JMIR Publications

ABSTRACT

Background:

Osteoarthritis is one of the most common degenerative musculoskeletal conditions and can result in necessity of surgeries such as total hip arthroplasty. Physical activity is one important preventive as well as rehabilitative measure and training physiological movement patterns is an enabler for treatment of corresponding functional deficits. Motivation to train in a frequent manner is of utmost importance and can be promoted by using digital real-time feedback.

Objective:

Main objective of this qualitative study was to gather user recommendations for prototype on-screen visualizations of a real-time exercise feedback system called homeSETT for functional deficits in the lower extremity. The homeSETT system gives real-time feedback to participants while performing exercises and focuses on three movement deviations. Findings should help optimizing the system. Thus, main research questions were how patients, physiotherapists and physicians evaluate the presented, current state of real-time visual feedback for selected functional exercises and what improvements and variations would be recommended.

Methods:

The paper describes a qualitative study to evaluate usability factors for prototype on-screen visualization for the homeSETT system. Data on usability factors was acquired using the Thinking Aloud method during and semi-structured interviews after the prototype testing. Transcribed audio recordings of the semi-structured interviews as well as scribing protocols of the Thinking Aloud method were examined using qualitative content analysis.

Results:

Nine participants could be recruited for the study, thereof two patients, two physicians and five physiotherapists. Each participant tested eleven different exercise feedback combinations. The overall results showed that participants enjoyed the prototype feedback-visualizations, and they assumed, that systems such as homeSETT could be applicable in a therapy setting. Participants appreciated that the visualizations were simple, clear, and self-explanatory. Most participants needed a short period of familiarization with the system, some had problems with recognizing the goal setting of the feedback itself and connecting the feedback visualization to their actual movement. In addition, recommendations for optimizing the system in terms of displayed color-schemes, sensitivity, difficulty adjustment and adding information as well as game design elements such as repetition counting, or reward systems were considered useful. Already implemented reward-based positive feedback and gamification elements were described as joyful and motivating. Main limitations of the study are small sample size as well as use of only one feedback modality, namely feedback on performance.

Conclusions:

The prototype on-screen visualizations for the homeSETT system were perceived positively by the participants and regarded as useful in rehabilitation scenarios. Insights were gathered for further improving the visualization and the design as well as implementing further gamification elements for positive feedback. Future work will include optimizing the homeSETT system following the study’s findings and future research will focus on evaluating the efficacy of the homeSETT system within a clinical trial.