Accepted for/Published in: JMIR Human Factors
Date Submitted: May 9, 2023
Date Accepted: Oct 5, 2023
A newly developed exergame-based telerehabilitation system for older adults: A usability and technology acceptance study
ABSTRACT
Background:
Telerehabilitation has gained significance as a tool to deliver and supervise a therapy/ training equally effective as traditional rehabilitation methods, yet more accessible and affordable. An exergame-based telerehabilitation system has recently been developed within the scope of the international COCARE (Continuum-of-Care) project. The system comprises training devices for the use in clinics (Dividat Senso) and at home (Dividat Senso Flex), an assessment system, and a rehabilitation-cockpit and its focus lays on a home-based, combined cognitive and physical training, which is remotely managed by healthcare-professionals (HPs).
Objective:
The present study aimed to analyze usability, acceptability, and enjoyment of the COCARE-system from the perspective of primary end-users (older adults (OAs)) and secondary end-users (HPs).
Methods:
A total of 45 OAs and 15 HPs (15 OAs and 5 HPs at each of three trial sites: Switzerland, Italy, and Cyprus) participated in a single-session trial of the COCARE-system. Mixed methods, including qualitative and quantitative questions and questionnaires, were employed to analyze the participants´ perceptions of the system and identify potential barriers to its implementation in a home setting. Additionally, potential usability-influencing factors, such as performance during gameplay, demographics, and training-related contextual factors, were explored.
Results:
The COCARE-system achieved good acceptance ratings (83% (OAs) and 81% (HPs) of the maximum score) and OAs indicated high enjoyment (73.3±12.7 out of 100 points in the Exergame Enjoyment Questionnaire) during the exergame session. The system´s usability, assessed with the System Usability Scale, received scores of 68.1±18.8 (OAs) and 70.6±12.2 (HPs) out of 100 points, with significant differences observed between the trial sites. Several requirements and recommendations for improvement were identified. Commonly mentioned barriers to adoption included the movement-recognition sensitivity of the Senso Flex, its limited markings, and difficulties in understanding certain instructions for assessments and games.
Conclusions:
The study´s findings will inform the further development of the COCARE-system towards a user-friendly and widely accepted version, enhancing cognitive and physical functions in OAs. Future randomized controlled trials (RCTs) should evaluate the system´s feasibility and effectiveness.
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