Refinement and Usability Analysis of an eHealth App for Ankylosing Spondylitis as a Complementary Treatment to Physical Therapy: Development and Usability Study (Preprint)

Abstract

BACKGROUND Mobile e-health applications have been used as a complementary treatment to increase the quality of life of patients and provide new opportunities for the management of rheumatic diseases. Telemedicine, particularly in the area of prevention, diagnostics, and therapy, has become an essential cornerstone in the care of patients with rheumatic diseases. Ankylosing spondylitis (AS) is an inflammatory process that affects mainly young patients and can lead to spinal deformities. Aside from anti-inflammatory drug therapy physical therapy can improve the range of motion and maintain the mobility of AS patients. Guidelines recommend a combination of daily stretching and strengthening exercises to reduce inflammation and prevent stiffness in AS. The advancements of mobile e-health applications can facilitate physical exercises for AS patients. In previous work, we have developed a prototype of a mobile e-health application called YogiTherapy, which offers yoga exercises and standardized assessments for AS patients. OBJECTIVE To improve the design and technology of YogiTherapy, and evaluate its usability and quality. METHODS We newly implemented the mobile e-health application YogiTherapy with a modern design, the option to change language, and easy navigation to improve the app's usability and quality for patients. After refinement, we evaluated the application by conducting a study with 16 AS patients (4 females; 12 males; age: 48.1 ± 16.8 years). In the study, we assessed the usability of YogiTherapy with the task performance test (TPT) with think-aloud protocol and the quality with the German version of the mobile app rating scale (MARS-G). RESULTS In the TPT, the participants had to solve six tasks. The overall task completion rate in the TPT was high (87.5%). Filtering for videos and navigating to perform a test caused the largest issues during the TPT while registering in the app and watching a video was highly intuitive. Additionally, 12 of the 16 participants filled the MARS-G. The quality of YogiTherapy was rated with an average MARS score of 3.79 ± 0.51 from a maximum score of 5. Furthermore, results from the MARS questionnaire demonstrated a positive evaluation regarding functionality and aesthetics. CONCLUSIONS The refined and tested YogiTherapy showed promising results amongst most of the participants. In the future, the application could serve its function as a complementary treatment for AS patients. As a substantial advance, we see the free and open availability of the application. CLINICALTRIAL No Trial Registration is necessary.