Remco Arensman

46 Chapter 3 ABSTRACT Background: Home-based exercise is an important part of physical therapy treatment for patients with low back pain. However, treatment effectiveness depends heavily on patient adherence to home-based exercise recommendations. Smartphone applications designed to support home-based exercise have the potential to support adherence to exercise recommendations and possibly improve treatment effects. A better understanding of patient perspectives regarding the use of smartphone applications to support homebased exercise during physical therapy treatment can assist physical therapists with optimal use and implementation of these applications in clinical practice. Objective: The aim of this study is to investigate patient perspectives on the acceptability, satisfaction, and performance of a smartphone application to support home-based exercise following recommendations from a physical therapist. Methods: Using a interpretivist phenomenology approach, nine patients (four males and five females, aged 20–71 years) with non-specific low back pain recruited from two primary care physical therapy practices were interviewed within two weeks after treatment ended. An interview guide was used for the interviews to ensure that different aspects of the patient’s perspective were discussed. The Physitrack® smartphone application was used to support home-based exercise as part of treatment for all patients. Data were analyzed using the “Framework Method” to assist with interpretation of the data. Results: Data analysis revealed 11 categories distributed among the three themes “acceptability,” “satisfaction,” and “performance.” Patients were willing to accept the application as part of treatment when it is easy to use, when it benefits the patient, and when the physical therapist instructs the patient in its use. Satisfaction with the app is determined by users’ perceived support from the application when exercising at home and the perceived increase in adherence. The video and text instructions, reminder functions, and self-monitor functions are considered most important for performance during treatment. The patients did not view the Physitrack® app as a replacement for the physical therapist and relied on their therapist for instruction and support when needed. Conclusions: Patients who used an app to support home-based exercise as part of treatment are accepting of the app when it is easy to use, when it benefits the patient, and when the therapist instructs the patient in its use. Physical therapists using an app to support home-based exercise can use the findings from this study to effectively support their patients when exercising at home during treatment.

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