JMIR Publications

ABSTRACT

Background:

Huntington’s Disease (HD) is an incurable neurodegenerative disease that leads to the progressive loss of cognitive and motor functions and mood disturbances, largely due to basal ganglia atrophy. Currently, there are no therapeutic interventions tailored to address cognitive and motor impairment in people with HD. Using an integrated knowledge translation (IKT) framework we developed the HD-DRUM intervention, a tablet-based rhythmic movement training application, with the aim to stimulate basal ganglia reliant cognitive and motor abilities in people with HD.

Objective:

The primary aim was to develop the HD-DRUM intervention for people with HD. Here we describe the IKT-based process, involving knowledge user engagement, co-design, and iterative usability testing for design refinement.

Methods:

The IKT framework was applied to iteratively refine the design of the HD-DRUM application. This process involved three phases of knowledge user engagement and co-design including an online survey into the use of digital technologies and usability testing for design refinement in people with HD. The developed HD-DRUM intervention was described according to the template for intervention description and replication (TIDieR) checklist.

Results:

Barriers and facilitators of using digital technologies were identified. Tablets with touch screens were identified as a feasible and accessible platform to deliver the application. Key elements to ensure that the application design and build met the needs of people with HD were identified. The developed tablet-based HD-DRUM intervention can be used at home and allows the quantification of performance changes, remote monitoring of adherence, matching of training difficulty to users’ performance levels using gamification, and future scaling-up for reaching a wide range of interested users.

Conclusions:

Applying iterative usability testing within the IKT framework allowed the refinement of the design and build of a novel tablet-based intervention to target cognitive and motor functions in people with HD. Mapping the intervention against the TIDieR framework for describing complex interventions, allowed the detailed description of the HD-DRUM intervention and identification of areas that required refinement prior to finalising the intervention protocol.