Smiley Aref, Finkelstein Joseph
Department of Biomedical Informatics, School of Medicine, University of Utah, Salt Lake City, UT, United States.
JMIR Biomed Eng. 2024 Dec 27;9:e65734. doi: 10.2196/65734.
Exercise is essential for physical rehabilitation, helping to improve functional performance and manage chronic conditions. Telerehabilitation offers an innovative way to deliver personalized exercise programs remotely, enhancing patient adherence and clinical outcomes. The Home Automated Telemanagement (HAT) System, integrated with the interactive bike (iBikE) system, was designed to support home-based rehabilitation by providing patients with individualized exercise programs that can be monitored remotely by a clinical rehabilitation team.
This study aims to evaluate the design, usability, and efficacy of the iBikE system within the HAT platform. We assessed the system's ability to enhance patient adherence to prescribed exercise regimens while minimizing patient and clinician burden in carrying out the rehabilitation program.
We conducted a quasi-experimental study with 5 participants using a pre- and posttest design. Usability testing included 2 primary tasks that participants performed with the iBikE system. Task completion times, adherence to exercise protocols, and user satisfaction were measured. A System Usability Scale (SUS) was also used to evaluate participants' overall experience. After an initial introduction, users performed the tasks independently following a 1-week break to assess retention of the system's operation skills and its functionality.
Task completion times improved substantially from the pretest to the posttest: execution time for task 1 reduced from a mean of 8.6 (SD 4.7) seconds to a mean of 1.8 (SD 0.8) seconds, and the time for task 2 decreased from a mean of 315 (SD 6.9) seconds to a mean of 303.4 (SD 1.1) seconds. Adherence to the prescribed cycling speed also improved, with deviations from the prescribed speed reduced from a mean of 6.26 (SD 1.00) rpm (revolutions per minute) to a mean of 4.02 (SD 0.82) rpm (t=3.305, n=5, P=.03). SUS scores increased from a mean of 92 (SD 8.6) to a mean of 97 (SD 3.3), indicating high user satisfaction and confidence in system usability. All participants successfully completed both tasks without any additional assistance during the posttest phase, demonstrating the system's ease of use and effectiveness in supporting independent exercise.
The iBikE system, integrated into the HAT platform, effectively supports home-based telerehabilitation by enabling patients to follow personalized exercise prescriptions with minimal need for further training or supervision. The significant improvements in task performance and exercise adherence suggest that the system is well-suited for use in home-based rehabilitation programs, promoting sustained patient engagement and adherence to exercise regimens. Further studies with larger sample sizes are recommended to validate these findings and explore the long-term benefits of the system in broader patient populations.
运动对于身体康复至关重要，有助于改善功能表现并管理慢性病。远程康复提供了一种创新方式，可远程提供个性化运动计划，提高患者的依从性和临床效果。家庭自动化远程管理（HAT）系统与交互式自行车（iBikE）系统集成，旨在通过为患者提供可由临床康复团队远程监测的个性化运动计划来支持居家康复。
本研究旨在评估iBikE系统在HAT平台内的设计、可用性和有效性。我们评估了该系统增强患者对规定运动方案依从性的能力，同时尽量减少患者和临床医生在实施康复计划时的负担。
我们采用前后测试设计对5名参与者进行了一项准实验研究。可用性测试包括参与者使用iBikE系统执行的2项主要任务。测量了任务完成时间、对运动方案的依从性和用户满意度。还使用系统可用性量表（SUS）来评估参与者的总体体验。在初步介绍后，用户在休息1周后独立执行任务，以评估系统操作技能及其功能的保留情况。
从测试前到测试后，任务完成时间有了显著改善：任务1的执行时间从平均8.6（标准差4.7）秒降至平均1.8（标准差0.8）秒，任务2的时间从平均315（标准差6.9）秒降至平均303.4（标准差1.1）秒。对规定骑行速度的依从性也有所提高，与规定速度的偏差从平均6.26（标准差1.00）转/分钟降至平均4.02（标准差0.82）转/分钟（t = 3.305，n = 5，P = .03）。SUS评分从平均92（标准差8.6）提高到平均97（标准差3.3），表明用户对系统可用性的满意度和信心较高。在测试后阶段，所有参与者均在无任何额外帮助的情况下成功完成了两项任务，证明了该系统在支持独立运动方面的易用性和有效性。
集成到HAT平台中的iBikE系统通过使患者能够遵循个性化运动处方，且几乎无需进一步培训或监督，有效地支持了居家远程康复。任务表现和运动依从性的显著改善表明，该系统非常适合用于居家康复计划，促进患者持续参与并坚持运动方案。建议进行更大样本量的进一步研究，以验证这些发现并探索该系统在更广泛患者群体中的长期益处。
