JMIR Publications

ABSTRACT

Background:

Evidence suggests that older adults can improve dual-task (DT) performance through specific motor-cognitive training programs. Recent technological advancements have enabled novel rehabilitative DT methodologies. The DUAL-REHAB project exploits 360° technology to develop ecological, cost-effective DT exercise scenarios for clinical and home settings.

Objective:

Using a user-centered design (UCD) approach, this study aimed to 1) Comprehensively understand the DUAL-REHAB project's end users (older adults with Subjective Memory Complaints – SMC - and Mild Cognitive Impairment - MCI); 2) Obtain feedback on an initial DUAL-REHAB mobile application prototype.

Methods:

The study employed a two-phase procedure. User requirements: Investigated end users' lifestyles, habits, perceived well-being, technology adoption, and expectations regarding cognitive and cognitive-motor DT training. Prototype evaluation: Developed and tested a DUAL-REHAB mobile application prototype with end users to assess functionality.

Results:

The study included 14 participants (7 females, mean age 79 ± 3.79; 7 males, mean age 82.43 ± 5.65), of which 8 were categorized as MCI and 5 as SMC. One female participant was excluded because she did not meet the criteria for either of the two groups. Participants reported structured daily routines with high autonomy, though some faced challenges with social connections. Perceived well-being was moderate across physical (M = 2.79, SD = 0.97), psychological (M = 3.14, SD = 0.86), and cognitive (M = 3.14, SD = 0.53) domains. Perceived technology skills were poor (M = 2.57, SD = 0.94), with low digital literacy (M = 2.21, SD = 0.89). Interest in cognitive training was high, with twelve participants aware of its benefits and demonstrating strong interest (M = 4.15, SD = 1.34) and perceived utility (M = 4.15, SD = 1.28). While only six were aware of the possibility of DT training with technology, twelve were willing to participate, and eleven were open to home-based training. Preferred frequency was 2-3 days/week (63.64%), with 10-20 minute sessions (72.72%). Prototype evaluation revealed some issues with icon identification, device interaction, and instruction comprehension.

Conclusions:

We obtained valuable insights into the lifestyles, habits, and technological needs of older adults with MCI and SMC, informing the future development of DUAL-REHAB training to align with user expectations and capabilities. The simplification of technological processes emerged as crucial, requiring intuitive and user-friendly interfaces. Our results also highlight the need for a pre-training system to familiarize participants with the application, potentially increasing engagement. Offering interaction opportunities during clinical sessions and at-home training could maintain motivation, address potential problems promptly, and fulfill participants' social interaction needs.