A Mobile Phone–Based Gait Assessment App for the Elderly: Development and Evaluation

Abstract

Background Gait disorders are common among older adults. With an increase in the use of technology among older adults, a mobile phone app provides a solution for older adults to self-monitor their gait quality in daily life. Objective This study aimed to develop a gait-monitoring mobile phone app (Pocket Gait) and evaluate its acceptability and usability among potential older users. Methods The app was developed to allow older adults to track their gait quality, including step frequency, acceleration root mean square (RMS), step regularity, step symmetry, and step variability. We recruited a total of 148 community-dwelling older adults aged 60 years and older from two cities in China: Beijing and Chongqing. They walked in three ways (single task, dual task, and fast walking) using a smartphone with the gait-monitoring app installed and completed an acceptability and usability survey after the walk test. User acceptability was measured by a questionnaire including four quantitative measures: perceived ease of use, perceived usefulness, ease of learning, and intention to use. Usability was measured using the System Usability Scale (SUS). Interviews were conducted with participants to collect open-ended feedback questions. Results Task type had a significant effect on all gait parameters, namely, step frequency, RMS, step variability, step regularity, and step symmetry (all P values <.001). Age had a significant effect on step frequency (P=.01), and region had a significant effect on step regularity (P=.04). The acceptability of the gait-monitoring app was positive among older adults. Participants identified the usability of the system with an overall score of 59.7 (SD 10.7) out of 100. Older adults from Beijing scored significantly higher SUS compared with older adults from Chongqing (P<.001). The age of older adults was significantly associated with their SUS score (P=.048). Older adults identified improvements such as a larger font size, inclusion of reference values for gait parameters, and inclusion of heart rate and blood pressure monitoring. Conclusions This mobile phone app is a health management tool for older adults to self-manage their gait quality and prevent adverse outcomes. In the future, it will be important to take factors such as age and region into consideration while designing a mobile phone–based gait assessment app. The feedback of the participants would help to design more elderly-friendly products.

Remote Assessment of Functional Mobility and Strength in Older Cancer Survivors: Protocol for a Validity and Reliability Study

“…For example, some apps can distinguish between the sit-to-stand and stand-to-sit subphases of the chair stand test [ 30 ], or the sit-to-stand, walk, turn, walk, stand-to-sit subphases of the iTUG test [ 28 - 30 ]. To date, most of these instrumented performance measures are still being evaluated in large studies, such as the PreventIT trial in Europe [ 30 ], have been commercialized (and thus are more expensive) [ 28 , 29 ], or are still being refined and evaluated [ 26 , 27 , 31 , 32 ].…”

Implementing Mobile Health–Enabled Integrated Care for Complex Chronic Patients: Patients and Professionals’ Acceptability Study

“…The scores for acceptability (UC1: NPS +67%; UC2: NPS +45%) and usability (UC1: mean SUS score 79, SD 14; UC2: mean SUS score 68, SD 24) were outstanding. These results are better than most results obtained in existing mHealth tools targeting chronic patients, for example, mHealth tools aiming to improve quality of life in breast cancer survivors such as BENECA (NPS +7%) [ 31 ] or Oncokompas (NPS −36%) [ 32 ], an Intelligent Virtual Assistant for promoting behavior change and self-care in older people with type 2 diabetes (mean SUS 74, SD 13) [ 33 ], or a gait-monitoring mobile phone app for older users (mean SUS 60, SD 11) [ 34 ]. Similarly, interventions targeting surgical patients by means of education and communication apps have obtained positive results in terms of acceptability and usability [ 35 , 36 ], comparable with results obtained with automated phone messaging platforms [ 37 , 38 ].…”

Implementing Mobile Health–Enabled Integrated Care for Complex Chronic Patients: Patients and Professionals’ Acceptability Study (Preprint)

“…The scores for acceptability (UC1: NPS +67%; UC2: NPS +45%) and usability (UC1: mean SUS score 79, SD 14; UC2: mean SUS score 68, SD 24) were outstanding. These results are better than most results obtained in existing mHealth tools targeting chronic patients, for example, mHealth tools aiming to improve quality of life in breast cancer survivors such as BENECA (NPS +7%) [31] or Oncokompas (NPS −36%) [32], an Intelligent Virtual Assistant for promoting behavior change and self-care in older people with type 2 diabetes (mean SUS 74, SD 13) [33], or a gait-monitoring mobile phone app for older users (mean SUS 60, SD 11) [34]. Similarly, interventions targeting surgical patients by means of education and communication apps have obtained positive results in terms of acceptability and usability [35,36], comparable with results obtained with automated phone messaging platforms [37,38].…”