Design and evaluate a mobile app for shoulder rehabilitation exercises

Thesis Abstract

Shoulder injuries and postoperative conditions pose significant challenges to effective rehabilitation, often hindered by limited access to consistent physiotherapy, patient adherence issues, and resource constraints. The advent of mobile health (mHealth) technologies offers promising opportunities for enhancing rehabilitative outcomes through personalized, accessible exercise interventions. This study aims to design, develop, and rigorously evaluate a mobile application tailored for shoulder rehabilitation exercises, with the overarching goal of improving patient adherence, engagement, and functional recovery. The specific objectives include (1) identifying essential features and content requirements for a shoulder rehabilitation mobile app based on current clinical guidelines and patient needs; (2) designing and developing an interactive, user-friendly mobile application incorporating evidence-based exercise modules, progress tracking, and motivational features; (3) assessing the usability, user satisfaction, and engagement levels among end-users; and (4) evaluating the effectiveness of the app in improving shoulder function, adherence to prescribed exercises, and patient-reported outcomes. The study adopts a mixed-methods research design, integrating qualitative assessments of user experience with quantitative measures of clinical outcomes. The research population comprises adult patients aged 18–60 years undergoing outpatient shoulder rehabilitation at a tertiary healthcare facility. A sample size of 120 participants will be recruited using stratified random sampling to ensure representation across different injury types and rehabilitation stages. Data collection instruments include a structured questionnaire for baseline and follow-up clinical assessments, the System Usability Scale (SUS) for app usability evaluation, the Intrinsic Motivation Inventory (IMI) for measuring user engagement, and adherence logs generated through the app itself. Additionally, semi-structured interviews will be conducted with a subset of participants (n=30) to explore user perceptions and contextual factors influencing app utilization. Quantitative data will be analyzed via descriptive statistics, paired t-tests, and multiple regression analysis to assess changes in shoulder function scores (e.g., Constant-Murley score) pre- and post-intervention and to identify predictors of adherence. Thematic analysis will be employed for qualitative interview data to extract key themes around user experience, barriers, and facilitators. The usability data will be analyzed using non-parametric tests such as Wilcoxon signed-rank tests. The evaluation will also incorporate the Unified Theory of Acceptance and Use of Technology (UTAUT) framework to interpret user acceptance and behavioral intention concerning the app. Expected findings suggest that the custom-designed mobile app will significantly improve adherence rates compared to conventional therapy, with higher engagement correlating positively with functional recovery outcomes. It is anticipated that usability scores will demonstrate high acceptability among users, and qualitative insights will shed light on factors influencing sustained usage. The study aims to establish that integrating evidence-based exercises into a mobile platform enhances patient motivation and compliance, thereby accelerating rehabilitation progress. This research contributes to the existing body of knowledge by providing a validated framework for mobile app-based shoulder rehabilitation, emphasizing user-centered design principles and behavior change theories. It advances understanding of how digital health interventions can complement traditional physiotherapy, especially amidst increasing demand for remote healthcare solutions. The main conclusion emphasizes the potential of well-designed mobile applications to transform shoulder rehabilitation practices, fostering patient empowerment and optimizing clinical outcomes. Recommendations include integrating such apps within standard care pathways, further exploring long-term adherence strategies, and expanding functionalities to include augmented reality or telemonitoring features for comprehensive remote management. Future studies are suggested to evaluate scalability across diverse healthcare settings and to assess cost-effectiveness in broader patient populations.