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Behrendt F1,2, McCaskey M1, Schuster-Amft C1,3,4
1Reha Rheinfelden, Research Department, Rheinfelden, Switzerland, 2University Children's Hospital Basel, Basel, Switzerland, 3Bern University of Applied Sciences, Institute for Rehabilitation and Performance Technology, Burgdorf, Switzerland, 4University of Basel, Department of Sport, Exercise and Health, Basel, Switzerland
Background: Restoring functional capacity during rehabilitation of patients after non-avoidable hospitalisation is essential to regaining and maintaining independence in daily living. In clinical reality, therapists struggle to support patients at a relevant intensity, frequency and duration that would induce functional re-adaptation and behavioural change. Implementing semi-autonomous and feedback-driven training devices to increase intensity during walking would pose a valuable activity during therapies and allow independent exercising during off-therapy times. To achieve this, a new kind of walking exercise shall be developed based on the Tonefit Belt (TFB), a belt with inbuilt resistance handles.
Purpose: Acknowledging the importance of early human factor engineering, this study aimed to ascertain requirements from a therapist's perspective to develop a mobile training device with maximum clinical relevance. The goal is to develop a version of the TFB version that meets demands of rehabilitation settings.
Methods: The existing TFB was used as a basis for the development of a new training device. It was handed to 5 therapists for self-testing over a period of 12 weeks. The therapists held a diary to record their experience with the device. Attitude and expectations were rated on a 100mm visual analogue scale. At the end of the trial period, a System Usability Questionnaire was filled in and the therapists were invited to a semi-structured focus group. The interview guide was divided into the following main question categories:
(1) experiences with the TFB and its features,
(2) required training and therapy functions in a TFB with rehabilitation purposes,
(3) development of assessments within a new version.
Statements were coded as major or minor improvements.
Results: The mean subjective attitude improved from 56% before the trial to 65% after the trial. However, the expectations towards its use in therapy decreased from 47% to 29% in the same time. The median (SD) score of SUS was 73.75 (14.2), suggesting a good' system usability (grade C). This ranks the device on the 65th to 69th percentile representing a normalised grade B- on SUS grading scale. The qualitative evaluation of the comments and the focus group revealed four major and three minor changes that would improve the usability of the device in a therapeutic application.
Conclusion(s): The main findings of this study suggest that the current version of the TONEFIT belt has limited usability in the therapy market, but few modifications could make it a useful instrument to encourage sedentary patients to increase their activity levels during their rehabilitation stay.
Implications: The user centred design of this development cycle provides manufacturers with valuable insights from future customers. Recovery and regained independence highly depends on the intensity, frequency, and task-specificity of the intervention. In therapeutic settings, it can be difficult to employ exercise that feels natural to the patient and can be continued after discharge. Providing a semi-autonomous exercise device that records exercise activity and allows feedback for exercise instruction and training protocol adaptation, even after discharge or in absence of therapists, could increase personal motivation and adherence rates which would be beneficial for functional rehabilitation outcomes.
Keywords: Human factor engineering, walking-exercise, rehabilitation
Funding acknowledgements: This project was fully funded by the Swiss Innovation Agency, Innossuisse.
Purpose: Acknowledging the importance of early human factor engineering, this study aimed to ascertain requirements from a therapist's perspective to develop a mobile training device with maximum clinical relevance. The goal is to develop a version of the TFB version that meets demands of rehabilitation settings.
Methods: The existing TFB was used as a basis for the development of a new training device. It was handed to 5 therapists for self-testing over a period of 12 weeks. The therapists held a diary to record their experience with the device. Attitude and expectations were rated on a 100mm visual analogue scale. At the end of the trial period, a System Usability Questionnaire was filled in and the therapists were invited to a semi-structured focus group. The interview guide was divided into the following main question categories:
(1) experiences with the TFB and its features,
(2) required training and therapy functions in a TFB with rehabilitation purposes,
(3) development of assessments within a new version.
Statements were coded as major or minor improvements.
Results: The mean subjective attitude improved from 56% before the trial to 65% after the trial. However, the expectations towards its use in therapy decreased from 47% to 29% in the same time. The median (SD) score of SUS was 73.75 (14.2), suggesting a good' system usability (grade C). This ranks the device on the 65th to 69th percentile representing a normalised grade B- on SUS grading scale. The qualitative evaluation of the comments and the focus group revealed four major and three minor changes that would improve the usability of the device in a therapeutic application.
Conclusion(s): The main findings of this study suggest that the current version of the TONEFIT belt has limited usability in the therapy market, but few modifications could make it a useful instrument to encourage sedentary patients to increase their activity levels during their rehabilitation stay.
Implications: The user centred design of this development cycle provides manufacturers with valuable insights from future customers. Recovery and regained independence highly depends on the intensity, frequency, and task-specificity of the intervention. In therapeutic settings, it can be difficult to employ exercise that feels natural to the patient and can be continued after discharge. Providing a semi-autonomous exercise device that records exercise activity and allows feedback for exercise instruction and training protocol adaptation, even after discharge or in absence of therapists, could increase personal motivation and adherence rates which would be beneficial for functional rehabilitation outcomes.
Keywords: Human factor engineering, walking-exercise, rehabilitation
Funding acknowledgements: This project was fully funded by the Swiss Innovation Agency, Innossuisse.
Topic: Robotics & technology; Research methodology & knowledge translation
Ethics approval required: No
Institution: Swissethics
Ethics committee: EKNZ (based on regulations)
Reason not required: This study does not fall under the Swiss Federal Act on Research involving Humans.
All authors, affiliations and abstracts have been published as submitted.
