Mobile Phone–Supported Physiotherapy for Frozen Shoulder: Feasibility Assessment Based on a Usability Study

Abstract

BackgroundPatients with frozen shoulder show limited shoulder mobility often accompanied by pain. Common treatment methods include physiotherapy, pain medication, administration of corticosteroids, and surgical capsulotomy. Frozen shoulder often lasts from months to years and mostly affects persons in the age group of 40 to 70 years. It severely reduces the quality of life and the ability to work.ObjectiveThe objective of this study was to evaluate the feasibility of a mobile health (mHealth) intervention that supports patients affected by “stage two” frozen shoulder. Patients were supported with app-based exercise instructions and tools to monitor their training compliance and progress. These training compliance and progress data supplement the patients’ oral reports to the physiotherapists and physicians and can assist them in therapy adjustment.MethodsIn order to assess the feasibility of the mHealth intervention, a pilot study of a newly developed app for frozen shoulder patients was conducted with 5 patients for 3 weeks. The main function of the app was the instruction for exercising at home. Standardized questionnaires on usability such as System Usability Scale (SUS) and USE (Usefulness, Satisfaction, and Ease of use), and Technology Acceptance Model-2 (TAM-2) were completed by the study participants at the end of the study. Additionally, a nonstandardized questionnaire was completed by all patients. The correctness of the exercises as conducted by the patients was assessed by a physiotherapist at the end of the study. The mobility of the shoulder and pain in shoulder movement was assessed by a physiotherapist at the start and the end of the study.ResultsThe pilot study was successfully conducted, and the app was evaluated by the patients after 3 weeks. The results of the standardized questionnaires showed high acceptance (TAM-2) and high usability (SUS) of the developed app. The overall usability of the system as assessed by the SUS questionnaire was very good (an average score of 88 out of 100). The average score of the TAM-2 questionnaire on the intention to further use the app was 4.2 out of 5, which indicated that most patients would use the app if further available. The results of the USE questionnaires highlighted that the patients learned how to use the app easily (an average score of 4.2 out of 5) and were satisfied with the app (an average score of 4.7 out of 5). The frequency of app usage and training was very high based on patient reports and verified by analysis of the usage data. The patients conducted the exercises almost flawlessly.ConclusionsOur results indicate the feasibility of the mHealth intervention, as the app was easy to use and frequently used by the patients. The app supported the patients’ physiotherapy by providing clear exercising instructions.

Effect of smartphone application-supported self-rehabilitation for frozen shoulder: a prospective randomized control study

“…In addition, the ease of learning and satisfaction scales of Ease of Use system were employed. 11 Answers were scored using a five-point Likert-type scale, from 1 ( negative/disagree ) to 5 ( positive/strongly agree ).…”

Avaliação do uso de aplicativo de celular para auxílio no processo de reabilitação da cirurgia do ombro

“…A vantagem do aplicativo proposto no estudo foi a capacidade de avaliar e registrar nele próprio o grau de amplitude de movimento e duração do exercício por paciente. 14 No presente estudo, o aplicativo não foi capaz de registrar o tempo de visualização de cada exercício; porém, foi possível identificar que este facilitou a comunicação e o entendimento dos exercícios, como o observado em diversas outras pesquisas. 4-6, 8 Gilbert et al 8 avaliaram a reabilitação de pacientes com doenças relativas ao ombro, através do aplicativo MUJO, (Paris, France) e concluíram que ele não interfere em nenhum protocolo de reabilitação já estabelecido.…”

ePhysio: A Wearables-Enabled Platform for the Remote Management of Musculoskeletal Diseases

“…Solutions for the treatment of MSDs at home that integrate wearable sensor devices are very limited. A study proposed by Stutz et al [20] is focused on the recovery of the frozen shoulder using a mobile application. The system gathers information regarding patient exercise activities using the sensors embedded in the smartphone.…”

“…Multiple studies, [20,21,22,23,24,25,26,27,28,29,30,31,32,33,34], highlighted how self-rehabilitation and autonomous quality assessment can lead to poor patient adherence to the treatment and a slow clinical course, due to the absence of continuous monitoring from the professionals. This usually leads to slow recovery time and recidivism of the disease.…”