The inaccessibility of exercise classes, difficulty of transit to them, and cost constraints can make it hard for people who are blind or low vision to participate in physical fitness. Gyms, sports arenas, and classrooms often do not have braille labels, accessible instructions, or standardized layouts. There are accessible exercises, including Goalball and Beep Baseball, but many people do not choose these sports or have access to these resources. Instead they may exercise on stationary equipment in the home, or not exercise at all. As a result, people who are blind or low vision are more likely to be obese than people who are sighted .
Interactive technologies that enhance exercise for people who are blind or low vision can increase independent access in the home, gym, or outdoor spaces. Adapting existing exercise games (exergames) or inventing new exergames (see the related work section of  for a survey as of fall 2015) can make in-home exercise more accessible. Additionally, mobile devices can enable people who are visually impaired to engage in outdoor activities including hiking. Along with innovation, it is important to consider the risks (e.g., safety) and how designers can account for these risks in their designs. Here, I will discuss related research and new opportunities for technology to make an impact in this area, along with design considerations .
Private exercise enables people to learn and participate in physical activities on their own schedules without being surrounded by others. Technologies such as body tracking (e.g., Wiimote, Microsoft Kinect), audio feedback, and haptic feedback can support this kind of private exercise instruction.
For example, I built Eyes-Free Yoga , which uses body tracking and verbal feedback to make yoga instruction accessible for people who are blind or low vision. I collaborated with researchers and yoga instructors to design, develop, and evaluate the system. Eyes-Free Yoga includes both accessible instructions that were developed by a yoga instructor and real-time, personalized verbal feedback for standing postures based on a person's current position (Figure 1). We assessed a person's yoga posture by checking the relevant body angles (e.g., angle of elbow joint). For each asana, we determined a set of rules that a person should follow based on the angles and relative positions of joints. We determined the rules after reading yoga resources and asking yoga instructors for common errors. In addition, I interviewed one yoga instructor at a yoga studio about the important and unimportant aspects of each pose.
|Figure 1. The six standing yoga postures where Eyes-Free Yoga provides real-time, personalized feedback.
When a person holds a standing yoga posture and performs a common error, Eyes-Free Yoga detects the error and speaks aloud a verbal correction to fix the issue. For example, Eyes-Free Yoga can calculate that the "armpit" angle is currently 45 degrees and the proper angle should be at least 80 degrees. The game responds with "Bring your arms closer to your head" (Figure 2).
|Figure 2. In Warrior II Pose, her arms are at 45 degrees and need to be raised to ≥ 80 degrees. Eyes-Free Yoga responds with a verbal correction: "Bring your arms closer to your head."
In our evaluation, we compared Eyes-Free Yoga, containing verbal instructions and real-time, personalized verbal feedback, to only receiving verbal instructions. We recruited 16 participants who were blind or low vision to participate in our study. The participants performed yoga postures both with and without personalized feedback. Our results showed that participants preferred Eyes-Free Yoga because they can hear how they are performing during their workout: "I'm glad to know that it actually tells you how you are doing because I wasn't sure on the first few [poses] if I was doing it right" . (Eyes-Free Yoga is available for download at http://eyesfreeyoga.kyle-rector.com.)
In recent research, we found that there are also opportunities to enhance exercises that are social or "in the wild" . We conducted semi-structured interviews with 10 people who are blind or low vision of different fitness levels, and 10 people who played a role in exercise for people who are blind or low vision (e.g., sighted guides, coaches). We also conducted a survey with 76 people in the general population. Below, I discuss the opportunities and considerations that emerged from our research.
Social exercise for people who are blind or low vision is valuable for developing a sense of community. There are several organizations (e.g., United States Association of Blind Athletes (USABA)) and sports (e.g., Goalball) that exist to support social exercise. However, many people may not be able to participate due to their location, athletic ability, or interest. Therefore, future interactive technology solutions have the potential to complement these organizations to reach a wider audience.
For example, Grabski et al.  explored techniques to create a competitive exergame that can be played by people who are both visually impaired and sighted. The game provides visual feedback for the sighted player and haptic, wind, and surround audio feedback for the player who is blind or low vision. They found that the players had an enjoyable experience while maintaining fairness in gameplay.
In our research, we found that technology can also enhance the experience of blind and low-vision people during mainstream exercise classes . In interviews, blind exercisers described how they did not enjoy mainstream classes: "I did that for about a few weeks and they came and told me they would like me to have special lessons by myself.... I was so offended and I never went back" .
Social exercise for people who are blind or low vision is valuable for developing a sense of community.
Descriptive verbal instructions may provide benefit when learning an exercise, as with Eyes-Free Yoga . We presented a hypothetical exercise idea to the different stakeholders. In this scenario, a person uses one headphone to hear extra feedback while in a mainstream exercise class. People in our interviews responded positively because they could receive the extra information they needed when the instructor was not available: "The instructor cannot take time to come around to each person" .
