Negami

Initial situation

Approximately 12 million people worldwide suffer a stroke every year. About 20% of these people develop neglect - a condition in which patients behave as if one side of their external space and body no longer exists. The treatment of this condition, which severely limits everyday life, is currently time-consuming and requires specialized and trained therapists. In addition, there is practically no possibility for patients to train themselves at home, so that those affected are always dependent on external facilities and institutions.

With the University Hospital of Tübingen as project leader, we began in 2019 with the implementation of an innovative tablet app that revolutionizes neglect therapy using augmented reality (AR). It should combine active, visual exploration with torso rotation and gamification to enable optimal therapy success in patients. At the same time, the app should be operable by patients themselves and more efficient than other treatment options.

Project start

After a detailed requirements analysis and the initial filling of the backlog, which serves as the basis for working according to the SCRUM process model used in this project, we moved on to the technology decision. Our experts compared a number of frameworks for cross-platform mobile app development, including Ionic, Flutter, NativeScript, and Xamarin. Taking into account the project-specific requirements, the final choice was Xamarin because it provides full access to native programming interfaces via bindings, allowing full control over platform-specific AR frameworks such as ARCore (Android) and ARkit (Apple).

Development

After defining the basic technologies, our experts started development right away. We took an agile approach to this, so that every 4 weeks (after a sprint) we provided our customers with a runnable version of the app that contained the current functionality. This allowed our customers to experience the project progress for themselves and report feedback and change requests to us at an early stage. After about half a year, the basic functionality of the application was fully implemented.

In the time that followed, we implemented change requests regarding the user interface as well as additional functions such as cloud synchronization of training data, an administration function for patients and voice control, which arose during parallel use of the app. We proceeded in such a way that after the end of a sprint (i.e., after 4 weeks), we presented the interim product in a joint meeting and included change requests and new functions as work packages in the backlog. Afterwards, we defined the work to be done for the next sprint together with our customer. This allowed us to react quickly to changing requirements and prioritization changes, so that the things that were of the highest importance to our customer were always implemented.

Project result

We were able to successfully implement the app within the specified time thanks to the good cooperation with our customer. Regular checks on the progress of the project ensured that the app actually met the requirements.

Over the duration of the project, the following functionality was implemented:

1. innovative neglect therapy using augmented reality in two separate task types
2. automatic evaluation and visualization of the performed exercises for therapy coordination by the treating person
3. user interface optimized for neglect patients
4. patient administration for simultaneous training with multiple patients
5. cloud synchronization of patients, templates and exercise results across multiple iPads
6. voice control for operating the app using simple voice commands
7. a simple landing page was developed and operated for the distribution of the app in a closed beta phase.

Since its development, the Negami app has been evaluated in a clinical trial. It was confirmed that it is excellently suited for neglect therapy and achieves better treatment success than comparable therapy approaches. At the same time, the participating patients reported no side effects, fun while exercising and increased motivation.

A closed beta phase is currently running and the launch is set for Q1 2024.