Currently submitted to: JMIR Rehabilitation and Assistive Technologies
Date Submitted: Dec 30, 2025
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Development and Usability Evaluation of a Mobile Health - Based Memory Exercise Application for Post Stroke Cognitive Rehabilitation in Indonesia
ABSTRACT
Background:
Post-stroke cognitive impairment (PSCI) is a common and disabling consequence of stroke that substantially limits functional recovery and quality of life. In low- and middle-income countries such as Indonesia, access to structured cognitive rehabilitation remains limited due to workforce shortages and geographic barriers. Mobile health–based cognitive rehabilitation applications may help address these challenges; however, culturally adapted and user-centered solutions remain scarce.
Objective:
Therefore, this study aimed to develop an early-stage prototype of a mobile phone–based memory exercise application for post-stroke cognitive rehabilitation in Indonesia and to explore user perceptions regarding design, usability, and content relevance.
Methods:
A qualitative prototypical development study was conducted following a six-step multimedia development framework. Eleven focus group discussions were held with 60 healthy adult participants from professional and non-professional backgrounds. Participants interacted with the prototype and provided feedback on usability, interface design, cultural relevance, and accessibility. Data were analyzed using qualitative content analysis with semiotic and conversational approaches
Results:
Four major themes emerged: (1) application and in-game design, (2) game concept and content, (3) technical aspects and navigation, and (4) game variability and accessibility. Participants emphasized the importance of adjustable text and image sizes, culturally familiar visual content, simplified navigation, and stable technical performance. The “memory box” game was perceived as the most engaging and cognitively challenging. Key usability issues included inconsistent scoring, interface bugs, and login complexity, which informed iterative refinements of the prototype.
Conclusions:
This qualitative development study provides foundational insights for refining a culturally adapted, mobile-based memory exercise application for post-stroke cognitive rehabilitation in Indonesia. The findings highlight the importance of user-centered and context-sensitive design in early-stage digital rehabilitation tools. Further development and clinical validation among stroke survivors are warranted before large-scale implementation.
Citation
Request queued. Please wait while the file is being generated. It may take some time.
Copyright
© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.