Apps to prescribe therapeutic exercise among rehabilitating adults: a systematic review

There is a growing interest across scientific literature on smartphone applications (apps) aiming to modify various health behaviors. Interventions that include behavior change techniques (BCTs) have been advocated to increase their efficacy. The extent to which those techniques are present among apps is unclear. The aim of this review is to analyze the existing apps for prescribing therapeutic exercise (TE) in rehabilitating adults.

The study sample was identified through systematic searches in iTunes (Apple) and Google Play (Android). Applications (apps) were assessed according to the taxonomy of BCTs for the presence/absence of these techniques. Mean and ranges were calculated for the number of observed BCTs. Number of techniques observed in free apps in both stores was calculated, but formal statistical were not conducted due to the exploratory nature of this study.

Eighteen apps were identified (11 for iPhone, two for Android, and five for both). The average number of BCT included in the eligible apps was 11 (range 4 to 16), with predominance of four techniques: "request the establishment of behavior" (100% of the apps), "providing instructions" (100%), "requesting an implementation" (100%), and "determine graded tasks" (100%). Techniques such as "taking a behavioral contract," "stress management," "prevention of relapse," and "promote the identification of barriers" were not used in the apps reviewed.

Our work demonstrates that apps prescribing TE among rehabilitating adults applied an average of 11 BCTs. Presence of BCTs varied by app type. No difference in the number of BCTs identified between iOS and Android apps was found.