crucial for potential user learning curves and ease of use. Additionally, maintaining a simple interface with visuals that avoid clutter was deemed essential to preserve immersion and the fluency of interactions.
4. Evaluation
Cognitive Walkthrough
Upon completing the first iteration of a low-fidelity prototype capturing the main interactions of the core user case for the patient, I recruited three XR design experts to conduct cognitive walkthroughs of the prototype. I chose this evaluation method due to the logistical barriers posed by the project in the midst of the pandemic. This involved user testing for the most crucial actions in the interaction sequence, providing scores, and offering additional feedback for potential issue mitigation.
Branding and Design System
After refining the prototype based on feedback from the walkthroughs, I developed the branding and design system for the solution. The brand concept revolves around a futuristic experience that feels deep and cutting-edge but also friendly and safe. Given that this is primarily a therapeutic tool, a color scheme based on blue tonalities provides the ease and calm required to face a previous therapy experience that might have been painful or uncomfortable. Ensuring high readability and clickability also enables the necessary affordance for smooth interactions.
The design system captured the visual specifications as well as guidelines for other senses at play. It involved defining specifications for how haptic response would operate and how sound design should be implemented to support the atmosphere and immersion. Sound is particularly important due to the musically-oriented experience but is also closely connected to the AI assistant guiding the onboarding and help processes.
High-Fidelity Prototype
Lastly, I developed a 2D High-Fidelity Prototype that depicted the immersive experience from all angles, covering access to the application, user onboarding, main menu, session types, therapy specifications, therapy interaction, evaluation output, consolidated metrics, and more. The mockups developed captured the visual output desired as per brand guidelines and the overall look and feel for users. It aimed to address a cutting-edge experience that feels futuristic but is also expressive, deep, and engaging.
Retrospective
How I solved the problem
The solution effectively addresses key challenges faced by physical therapy patients, including mobilization, physical pain, and costs. By providing a remote platform, it offers concrete benefits to therapists, patients, and caregivers.
Therapists benefit from the ability to assign and monitor therapy programs remotely, saving time and costs associated with home visits. Patients, especially those with severe lesions, experience time savings by avoiding the need to travel for therapy. The gamified 'dance' sessions make therapy enjoyable, shifting the focus from pain to engagement. From a cost perspective, the success case of XR Health demonstrates the potential for insurance coverage and affordable hardware, making the solution accessible for various purposes beyond therapy. Additionally, the platform encourages caregiver involvement, allowing them to observe sessions, monitor performance, and connect with therapists, enhancing the overall support system.
Challenges
I lack experience in 3D or game-engine development, which posed a significant barrier to creating a real 3D prototype for testing with actual users. To compensate for this gap, I sought the expertise of designers with substantial experience in XR design to conduct cognitive walkthroughs, examining the overall experience and identifying usability issues. While this approach proved extremely helpful and revealed instances of user confusion or perceived challenges,
I am confident that the solution aligns with essential XR design principles and is technologically feasible. Nevertheless, developing a formal spatial prototype would have been ideal.
What I learned
This project provided me with a fresh perspective on the evolving landscape of usability principles, particularly in the realm of spatial user experiences. While traditional 2D solutions dominate our web and mobile interfaces, the shift to spatial design introduces novel challenges that impact both our bodies and cognition. Research indicates the limitations of sustained virtual reality use, highlighting constraints such as user fatigue. This underscores the importance of considering physical constraints in interface design, recognizing the impracticality of extended arm movements or prolonged standing.
Working independently on this project granted me unparalleled creative freedom, but paradoxically heightened my sense of responsibility. The autonomy necessitated a rigorous approach to decision-making, especially given the clinical nature of the potential solution with inherent risks and barriers. Embracing user-centric methodologies, I realized that well-founded decisions not only enhance stakeholder buy-in but also revolutionize communication with stakeholders.
