Membrilla-Mesa Miguel, Heredia-Jiménez Jose, Di Caudo Carla, Serrano-Garcia Maria Almudena, Archilla Bonilla Yolanda, Ruiz-Zafra Angel, Benghazi-Akhlaki Kawtar, Noguera-Garcia Manuel, Ortiz de Andres Alberto, Perez-Garcia Simon, Pozuelo-Calvo Rocio
Department of Physical Medicine and Rehabilitation, Hospital Universitario Virgen de las Nieves, Granada, Spain.
Instituto de Investigación Biosanitaria ibs.GRANADA, Avda. de Madrid, 15, Granada, 18012, Spain, 34 958021574.
JMIR Rehabil Assist Technol. 2025 Aug 26;12:e60867. doi: 10.2196/60867.
Physical exercise and stretching programs are the best initial options to treat idiopathic toe walking (ITW). These programs are designed to improve the flexibility and strength of lower limb muscles, enhancing the ankle's range of motion and allowing for a normal gait pattern. In the pediatric population, one of the major limitations reported by therapists is low adherence to rehabilitation treatments or a lack of follow-up. In this context, children using mobile health (mHealth) tools could play an active and central role in their treatment of ITW, while mobile apps could also allow for daily monitoring by health care professionals.
This study aims to design and develop a mHealth platform for individuals with ITW. In addition, a feasibility and acceptance test of a home-based exercise program was conducted using a comprehensive mobile app intended to improve walking in children with ITW.
This study describes the context, content preparation, and mHealth platform design, as well as subsequent evaluation using a self-administered satisfaction questionnaire. Initially, the main features of the Active-Feet platform were discussed, focusing on its primary goal of helping children with ITW adhere to the rehabilitation program. However, this study did not evaluate the platform's effectiveness in improving adherence or ankle range of motion. A set of 3D avatars consisting of animated characters was designed. Posterior muscle chain stretching exercises were selected following the main guidelines. The Active-Feet development process was carried out in 5 stages: requirements specification, platform design, platform implementation, platform deployment, and alpha testing of the app.
The final version of the Active-Feet app was evaluated from both the parents' and children's perspectives. Twenty patients and 1 parent per child assessed the app over 2 weeks and answered specially designed questionnaires. Parents rated the app's impact on their child's motivation and its overall effectiveness highly, with median scores of 4 (IQR 4-4). Notably, the item related to reconciling family life with rehabilitation treatment received a median score of 5 (IQR 4-5). Children's responses also indicated positive ratings for motivation and user-friendliness, with a median score of 4 (very good; IQR 3.25-4). Questions about the app's impact, helpfulness in learning, and exercise mirroring received a median score of 3 (good; IQR 3-4).
This study describes the development process and testing of Active-Feet, an mHealth-based platform designed to offer treatment for children with ITW. After the long process, an attractive and easy-to-use platform for ITW was developed for the first time.
体育锻炼和伸展训练项目是治疗特发性足尖行走（ITW）的最佳初始选择。这些项目旨在提高下肢肌肉的柔韧性和力量，增加踝关节的活动范围，并实现正常的步态模式。在儿科人群中，治疗师报告的主要限制之一是对康复治疗的依从性低或缺乏随访。在这种情况下，使用移动健康（mHealth）工具的儿童可以在其ITW治疗中发挥积极且核心的作用，而移动应用程序也可以让医疗保健专业人员进行日常监测。
本研究旨在为ITW患者设计和开发一个移动健康平台。此外，使用一个旨在改善ITW儿童行走能力的综合移动应用程序，对一项居家锻炼计划进行了可行性和可接受性测试。
本研究描述了背景、内容准备和移动健康平台设计，以及随后使用自我管理的满意度问卷进行的评估。最初，讨论了Active-Feet平台的主要功能，重点是其帮助ITW儿童坚持康复计划的主要目标。然而，本研究并未评估该平台在提高依从性或踝关节活动范围方面的有效性。设计了一组由动画角色组成的3D虚拟形象。根据主要指南选择了后肌肉链伸展运动。Active-Feet的开发过程分5个阶段进行：需求规格说明、平台设计、平台实施、平台部署和应用程序的alpha测试。
从家长和孩子的角度对Active-Feet应用程序的最终版本进行了评估。20名患者和每个孩子的1名家长在2周内对该应用程序进行了评估，并回答了专门设计的问卷。家长对该应用程序对孩子积极性的影响及其整体有效性评价很高，中位数得分为4（四分位间距4 - 4）。值得注意的是，与协调家庭生活和康复治疗相关的项目中位数得分为5（四分位间距4 - 5）。孩子的回答也表明对积极性和用户友好性给予了积极评价，中位数得分为4（非常好；四分位间距3.25 - 4）。关于该应用程序的影响、学习帮助和运动模仿的问题中位数得分为3（好；四分位间距3 - 4）。
本研究描述了Active-Feet的开发过程和测试，这是一个基于移动健康的平台，旨在为ITW儿童提供治疗。经过漫长的过程，首次开发出了一个吸引人且易于使用的ITW平台。
