Development and feasibility testing of a remote support application for adherence to home exercise programs: a randomized pilot study

Adedoyin, Rufus A, Makinde, John O, Ademoyegun, Adekola B, Fatoye, Francis ORCID: https://orcid.org/0000-0002-3502-3953 and Mbada, Chidozie E ORCID: https://orcid.org/0000-0003-3666-7432 (2023) Development and feasibility testing of a remote support application for adherence to home exercise programs: a randomized pilot study. Progress in Rehabilitation Medicine, 8. 20230045. ISSN 2432-1354

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Abstract

Objectives: Poor adherence to home exercise programs (HEPs) is a significant barrier to continuity of care and eventual outcomes, thus requiring innovative mitigating approaches. This study aimed to develop and test the feasibility of a remote support application (RSA) designed to encourage adherence to HEPs. Methods: Using standard computer programing, an RSA with administrator and user interfaces was developed for mobile phone or tablet. Consenting patients receiving physiotherapy for musculoskeletal conditions (n=19) were randomly assigned into the experimental group (n=10) or the control group (n=9). The experimental group received their customized HEP reminders via the RSA, whereas the control group used conventional paper handouts for HEPs. Adherence to HEPs was assessed over 4 weeks. The feasibility of the RSA was assessed using the Mobile Application Rating Scale and System Usability Scale (SUS) questionnaires. Data were summarized using descriptive and inferential statistics. Results: The adherence rate of patients in experimental group was significantly higher than that of patients in the control group after 2 weeks [median diff.=−6.0, 95% confidence interval (CI): −8.0 to −5.0; U=5.00; Z=−3.304; P=0.001; r=0.75] and 4 weeks (median diff.=−7.0, 95% CI: −8.0 to −5.0; U=0; Z=−3.695; P<0.001; r=0.84) of intervention. The RSA had a mean SUS score of 82.53±9.04 (out of 100) and a mean app quality rating score of 75.95±4.98 (out of 95). Conclusions: The use of an RSA to improve adherence to HEPs is feasible for patients with musculoskeletal conditions.