58 Chapter 3 should support patients with the shift toward the use of mHealth apps during treatment to allow patients to experience the benefits these new developments bring. The last theme, “performance,” describes which functions of the app are most important according to the patients and how the performance of the app could be improved in the future. The video and text instructions, the reminders, and the option to self-monitor adherence were considered to be the most important functions of the app. Suggestions for future improvements were mainly aimed at making it even easier to use the app at home. The findings of this study are similar to the results from studies on other mHealth or eHealth apps (23,24). For instance, Svendsen et al reviewed the qualitative literature on digital interventions for the self-management of LBP (23). After analyzing the included studies, 4 major themes were found: information technology (IT) usability and accessibility, quality and amount of content, tailoring and personalization, and motivation and support. A different review found that health status, usability, convenience and accessibility, perceived utility, and motivation were the main themes describing the barriers to and facilitators of engagement with remote measurement technology for health management (24). Although the terminology describing the themes differs between studies, the content of the themes is broadly similar. For instance, “reminders and notifications,” “accessible at all hours and locations,” “easily accessible with low effort,” and “high user friendliness” were found to be facilitators for IT usability and accessibility in the study by Svendsen et al, whereas the themes “usability” and “convenience and accessibility” from the study by Simblett et al have similar facilitators (23,24). In this study, the use of reminders, easy integration in daily life, and the high usability of the app contributed to its acceptability, corresponding with the findings from the previous studies. The high agreement between previous studies and this study, despite the different types of apps used by patients with different health problems, suggests that these findings can most likely be generalized between apps and health problems. This study adds to the findings that patients view the interaction between patients and physical therapists as vital when using an app as part of treatment. This suggests that Physitrack is well suited to support treatment but not to replace a physical therapist. LIMITATIONS AND TRUSTWORTHINESS To put these results into perspective, several issues must be discussed. First, none of the included participants scored the usability of Physitrack lower than 70 (i.e., acceptable) on the SUS. A possible explanation is that the physical therapists treating potential participants for the study only used Physitrack with patients they expected to benefit
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