Go-with-the-Flow: Tracking, Analysis and Sonification of Movement and Breathing to Build Confidence in Activity Despite Chronic Pain

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.