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Movement Retraining using Real-time Feedback of Performance
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Real-Time Digitized Visual Feedback in Exercise Therapy for Lower Extremity Functional Deficits: Qualitative Study of

Klaus Widhalm1,2,3, Lukas Maul4,5, Sebastian Durstberger3,4,5

  • 1Physiotherapy, FH Campus Wien, University of Applied Sciences, Vienna, Austria.

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Summary

Digital real-time feedback systems show promise for treating functional deficits in osteoarthritis patients. User feedback on prototype visualizations highlighted the need for improved clarity, instructional elements, and gamification for enhanced therapeutic use.

Keywords:
digitized visual feedbackexercise therapyfunctional deficitlower extremitymobile phoneosteoarthritisphysiotherapyrehabilitationserious gameusabilityvisualization

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Area of Science:

  • Biomechanics and Rehabilitation Engineering
  • Human-Computer Interaction in Healthcare
  • Digital Health Interventions

Background:

  • Osteoarthritis is a prevalent degenerative musculoskeletal disease, often necessitating surgical interventions like total knee or hip arthroplasty.
  • Functional movement deficits in lower extremities are prognostic factors for osteoarthritis, suggesting targeted exercise training can aid treatment.
  • Digital real-time feedback systems can enhance patient motivation and adherence to exercise regimens.

Purpose of the Study:

  • To gather user recommendations for optimizing prototype feedback visualizations within the homeSETT system, designed for treating functional deficits.
  • To evaluate patient, physiotherapist, and physician perceptions of current feedback visualizations for exercises targeting lateral trunk lean, pelvic drop, and valgus thrust.
  • To identify specific improvements and variations for enhancing the usability and effectiveness of the feedback system.

Main Methods:

  • A qualitative study employing a movement laboratory with 3D optoelectronic motion analysis.
  • Usability data collected via the 'thinking aloud' method during prototype testing and semistructured interviews post-testing.
  • Qualitative content analysis of transcribed interviews and thinking aloud logs to identify user feedback and recommendations.

Main Results:

  • Participants (patients, physiotherapists, physicians) found the prototype feedback visualizations enjoyable and therapeutically applicable, appreciating their simplicity and clarity.
  • Some users experienced challenges in recognizing feedback goals and correlating visualizations with their movements, indicating a need for refinement.
  • Key recommendations included optimizing color schemes, sensitivity, and difficulty, alongside incorporating instructional information and gamification elements like rewards and repetition counting.

Conclusions:

  • The prototype feedback visualizations were positively received and deemed suitable for clinical therapy settings.
  • User feedback provided valuable insights for enhancing color schemes, sensitivity, and recognizability of visualizations.
  • Future development will focus on incorporating gamification and instructional elements, followed by efficacy evaluation of the homeSETT system in patient populations.