JMIR Publications

ABSTRACT

Background:

Exergames are increasingly used in rehabilitation, but their usability and user experience for patients and therapists are not well-studied, especially for functional model systems.

Objective:

This study aimed to evaluate the usability, safety, and user experience of a novel exergame functional model, the ExerG, from the perspectives of patients and therapists in a rehabilitation setting.

Methods:

In this mixed-methods study, 15 patients (primary end-users, PEU) and 20 therapists (secondary end-users, SEU) from two rehabilitation centers in Switzerland and Austria participated in Exercising and Observation sessions with the ExerG. SEU received training on system use and technical issue management, enabling them to effectively fulfill their therapist roles while treating patients or mock patients during evaluation. Usability was assessed with questionnaires, semi-structured interviews, and through observations during the ExerG testing.

Results:

Patients and therapists reported overall good usability and positive experiences with the exergame, despite challenges related to its functional model status. Overall, 79.3% of PEU rated the clarity of instructions as acceptable, while 65.5% demonstrated good-to-very-good exercise performance, with 96.6% of tasks completed. Patients showed improved performance and enjoyment across ExerG Exercising Rounds, with over 90% expressing positive emotions such as enjoyment, curiosity, attention, and amazement. No adverse events were reported. Most patients enjoyed the training and indicated a willingness to continue using the device if improvements were made, including better graphic design, upgraded tracking systems, and enhanced projector quality. They suggested increasing the variety of game activities and difficulty levels. Although most PEU understood the instructions and feedback, they preferred shorter, clearer directives with adequate reading time. PEU felt secure in the comfortable safety harness but recommended enhancements to the swivel arm's movements for improved balance control. SEU executed scenarios effectively, with hesitation and difficulties observed in only 1.7% and 0.2% of the 820 total task cases, respectively; however, they identified areas for optimization. Quantitative usability ratings were high, with a median System Usability Scale score of 82.5 for therapists. They noted that video-game-based training could enhance patient motivation through engaging design and surprise elements, making sessions more enjoyable than traditional therapy. SEU found the activities beneficial for both physical and cognitive functions but suggested incorporating exercises that simulate daily living tasks and offering a broader selection of customizable options. They appreciated the audio-visual feedback and star awards but called for more specific motivational feedback and simplified performance summaries. For independent training, SEU recommended clearer, shorter activity instructions that remain visible until acknowledged, emphasizing the importance of the patient's cognitive and physical condition.

Conclusions:

The interdisciplinary, iterative development approach of the ExerG shows promise. Findings will inform future optimizations. Future work will assess long-term impact. Clinical Trial: ClinicalTrials.gov ID NCT05967078; OSF Preregistration OSF.IO/CQ9AT