Exploring the Usability and Quality of a Mobile App-Based Intervention for Personalized Exercises in Individuals With Spinal Cord Injury: Convergent Parallel Mixed Methods Study.

BACKGROUND

Mobile health technologies offer scalable opportunities to support home-based exercise programs. However, most commercially available apps are not tailored to individuals with spinal cord injury (SCI) and have rarely been evaluated for usability and implementation outcomes in this population.

OBJECTIVE

This study aims to assess the acceptability, appropriateness, feasibility, and quality of a mobile app-based intervention designed to support exercise adherence in individuals with SCI.

METHODS

We conducted a convergent parallel mixed methods study using quantitative data from standardized measures and qualitative feedback from focus groups. Twelve individuals with SCI (mean age 50.5, SD 17 years; n=6, 50% male; n=8, 67% White; n=6, 50% with thoracic injuries; n=6, 50% ambulators) engaged in a customized exercise regimen using the app for 2 weeks. Acceptability, appropriateness, and feasibility of this mobile intervention were assessed using the Acceptability of Intervention Measure, Intervention Appropriateness Measure, and Feasibility of Intervention Measure. The objective and subjective qualities, and the perceived impact, of the app-based intervention were evaluated using the User Version of the Mobile Application Rating Scale.

RESULTS

Using a cutoff score of >4 out of 5, 67% (8/12) of participants rated the app-based intervention as highly acceptable and feasible, and 50% (6/12) rated it as highly appropriate. The objective quality of the app was rated 3.57 out of 5 on the User Version of the Mobile Application Rating Scale. At the scale level, information received the highest score (mean 4.10, SD 0.52), with functionality (mean 3.51, SD 0.66) and aesthetics (mean 3.50, SD 0.70) closely following. Engagement scored lowest (mean 3.18, SD 0.72). The app's subjective quality averaged 3.27 (SD 0.88), and its perceived impact on exercise adherence was rated 3.79 (SD 0.92). Qualitative feedback indicated that customization, access to professional support, and SCI-specific exercises were positive features. Areas for improvement included bug fixes and enhanced features to boost engagement.

CONCLUSIONS

The smartphone-based intervention demonstrates adequate acceptability and feasibility, along with high information quality and favorable usability, for supporting exercise adherence in individuals with SCI. Improvements in engagement features are recommended to enhance sustainable implementation.