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Currently submitted to: JMIR Formative Research

Date Submitted: Dec 4, 2025
Open Peer Review Period: Dec 8, 2025 - Feb 2, 2026
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High user satisfaction and recommendation rates of a digital exercise and disease management app for patients with axial Spondyloarthritis: 12-week user experience survey

  • Hannah Labinsky; 
  • Amelie Wuest; 
  • Patricia Possler; 
  • Tobias Heusinger; 
  • Maxime le Maire; 
  • Anna Fleischer; 
  • Karsten Sebastian Luetkens; 
  • Michael Gernert; 
  • Ottar Gadeholt; 
  • Robert Leppich; 
  • Astrid Schmieder; 
  • Ludwig Hammel; 
  • Billy Sperlich; 
  • Matthias Fröhlich; 
  • Marc Schmalzing; 
  • Patrick-Pascal Strunz

ABSTRACT

Background:

Axia is a digital therapeutic (DTx) that provides a disease-specific and patient-tailored home-based exercise program for axial spondyloarthritis patients (axSpA). The app combines structured exercise with patient education and disease-management features and has a strong emphasis on gamification and behavioral conditioning to maximize long-term adherence. However, it has remained unclear how Axia is perceived and evaluated by patients

Objective:

This study aimed to describe the specific gamification elements implemented in Axia and evaluate their impact on perceived app quality, user experience, and likelihood of recommending the app to others after 12 weeks of use.

Methods:

This single-center study was conducted at an outpatient rheumatology clinic. After 12 weeks of ad libitum app use, 27 participants with axSpA completed paper-based assessments of the user version of the Mobile Application Rating Scale (uMARS, range 0-5) and the Net Promoter Score (NPS, range -100% - 100%).

Results:

The mean overall uMARS app quality score was 4.44 (SD 0.43). Functionality received the highest mean score (4.54, SD 0.53), while information received the lowest (4.34, SD 0.49). The mean NPS rating was 9.52 (SD 0.75), corresponding to an overall NPS of 92.6%. The uMARS overall quality score correlated strongly with the NPS (ρ=0.57, p=0.002). No associations were found between age or sex and either uMARS scores or NPS.

Conclusions:

The mean overall uMARS app quality score was 4.44 (SD 0.43). Functionality received the highest mean score (4.54, SD 0.53), while information received the lowest (4.34, SD 0.49). The mean NPS rating was 9.52 (SD 0.75), corresponding to an overall NPS of 92.6%. The uMARS overall quality score correlated strongly with the NPS (ρ=0.57, p=0.002). No associations were found between age or sex and either uMARS scores or NPS. Clinical Trial: DRKS-ID: DRKS00038067


 Citation

Please cite as:

Labinsky H, Wuest A, Possler P, Heusinger T, le Maire M, Fleischer A, Luetkens KS, Gernert M, Gadeholt O, Leppich R, Schmieder A, Hammel L, Sperlich B, Fröhlich M, Schmalzing M, Strunz PP

High user satisfaction and recommendation rates of a digital exercise and disease management app for patients with axial Spondyloarthritis: 12-week user experience survey

JMIR Preprints. 04/12/2025:88949

DOI: 10.2196/preprints.88949

URL: https://preprints.jmir.org/preprint/88949

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