JMIR Publications

ABSTRACT

Background:

Home-based exercise is an important part of physical therapy treatment for patients with low back pain. However, treatment effectiveness depends heavily on patient adherence to home-based exercise recommendations. Smartphone applications designed to support home-based exercise have the potential to support adherence to exercise recommendations and potentially improve treatment effects. A better understanding of patient perspectives on the use of smartphone applications to support home-based exercise during physical therapy treatment can assist physical therapists with optimal use and implementation of these applications in clinical practice.

Objective:

The aim of this study is to investigate patient perspectives on the acceptability, satisfaction, and performance of a smartphone application to support home-based exercise following recommendations from a physical therapist.

Methods:

Using a interpretivist phenomenology approach, nine patients with non-specific low back pain recruited from two primary care physical therapy practices were interviewed within two weeks after treatment ended. The Physitrack® smartphone application was used to support home-based exercise as part of treatment for all patients. Data was analyzed using a framework approach to assist with interpretation of the data.

Results:

Data-analysis revealed eleven categories distributed among the three themes “acceptability”, “satisfaction”, and “performance”. Patients are willing to accept the application as part of treatment when it is easy to use, benefits the patient, and when the physical therapist instructs the patient in its use. Satisfaction with the app is determined by the perceived support from the application when exercising at home and the perceived increase in adherence. The video and text instructions, reminder functions, and self-monitor functions are considered most important for performance during treatment. The patients did not view the Physitrack® app as a replacement for the physical therapist and relied on their therapist for instruction and support when needed.

Conclusions:

Patients who used an app to support home-based exercise as part of treatment are accepting of the app when it is easy to use, benefits the patient, and the therapist instructs the patient in its use. Physical therapists using an app to support home-based exercise can use the findings from this study to more effectively support their patients when exercising at home during treatment.