Usability and Effectiveness of an Individualized, Tablet-Based, Multidomain Exercise Program for People With Dementia Delivered by Nursing Assistants: Protocol for an Evaluation of the InCoPE-App

Abstract

Background The COVID-19 pandemic has had drastic consequences on everyday life in nursing homes. Limited personnel resources and modified hygiene and safety measures (eg, no external exercise instructors, no group settings) have often led to interrupted physical exercise treatments. As a consequence, people with dementia benefiting from individualized exercise programs are affected by the pandemic’s impact. Objective Our goal is to develop an easily applicable mobile application (Individualized Cognitive and Physical Exercise [InCoPE] app) allowing nursing assistants to test cognitive function and physical performance and subsequently train people with dementia through a multidomain, individualized exercise program. Methods We will evaluate the usability and effectiveness of the InCoPE-App by applying a mixed method design. Nursing assistants will use the InCoPE-App for 18 weeks to assess the cognitive function and physical performance of 44 people with dementia every 3 weeks and apply the individualized exercise program. We will record overall usability using questionnaires (eg, Post-Study System Usability and ISONORM 9241/10), log events, and interviews. Perceived hedonic and pragmatic quality will be assessed using the AttrakDiff questionnaire. Effectiveness will be evaluated by considering changes in quality of life as well as cognitive function and physical performance between before and after the program. Results Enrollment into the study will be completed in the first half of 2022. We expect an improvement in the quality of life of people with dementia accompanied by improvements in cognitive function and physical performance. The usability of the InCoPE-App is expected to be rated well by nursing assistants. Conclusions To date, there is no scientifically evaluated app available that enables nursing assistants without expertise in sports science to deliver an individualized exercise program among people with dementia. A highly usable and effective InCoPE-App allows nursing assistants to test cognitive function and physical performance of people with dementia and, based thereon, select and deliver an appropriate individualized exercise program based on the cognitive and physical status of an individual, even in times of a pandemic. Trial Registration German Register of Clinical Trials DRKS00024069; https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00024069 International Registered Report Identifier (IRRID) DERR1-10.2196/36247

A Tablet-Based App to Support Nursing Home Staff in Delivering an Individualized Cognitive and Physical Exercise Program for Individuals With Dementia: Mixed Methods Usability Study

“…To adjust the exercise plan to individual changes in cognitive and physical performance, the InCoPE-App reminds the nursing home staff to repeat and record cognitive and physical performance tests every 3 weeks. In general, the exercise plan integrated into the InCoPE-App consists of ritualized warm-up and cooldown and 2 individualized workout phases that integrate exercises for balance, mobility, and upper and lower body strength [ 45 ].…”

“…The cognitive and physical tests integrated into the InCoPE-App are oriented to recommendations for individuals with dementia [43,44]. On the basis of the individual performance results, each individual with dementia is assigned to one of four exercise clusters, which are integrated in the app [45]: (1) individuals with below-average cognitive and physical performance, (2) individuals with average cognitive performance and above average physical performance, (3) individuals with above average cognitive performance and below average physical performance, and (4) individuals with above average cognitive and physical performance. The clustering into these 4 groups is based on previous studies by our group that have demonstrated the need for individualization of PA programs for individuals with dementia [8][9][10]46].…”

Editorial for advances in human-centred dementia technology

“…As such, several research works have designed interventions to motivate physical exercise through gaming technologies or what is known as exergames. Studies have utilised a range of technologies to promote physical exercise, including VR (Eisapour et al, 2020;Muñoz et al, 2022;Rings et al, 2020), mobile applications (Barisch-Fritz et al, 2022) and gaming consoles (Liao et al, 2022). Many studies have highlighted the benefits of using exergames to promote physical exercise amongst PwD, including increased motivation to exercise regularly, or that exergames, unlike traditional exercising, sessions do not feel burdensome (Eisapour et al, 2018), individualised and tailored exercises to PwDs' capabilities helps PwD feel capable and motivated (Barisch-Fritz et al, 2022).…”

A Tablet-Based App to Support Nursing Home Staff in Delivering an Individualized Cognitive and Physical Exercise Program for Individuals With Dementia: Mixed Methods Usability Study (Preprint)

“…The cognitive and physical tests integrated into the InCoPE-App are oriented to recommendations for individuals with dementia [43,44]. On the basis of the individual performance results, each individual with dementia is assigned to one of four exercise clusters, which are integrated in the app [45]: (1) individuals with below-average cognitive and physical performance, (2) individuals with average cognitive performance and above average physical performance, (3) individuals with above average cognitive performance and below average physical performance, and (4) individuals with above average cognitive and physical performance. The clustering into these 4 groups is based on previous studies by our group that have demonstrated the need for individualization of PA programs for individuals with dementia [8][9][10]46].…”