Rheumatic and musculoskeletal diseases (RMDs), a group of chronic conditions that affect the joints, muscles, and bones, are the most common cause of chronic pain and physical disability worldwide, affecting over 494 million people globally and projected to impact 1.6 billion people by 2050. In Ireland, RMDs are the leading cause of disability, affecting one in four people across all age groups. Effective recovery is achievable with consistent physiotherapy, occupational therapy, and self-care; however, barriers such as rheumatologist shortages and economic costs can result in patients receiving less than the recommended therapy hours.

Given the scale of this global problem, technologies have been explored to address RMDs, including wearable devices for early detection, asynchronous telehealth solutions for health data collection and management, and AI-based tools to monitor progress and create tailored rehabilitation plans. However, these technologies often have limited direct impact on patient care, leading to discontinued use among patients.

At Peamount Healthcare, self-management, a vital strategy for effective rehabilitation in which patients develop the ability to manage their symptoms and treatment and cope with lifestyle changes resulting from disease, is promoted to mitigate systemic challenges related to time and resource constraints and to improve care outcomes. Self-management however relies on patients’ motivation to engage in necessary activities outside scheduled therapy hours, which research has at times shown to prove a significant barrier in other settings.

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It was this challenge of enhancing time spent in rehabilitation therapy that Uzoma Ibekwe, Ashwita Jagannath, Chengteng Lam, and Rutuja Pote took on through their MSc HCI Design Project. Adopting a highly collaborative, human-centred approach, the team conducted in-person participant observations across outpatient and inpatient rehabilitation programmes, engaging in rehabilitation activities alongside patients. Individual and group interviews with patients, physiotherapists, occupational therapists, psychologists, and pharmacists in the Rheumatic and Musculoskeletal Diseases Ward further provided the team knowledge of the lived experiences of patients, the rehabilitation context, and healthcare providers’ roles in supporting recovery.

This analysis revealed key insights, including concerning patients’ hesitation to engage in activities without staff for fear of worsening their condition, the stigma associated with using assistive tools, and the importance of peer support. A critical finding that contradicted prior literature was that patients at Peamount Healthcare did not lack motivation to engage in rehabilitation activities; rather, other factors such as possible improvements to the onboarding process and a lack of tools limited their ability to do so. These insights informed the team’s ideation, sketching, and design of low-fidelity tangible and video prototypes of diverse approaches to optimising onboarding and integrating rehabilitation activities into patients’ everyday environments. Following co-design workshops with the patients and healthcare providers of the RMD ward, a bespoke interactive rehabilitation mirror was selected as the concept for implementation and further iterative co-design.

This innovative interactive rehabilitation mirror integrates the self-management resource pack provided by healthcare professionals at the RMD ward, transforming this into engaging, personalised activities that patients can complete in their free time. The mirror seamlessly blends into the hospital environment, alleviating stigma, and features a life-sized virtual coach, community support, resource repository, and self-reported progress tracking features.