Cycli: A Guided Exercise System for Reducing Comorbidities in Individuals with Alzheimer's Disease - Alzheimer’s disease (AD) is a common condition that affects over 5 million older adults in the US. AD
inhibits self-care and is associated with an increase in comorbidities, including diabetes, congestive heart
failure, and cerebrovascular disease. One of the most important factors in maintaining autonomy with AD
and in reducing comorbidities is participation in regular physical activity. Unfortunately, for individuals with
mild cognitive impairment (MCI) or mild dementia due to AD, routine participation in physical activity is
difficult due to safety concerns and the need for supervision, reminders, or guidance. A guided exercise
system could make it easier for individuals with MCI or mild dementia to remain active, however, to our
knowledge, there is no commercially available exercise system that is specifically designed to safely
encourage routine physical activity in individuals with these conditions. Flint Rehab has previously
developed Cycli, a low-profile, Bluetooth-enabled exercise cycle that would be well-suited for use by
individuals with MCI or mild dementia to exercise. Flint Rehab has also previously developed a 10”
touchscreen tablet called the Flint Tablet that runs a customized operating system to increase the ease-of-
use of our software for individuals that are unfamiliar with technology. Cycli was originally developed for
general wellness, but we hypothesize that, with the addition of a guided exercise application designed
specifically for individuals with MCI or mild dementia, Cycli can safely increase the amount of physical
activity performed by these individuals in routine life. Thus, for this Phase I project we propose to develop a
novel guided exercise application for Cycli that runs on the Flint Tablet and is specifically designed to
support individuals with MCI or mild dementia and their caregivers as they work together to maintain
regular exercise habits. This approach has three key advantages. First, it will provide easy access to a safe
and effective exercise modality for older individuals: stationary cycling. Second, it will be able to monitor a
user’s exercise performance, increasing accountability. Third, it will motivate users to maintain regular
exercise habits by using automated reminders, immersive audio and visual feedback during exercise, and
social networking features. Our specific aims are to: 1) Perform structured interviews with clinical experts
(N=10) to optimize the design of the Cycli guided exercise system; 2) Develop a prototype exercise guidance
application for the Flint Tablet based on design requirements from Aim 1 and iterative expert feedback; and
3) Perform a usability study of Cycli with 10 individuals with MCI or mild dementia due to AD to determine
if it can safely promote unsupervised physical activity. If this project is successful, it would be the first step
in developing Cycli as a home exercise tool that could promote a healthier and more autonomous lifestyle
for individuals with AD, leading to lower rates of comorbidities.
