JMIR Publications

ABSTRACT

Background:

People with Achilles tendinopathy (AT) experience persistent pain which can limit engagement with daily occupations and negatively impact mental health. Current therapeutic exercise approaches vary in success, with many people experiencing reinjury resulting in a cycle of chronic tendinopathy often lasting years. High magnitude precision loading may help people to exit this feedback cycle, but applying these principles clinically is challenging.

Objective:

This study aimed to develop and evaluate a prototype of the ‘PhysViz’ system, a novel remote rehabilitation intervention for AT management, following the Framework for Accelerated and Systematic Technology-based intervention development and Evaluation Research (FASTER).

Methods:

The development process engaged a multidisciplinary team comprising people with AT experiences, clinicians, and engineers. It followed the five stages within the FASTER development phase, encompassing empathizing with users, defining the problem, generating intervention ideas, prototyping intervention components, and testing prototypes. PhysViz development and evaluation were informed by needs assessments, surveys, literature reviews, case studies, roundtable discussions, and usability testing. The FASTER systematically guided the integration of evidence-based features and behavior change theory.

Results:

By using the FASTER and ensuring the PhysViz system was underpinned by diverse stakeholder needs, this work resulted in the development of a working prototype for both the PhysViz physical exercise tool and the accompanying PhysViz software package (mobile and web applications). A variety of study designs informed user-desired features that were integrated into the PhysViz prototype including real-time biofeedback in the form of precision load monitoring, customizable exercise programs, and pain tracking. Additionally, clinicians can visualize client-data longitudinally and make changes to client exercise prescriptions remotely based on objective data. Identified areas for improvement, such as upgrading the user interface/user experience, and expanding clinical applications, provides valuable insights for future PhysViz iterations. Further research is warranted to assess the long-term efficacy and feasibility of the PhysViz in diverse clinical settings, evaluating its potential to improve AT symptoms.

Conclusions:

Being one of the first technology development initiatives guided by FASTER, this study exemplifies a systematic and multidisciplinary approach to creating a remote rehabilitation intervention. By incorporating stakeholder feedback and evidence-based features, the PhysViz addresses key challenges in AT rehabilitation, offering a novel solution for precision loading and therapeutic exercise engagement. Positive feedback from users and clinicians underscores the potential impact of the PhysViz in improving AT management outcomes. The PhysViz serves as a model for technology-based intervention development, with potential implications for other tendinopathies and remote rehabilitation strategies.