JMIR Publications

ABSTRACT

Background:

Mobile health (mHealth) technologies offer scalable opportunities to support home-based exercise programs. However, most commercially available apps are not tailored to individuals with spinal cord injury (SCI) and have rarely been evaluated for usability and implementation outcomes in this population.

Objective:

This study aims to assess the acceptability, appropriateness, feasibility, and quality of a mobile app-based intervention designed to support exercise adherence in individuals with SCI.

Methods:

We conducted a convergent parallel mixed-methods study using quantitative data from standardized measures and qualitative feedback from focus groups. Twelve individuals with SCI (mean age = 50.5 years; 6 males [50%]; 8 Whites [67%]; 6 with thoracic injuries [50%]; 6 ambulators [50%]) engaged in a customized exercise regimen using the app for two weeks. Acceptability, appropriateness, and feasibility of this mobile intervention were assessed using the Acceptability of Intervention Measure (AIM), Intervention Appropriateness Measure (IAM), and Feasibility of Intervention Measure (FIM). The objective and subjective qualities, and the perceived impact of the app were evaluated using the User Version of the Mobile Application Rating Scale (uMARS).

Results:

Using a cut-off score > 4 out of 5, 8 of 12 participants (67%) rated the app as highly acceptable and feasible, and 6 of 12 (50%) rated it as highly appropriate. The objective quality of the app was rated 3.57 out of 5 on the uMARS. At the scale-level (reported as mean ± standard deviation), information received the highest score (4.10 ± 0.52), with functionality (3.51 ± 0.66) and aesthetics (3.50 ± 0.70) closely following. Engagement scored lowest (3.18 ± 0.72). The app’s subjective quality averaged 3.27 ± 0.88, and its perceived impact on exercise adherence was rated 3.79 ± 0.92. Qualitative feedback indicated customization, access to professional support, and SCI-specific exercises are positive features. Areas for improvement included bug fixes and enhanced features to boost engagement.

Conclusions:

The smartphone-based app demonstrates adequate acceptability and feasibility, along with high information quality and favorable usability, for supporting exercise adherence in individuals with SCI. Improvements in engagement features are recommended to enhance sustainable implementation.