Though headphones may help, it is possible that wearing headphones may reduce people's ability to follow along with the instructor or listen to their surroundings. One of the interviewees said, "I would not wear headphones if it would distract me from hearing the instructor" . Additionally, exercise instructors would need to be on board with using an adaptive technology. To make this idea feasible, it may be advantageous to develop a minimally invasive solution that uses one headphone, bone conduction headphones, haptic feedback, or a system that presents feedback only when the instructor is not speaking.
Accessible exercise in the wild provides people who are blind or low vision with the ability to exercise outdoors and interact with others who exercise. There are organizations that encourage outdoor exercise such as Ski for Light, but they may not be available to many people who are blind or low vision due to their location, athletic ability, or interest. Interactive technologies could complement these efforts to provide more people with access to outdoor exercise. Below, I describe two ideas: helping people navigate exercise spaces and complementing a sighted guide by providing information directly to the athlete.
One way to enable rigorous exercise in the wild is to help people navigate existing exercise spaces such as a running track, swimming pool, or gym. Stationary rigorous activity  may become monotonous and feel less productive: "I know it's kind of ridiculous to expend all of that effort and not even move an inch" . While there are possible safety concerns, participants have a desire to engage in more open exercises , including rigorous physical activity outdoors. We presented another hypothetical exercise idea to the participants: help someone who is blind navigate a running track. It consisted of a mounted camera and headphones, and gave feedback—whether or not they were staying in their lane, nearby obstacles. While we noticed enthusiasm for the idea, people wanted a viable backup plan in case something went wrong: "Find someone to do it with or switch to an indoor equivalent where a sighted person isn't necessary" . Eelke Folmer used aerial robots to guide runners who are blind or low vision around a running track ; using the sound from the aerial robot, the runner would be able to follow the sound without needing to wear any on-body sensors or actuators.
Wearing headphones may reduce people's ability to listen to their surroundings.
We also found another opportunity to develop interactive technologies to complement the strengths of a sighted guide. According to the United States Association for Blind Athletes (USABA), "Often runners are hesitant to serve as guide runners, fearing they will do something or not do something that could result in injury or a poor performance for the blind athlete." If a sighted guide has to exercise at the level of the athlete while providing frequent verbal communication, this may discourage people from volunteering. Innovative lightweight technologies may offset the amount of communication needed while exercising. A sighted guide interviewee mentioned, "There are the verbal cues that I do give throughout the race, all the better that it could be technology because here again that's one of the pressures on the guide—to not only run as fast as the athlete but also talk at the higher level" . For example, technology could provide knowledge about the environment or other athletes in a race by using transponders on the athletes.
One consideration when designing interactive technology for exercise in the wild is that it is important for someone to have an awareness of his or her environment. For example, if someone was hearing constant auditory feedback through their headphones while outside, this could pose a serious safety risk. As mentioned by an interviewee, "It's a big world outside, and it can be everything from being accosted by somebody to traffic ... You still need your hearing whenever you're in public" . With impaired hearing, someone may miss unexpected obstacles such as a flying football while running around a track. With this type of work, designers should account for safety. With piloting, training, and proper fail cases, this line of research has the potential to expand exercise opportunities for people who are blind or low vision.
There is an opportunity for HCI researchers and designers to develop interactive technologies to enhance exercise for people who are blind or low vision. It is important to engage with this community and domain experts either as active members of the research group or as consultants. This area of research and innovation has several benefits: 1) there is a direct impact for people who are blind or low vision, 2) this work can benefit people who are sighted and prefer not to consume visual information while exercising, and 3) this work can inform a more inclusive design of existing interactive exercise technologies.
2. Rector, K., Milne, L., Ladner, R.E., Friedman, B., and Kientz, J.A. Exploring the opportunities and challenges with exercise technologies for people who are blind or low-vision. Proc. of the 17th International ACM SIGACCESS Conference on Computers & Accessibility. ACM, New York, 2015, 203–214; http://dx.doi.org/10.1145/2700648.2809846
3. Rector, K., Bennett, C.L., and Kientz, J.A. Eyes-free yoga: An exergame using depth cameras for blind & low vision exercise. Proc. of the 15th International ACM SIGACCESS Conference on Computers and Accessibility. ACM, New York, 2013, Article 12; http://dx.doi.org/10.1145/2513383.2513392
4. Grabski, A., Toni, T., Zigrand, T., Weller, R., and Zachmann, G. Kinaptic - Techniques and insights for creating competitive accessible 3D games for sighted and visually impaired users. Proc. of 2016 IEEE Haptics Symposium. IEEE, 2016, 325–331; http://dx.doi.org/10.1109/HAPTICS.2016.7463198
6. Folmer, E. Exploring the use of an aerial robot to guide blind runners. SIGACCESS Access. Comput. 112 (July 2015), 3–7; http://dx.doi.org/10.1145/2809915.2809916
Kyle Rector is an assistant professor at the University of Iowa Department of Computer Science. In her research, she designs, develops, and evaluates accessible technologies for people who are blind or low vision to enhance quality of life through activities including exercise and exploring art. [email protected]
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