A Recent Usability Study of Apps for Rehabilitation at Michigan Technological University Using the FORCE TherEx Platform for Physical Therapists
Katrina M. Ellis, Chad Norman, & Alex Van der Merwe
Michigan Technological University, Houghton, MI
ABSTRACT: Our research investigated instructional materials given to patients of physical therapy, and methods for checking patient comprehension and compliance. We conducted environmental and task analyses by interviewing practicing physical therapists to map the problem space. Responses to surveys taken by patients of physical therapy and practicing physical therapists suggested that video instruction of exercises and video conference meetings between clinic visits would be beneficial to patient rehabilitation. Using a convenience sample of undergraduates, we investigated the influence of self-efficacy and format of instructional materials on willingness to comply, satisfaction with information, and anxiety related to completing rehabilitation. We found that video with text instructions were most satisfying to students.
METHODS: There were two phases to this experiment. The purpose of the first phase was to compile information from practicing physical therapists and patients of physical therapy on their perceptions of their experiences with physical therapy recommendations and compliance. The purpose of the second phase was to investigate the role of instructional medium on information satisfaction, and to see if medium is a mediator between exercise self-efficacy and willingness to comply.
RESULTS: Recommended length of rehabilitation varied from 3 to 5 weeks to over 12 weeks. The majority of physical therapists reported that 6 to 8 weeks was the typical length of rehabilitation (54%; 3 to 5 weeks, 23%; 9 to 12 weeks, 15%; and more than 12 weeks, 8%). The majority (77%) of PTs encouraged unsupervised exercises after the first visit. The amount of unsupervised exercises between visits varied between 1 to 2 and 5 to 6. The majority of PTs suggested that 1 to 2 unsupervised exercise sessions occurred between face to face visits (54%; 3 to 4, 38%; and 5 to 6, 8%). 100% of PTs suggested that demonstration was the best way to instruct patients on exercises to be performed unsupervised at home. 92% of PTs have not previously used videos for instruction of unsupervised exercises and almost half do not check for compliance. The majority (12/13) would consider a different method for checking compliance. PTs also believed that video instructions should improve patient confidence in their ability to perform the unsupervised exercises and that videos transfer proper exercise technique.
UNDERGRADUATE SURVEY: A few interesting trends which should be noted. Movie & text instructions received the highest rating in satisfaction—this group also had high ratings of compliance and low ratings of anxiety. This further supports the addition of video instruction in physical therapy prescriptions.
DISCUSSION: After our preliminary interviews with practicing physical therapists, it was clear that there needed to be some change in the instructional materials given to patients of physical therapy of unsupervised exercise prescriptions and a change in the procedures for tracking patient compliance. We surveyed current practicing physical therapists, patients of physical therapy, and a convenience sample of undergraduate students to gather perceptions of physical therapy practices, instructional materials, and compliance-tracking.
We did find that instructional medium influenced satisfaction with the information. This result suggested that video & text instructional materials were rated higher than other mediums or combinations of mediums.
CONCLUSIONS: This research investigated the influence of video instruction and video conference feedback on willingness to comply. We found that video instruction was rated higher than text or picture instruction, but power was not sufficient to find additional significant results. Survey of PTs and patients of PTs perceptions suggested that video instruction and video conferences between clinic visits would be beneficial to patient confidence, compliance and rehabilitation.
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