56 Chapter 3 Self-monitoring Not all patients mentioned recording pain or adherence to exercises in Physitrack. However, patients who did record these metrics used the information to monitor their progress or demonstrate to the physical therapist that they had followed the exercise recommendations. I felt that my back was very painful this week, but actually my pain score after doing the exercises is decreasing. That is, for me, a reminder I’m going in the right direction, and I find that very reassuring. [Participant #2] Performance According to the patients, the most appreciated or essential functions of Physitrack were the video and text instructions and the reminder function. Recording and monitoring their own progress and the chat function were mentioned less often but were still considered important by several patients. Something that should stay in the app is this overview with all the videos and the names of the exercises and how often I’m supposed to do them. Together with the reminder, I think those are important. [Participant #5] The patients also suggested several improvements for the app, including connecting the app with the calendar on users’ mobile phones, such that follow-up visits could be automatically entered into the calendar. Other suggestions included repeated reminders when exercise performance was not recorded in the app, the option to connect the exercise videos to the television, and a loop or timer in the videos so that the patient could exercise along with the video. DISCUSSION Principal findings The aim of this study was to investigate patient perspectives regarding an app to support HBE recommended by a primary care physical therapist. Qualitative data analysis revealed 11 categories describing the 3 themes of “acceptability,” “satisfaction,” and “performance.” The “acceptability” theme contains the subthemes of usability, availability, willingness to use the app, and importance of instruction, and it describes what the patients perceived as essential to accept the app as part of treatment. Participants commented on how easy or difficult it was to use the app in their daily lives. Patients’ acceptance and continued
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