JMIR Publications

ABSTRACT

Background:

Mobile e-health applications have been used as a complementary treatment to increase the quality of life of patients and provide new opportunities for the management of rheumatic diseases. Telemedicine, particularly in the areas of prevention, diagnostics, and therapy, has become an essential cornerstone in the care of patients with rheumatic diseases. Ankylosing spondylitis (AS) is an inflammatory process that affects mainly young patients and can lead to spinal deformities. Aside from anti-inflammatory drug therapy, physical therapy can improve the range of motion and maintain the mobility of AS patients. Guidelines recommend a combination of daily stretching and strengthening exercises to reduce inflammation and prevent stiffness in AS. The advancements of mobile e-health applications can facilitate physical exercises for AS patients. In previous work, we have developed a prototype of a mobile e-health application called YogiTherapy, which offers yoga exercises developed for AS patients via video tutorials and standardized tests for self-assessments to track disease progression. Patients can thus exercise flexibly and independently under professional guidance from home.

Objective:

To improve the design and technology of YogiTherapy, and evaluate its usability and quality.

Methods:

We newly implemented the mobile e-health application YogiTherapy with a modern design, the option to change language, and easy navigation to improve the app's usability and quality for patients. After refinement, we evaluated the application by conducting a study with 16 AS patients (4 females; 12 males; age: 48.1 ± 16.8 years). In the study, we assessed the usability of YogiTherapy with the task performance test (TPT) with think-aloud protocol and the quality with the German version of the mobile app rating scale (MARS-G).

Results:

In the TPT, the participants had to solve six tasks that should be performed on the app. The overall task completion rate in the TPT was high (87.5%). Filtering for videos and navigating to perform an assessment test caused the largest issues during the TPT while registering in the app and watching a yoga video was highly intuitive. Additionally, 12 of the 16 participants filled the MARS-G. The quality of YogiTherapy was rated with an average MARS score of 3.79 ± 0.51 from a maximum score of 5. Furthermore, results from the MARS questionnaire demonstrated a positive evaluation regarding functionality and aesthetics.

Conclusions:

The refined and tested YogiTherapy app showed promising results among most participants. In the future, the application could serve its function as a complementary treatment for AS patients. For this purpose, surveys with a larger number of patients should still be conducted. As a substantial advance, we see the free and open availability of the application as we made it available in the IOS App and Google Play store. Clinical Trial: There was no trial registration necessary.