Accepted for/Published in: JMIR Human Factors
Date Submitted: May 9, 2023
Date Accepted: Oct 5, 2023
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Usability and acceptance of a newly developed exergame-based telerehabilitation system for older adults
ABSTRACT
Background:
Telerehabilitation is gaining in relevance as a tool to provide and supervise a therapy/ training, which can be equally effective as traditional rehabilitation methods, yet more accessible and affordable. An exergame-based telerehabilitation system was recently developed within the scope of the international COCARE-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 at analyzing the usability, acceptability, and enjoyment of the whole COCARE-system for use in older adults (OAs).
Methods:
In total, 45 OAs and 15 HPs (15 OAs and 5 HPs in each of the three trial sites (Switzerland, Italy, and Cyprus)) were invited to try out the system in a single session. Mixed methods (qualitative and quantitative questions and questionnaires) were applied to analyze OAs’ and HPs’ perceptions of the system and to figure out possible barriers to its implementation in a home setting. In addition, potential usability-influencing factors (i.e., performance during gameplay, demographics, and training-related contextual factors) were explored.
Results:
The COCARE-system received good acceptance ratings (83.2% (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) while playing the exergames. The system´s usability, assessed with the System Usability Scale, was rated with a score of 68.1±18.8 (OAs), respectively 70.6±12.2 (HPs) out of 100 points, whereas significant differences between the trial sites were observed. A number of requirements and recommendations for improvement were revealed. Mostly mentioned barriers to adoption included the movement-recognition sensitivity of the Senso Flex, its limited markings, and difficulties understanding certain instructions of assessments and games.
Conclusions:
The results of this study will serve as input to the further development of the COCARE-system towards a user-friendly and accepted version, aiming to stimulate older adult’s cognitive and physical functions. Feasibility and effectiveness of the system should further be evaluated in future randomized controlled trials.
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