Physiotherapists' clinical use and acceptance of a telemonitoring platform during anterior cruciate ligament rehabilitation: a prospective clinical study.

PURPOSE: The aim of this study was to assess physiotherapists' clinical use and acceptance of a novel telemonitoring platform to facilitate the recording of measurements during rehabilitation of patients following anterior cruciate ligament reconstruction. Additionally, suggestions for platform improvement were explored. METHODS: Physiotherapists from seven Dutch private physiotherapy practices participated in the study. Data were collected through log files, a technology acceptance questionnaire and focus group meetings using the "buy a feature" method. Data regarding platform use and acceptance (7-point/11-point numeric rating scale) were descriptively analysed. Total scores were calculated for the features suggested to improve the platform, based on the priority rating (1 = nice to have, 2 = should have, 3 = must have). RESULTS: Participating physiotherapists (N= 15, mean [SD] age 33.1 [9.1] years) together treated 52 patients during the study period. Platform use by the therapists was generally limited, with the number of log-ins per patient varying from 3 to 73. Overall, therapists' acceptance of the platform was low to moderate, with average (SD) scores ranging from 2.5 (1.1) to 4.9 (1.5) on the 7-point Likert scale. The three most important suggestions for platform improvement were: (1) development of a native app, (2) system interoperability, and (3) flexibility regarding type and frequency of measurements. CONCLUSIONS: Even though health care professionals were involved in the design of the telemonitoring platform, use in routine care was limited. Physiotherapists recognized the relevance of using health technology, but there are still barriers to overcome in order to successfully implement eHealth in routine care.Implications for rehabilitationThe use and acceptance of the telemonitoring platform by physiotherapists for patients following anterior cruciate ligament reconstruction was limited.Suggestions made by therapists for platform improvement mainly related to user-friendliness and efficiency of workflow.Novel digital health technology needs to fit into daily routines, be easily accessible and easy to use for the end users.

Design of the user interface for "Stappy", a sensor-feedback system to facilitate walking in people after stroke: a user-centred approach.

Introduction: Sensor-feedback systems can be used to support people after stroke during independent practice of gait. The main aim of the study was to describe the user-centred approach to (re)design the user interface of the sensor feedback system "Stappy" for people after stroke, and share the deliverables and key observations from this process.Methods: The user-centred approach was structured around four phases (the discovery, definition, development and delivery phase) which were fundamental to the design process. Fifteen participants with cognitive and/or physical limitations participated (10 women, 2/3 older than 65). Prototypes were evaluated in multiple test rounds, consisting of 2-7 individual test sessions.Results: Seven deliverables were created: a list of design requirements, a personae, a user flow, a low-, medium- and high-fidelity prototype and the character "Stappy". The first six deliverables were necessary tools to design the user interface, whereas the character was a solution resulting from this design process. Key observations related to "readability and contrast of visual information", "understanding and remembering information", "physical limitations" were confirmed by and "empathy" was additionally derived from the design process.Conclusions: The study offers a structured methodology resulting in deliverables and key observations, which can be used to (re)design meaningful user interfaces for people after stroke. Additionally, the study provides a technique that may promote "empathy" through the creation of the character Stappy. The description may provide guidance for health care professionals, researchers or designers in future user interface design projects in which existing products are redesigned for people after stroke.Implications for rehabilitationThe case study provides a structured methodology and seven deliverables that may contribute to the (re)design of interfaces of existing supportive technologies for stroke rehabilitation.For supportive technologies in stroke rehabilitation important aspects to consider are the provision or presence of "feedback" (sensor-feedback system), "readability and contrast of visual information", "understanding and remembering information", "physical limitations" and "empathy".Apart from functional requirements and an understandable user interface, i.e., good usability, our case study demonstrates that the inclusion of a (fictional) character like "Stappy" may lead to a more meaningful and enjoyable user experience.

The process of co-creating the interface for VENSTER, an interactive artwork for nursing home residents with dementia.

INTRODUCTION: Interactive art installations might engage nursing home residents with dementia. The main aim of this article was to describe the challenging design process of an interactive artwork for nursing home residents, in co-creation with all stakeholders and to share the used methods and lessons learned. This process is illustrated by the design of the interface of VENSTER as a case. METHODS: Nursing home residents from the psychogeriatric ward, informal caregivers, client representatives, health care professionals and members of the management team were involved in the design process, which consisted of three phases: (1) identify requirements, (2) develop a prototype and (3) conduct usability tests. Several methods were used (e.g. guided co-creation sessions, "Wizard of Oz"). Each phase generated "lessons learned", which were used as the departure point of the next phase. RESULTS: Participants hardly paid attention to the installation and interface. There, however, seemed to be an untapped potential for creating an immersive experience by focussing more on the content itself as an interface (e.g. creating specific scenes with cues for interaction, scenes based on existing knowledge or prior experiences). "Fifteen lessons learned" which can potentially assist the design of an interactive artwork for nursing home residents suffering from dementia were derived from the design process. CONCLUSIONS: This description provides tools and best practices for stakeholders to make (better) informed choices during the creation of interactive artworks. It also illustrates how co-design can make the difference between designing a pleasurable experience and a meaningful one. Implications for rehabilitation Co-design with all stakeholders can make the difference between designing a pleasurable experience and a meaningful one. There seems to be an untapped potential for creating an immersive experience by focussing more on the content itself as an interface (e.g. creating specific scenes with cues for interaction, scenes based on existing knowledge or prior experiences). Content as an interface proved to be a crucial part of the overall user experience. The case-study provides tools and best practices (15 "lessons learned") for stakeholders to make (better) informed choices during the creation of interactive artworks.

How nursing home residents with dementia respond to the interactive art installation 'VENSTER': a pilot study.

The goal of this study was (1) to determine whether and how nursing home residents with dementia respond to the interactive art installation in general and (2) to identify whether responses change when the content type and, therefore, the nature of the interaction with the artwork changes. The interactive art installation 'VENSTER' evokes responses in nursing home residents with dementia, illustrating the potential of interactive artworks in the nursing home environment. Frequently observed responses were naming, recognizing or asking questions about depicted content and how the installation worked, physically gesturing towards or tapping on the screen and tapping or singing along to the music. It seemed content matters a lot. When VENSTER is to be used in routine care, the choice of a type of content is critical to the intended experience/usage in practice. In this study, recognition seemed to trigger memory and (in most cases) a verbal reaction, while indistinctness led to asking for more information. When (initially) coached by a care provider, residents actively engaged physically with the screen. Responses differed between content types, which makes it important to further explore different types of content and content as an interface to provide meaningful experiences for nursing home residents. Implications for rehabilitation VENSTER can facilitate different types of responses ranging from verbal reactions to active physical engagement. The choice of a type of content is critical to the intended experience/usage in practice. Activating content seems suitable for use as a meaningful experience during the spare time in between existing activities or therapy. Sessions with interactive content are short (avg. 30 mins) and intense and can therefore potentially be used as an activating therapy, activity or exercise. In order to actively engage residents with dementia, the role of the care provider seems very important.