Development of a Mobile App for Home-Based Physiotherapy Adherence and Monitoring

Thesis Abstract

The effectiveness of physiotherapy, particularly home-based programmes, heavily depends on patient adherence to prescribed exercises and consistent monitoring by healthcare providers, yet current practices often face challenges related to lack of real-time feedback, patient engagement, and accurate tracking of compliance. This study aims to develop, implement, and evaluate a mobile application designed to enhance adherence to physiotherapy protocols and enable remote monitoring of patient progress, thereby addressing gaps in patient engagement and clinical oversight. The specific objectives include designing an intuitive mobile app tailored to physiotherapy routines, assessing user acceptability among patients and physiotherapists, and evaluating the app’s impact on adherence rates and clinical outcomes. Employing a mixed-method research design, the study integrates qualitative and quantitative approaches over a 12-month period. The quantitative phase involves a randomized controlled trial with a sample of 200 post-operative or injury-related physiotherapy patients recruited from outpatient clinics within a metropolitan healthcare network. Participants are randomly assigned to either the intervention group, using the mobile app, or the control group receiving standard physiotherapy instructions. Data collection instruments include structured questionnaires to assess baseline adherence, app usability (System Usability Scale), and satisfaction, as well as objective adherence data generated by the app’s activity logs. For qualitative insights, semi-structured interviews with 20 patients and 10 physiotherapists explore user experiences, barriers, and facilitators related to app utilization. Validity and reliability are established through pilot testing instruments, Cronbach’s alpha for internal consistency, and triangulation of qualitative data. Data analysis employs descriptive statistics to profile participant characteristics and adherence levels, while inferential analyses include multiple regression analysis to examine the effect of the app on adherence rates, and ANOVA to compare clinical outcomes between groups. Thematic analysis is applied to qualitative interview data to identify common themes related to user experience and usability challenges. The integrated analysis aims to determine whether the app significantly improves adherence and physiotherapy outcomes, and to elucidate user perceptions that influence engagement. Expected findings suggest that the mobile app will lead to statistically significant increases in adherence rates, measured through activity logs and self-reported compliance, compared to traditional methods. Enhanced patient engagement is anticipated, positively affecting clinical recovery metrics such as pain reduction and functional scores. The qualitative data are expected to reveal key usability factors, resistance points, and motivational drivers influencing sustained app use. The study's contribution lies in providing empirical evidence on the efficacy of digital health tools in physiotherapy management and advancing knowledge on integrating mobile health technologies within rehabilitation protocols. It offers a validated framework for designing patient-centered applications that promote adherence, and highlights best practices for remote monitoring in physiotherapy contexts. Concluding, the research underscores the potential of mobile health solutions to transform physiotherapy practice by fostering autonomous, monitored, and outcome-oriented rehabilitation. Recommendations include integrating the app into routine clinical workflows, conducting larger-scale trials for generalizability, and exploring adaptation for diverse patient populations. Future research directions involve longitudinal studies to assess long-term adherence and outcome sustainability, as well as the incorporation of emerging technologies such as wearable sensors and artificial intelligence to further customize patient engagement strategies.