%0 Journal Article
%T Assessment of a Downloadable Application with Avatar Guidance for PT-Prescribed Home Exercise after Total Knee Arthroplasty: A 30-Day Usability and Feasibility Study
%A Joel Carmichael
%A Sheryl Flynn
%A Tamara Struessel
%A Stefano Bini
%A Michael Bade
%A Jennifer Stevens-Lapsley
%J Advances in Aging Research
%P 98-115
%@ 2169-0502
%D 2022
%I Scientific Research Publishing
%R 10.4236/aar.2022.114008
%X <b><span style=\"font-family:&quot;\">Objective:</span></b><span style=\"font-family:&quot;\"> To explore the usability and feasibility of a downloadable application
(APP) compared to paper handouts (CONTROL) in guiding 30 days of PT-prescribed
home exercise after total knee arthroplasty (TKA), and to compare functional
outcomes at 30 days postoperatively between APP and CONTROL. <b>Design:</b> Randomized controlled usability and feasibility study. <b>Setting:</b> Rehabilitation laboratories at two regional medical centers. <b>Participants:</b> Individuals with knee osteoarthritis undergoing unilateral TKA (APP group: N =
26; mean age, 67.0 ¡À 8.2 y; CONTROL group: N = 31; mean age, 64.7 ¡À 7.7 y). <b>Interventions:</b> This study assessed the user experience of a downloadable app to guide 30 days
of home exercises and instruction after TKA and compared exploratory outcomes
to a group using paper handouts. <b>Main</b> <b>Outcome</b> <b>Measures:</b> The System Usability Scale (SUS) score was used to assess patient usability
experience. Raw SUS scores were dichotomized (¡Ý72% or &lt;72%) to determine app
usability against a 75% <i>a</i> <i>priori</i> criterion for mean APP group score. Feasibility for app use was similarly
evaluated in the APP group only through <i>a</i> <i>priori</i> criteria applied to computing device ownership
and study use, to the absence of technology-based barriers to participation,
and to completion of app-based testing. Exploratory measures <span>compared change from baseline to 30 days for
functional and pa</span>tient-reported outcomes between APP and CONTROL. <b>Results:</b> The APP group¡¯s mean SUS score of 79.2% at 30 days exceeded the 75% threshold
for good usability. The app met the predetermined a <i>priori</i> feasibility
criteria for absence of technology-based barriers to participation (75% of
participants) and completion of app-based testing (91.3% of participants).
Personal computing devices were used by 71.4% of APP participants, which was
below the 75% <i>a</i> <i>priori</i> feasibility criterion. No differences between the APP and CONTROL groups were
observed for functional or patient-reported outcomes. <b>Conclusions:</b> <span>The app-based platform met the <i>a</i> <i>priori</i> criteria for usability
for 79% of APP participants. Our findings suggest that app-based, avatar-guided
home exercise after TKA has acceptable usability and feasibility. The
app-guided patient assessment capability also demonstrates preliminary
feasibility for guiding and administering functional and self-reported outcomes
assessments.
%K Mobile Health Technology
%K Feasibility
%K Usability
%K Total Knee Replacement
%K System Usability Scale
%U http://www.scirp.org/journal/PaperInformation.aspx?PaperID=118479