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Cited by 43Telemedicine and Telehealth ImplementationPain Management and TreatmentUsability and User Interface Design

Design and Development of a Telerehabilitation Platform for Patients With Phantom Limb Pain: A User-Centered Approach

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Rothgangel, Andreas, Braun, Susy, Smeets, Rob, Beurskens, Anna·2017·JMIR Rehabilitation and Assistive Technologies
DOI 10.2196/rehab.6761PMC PMC5454587
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Abstract

BACKGROUND: Phantom limb pain is a frequent and persistent problem following amputation. Achieving sustainable favorable effects on phantom limb pain requires therapeutic interventions such as mirror therapy that target maladaptive neuroplastic changes in the central nervous system. Unfortunately, patients' adherence to unsupervised exercises is generally poor and there is a need for effective strategies such as telerehabilitation to support long-term self-management of patients with phantom limb pain. OBJECTIVE: The main aim of this study was to describe the user-centered approach that guided the design and development of a telerehabilitation platform for patients with phantom limb pain. We addressed 3 research questions: (1) Which requirements are defined by patients and therapists for the content and functions of a telerehabilitation platform and how can these requirements be prioritized to develop a first prototype of the platform? (2) How can the user interface of the telerehabilitation platform be designed so as to match the predefined critical user requirements and how can this interface be translated into a medium-fidelity prototype of the platform? (3) How do patients with phantom limb pain and their treating therapists judge the usability of the medium-fidelity prototype of the telerehabilitation platform in routine care and how can the platform be redesigned based on their feedback to achieve a high-fidelity prototype? METHODS: The telerehabilitation platform was developed using an iterative user-centered design process. In the first phase, a questionnaire followed by a semistructured interview was used to identify the user requirements of both the patients and their physical and occupational therapists, which were then prioritized using a decision matrix. The second phase involved designing the interface of the telerehabilitation platform using design sketches, wireframes, and interface mock-ups to develop a low-fidelity prototype. Heuristic evaluation resulted in a medium-fidelity prototype whose usability was tested in routine care in the final phase, leading to the development of a high-fidelity prototype. RESULTS: A total of 7 categories of patient requirements were identified: monitoring, exercise programs, communication, settings, background information, log-in, and general requirements. One additional category emerged for therapists: patient management. Based on these requirements, patient and therapist interfaces for the telerehabilitation platform were developed and redesigned by the software development team in an iterative process, addressing the usability problems that were reported by the users during 4 weeks of field testing in routine care. CONCLUSIONS: Our findings underline the importance of involving the users and other stakeholders early and continuously in an iterative design process, as well as the need for clear criteria to identify critical user requirements. A decision matrix is presented that incorporates the views of various stakeholders in systematically rating and prioritizing user requirements. The findings and lessons learned might help health care providers, researchers, software designers, and other stakeholders in designing and evaluating new teletreatments, and hopefully increase the likelihood of user acceptance.

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  • Multiple studies indicated that values or requirements of the to-be-developed eHealth technology can be used to guide usability tests.

    “Third, in multiple studies, authors indicated that values or requirements of the to-be-developed eHealth technology can be used to guide usability tests.”

    From Methods for Human-Centered eHealth Development: Narrative Scoping Review (2022) · cites this paper as [113]

  • It is important to have a rough idea of the costs of developing a technology as soon as possible, mostly to prevent the final version of the prototype from seeming to be too expensive.

    “Second, it is important to have a rough idea of the costs of developing a technology as soon as possible, mostly to prevent the final version of the prototype from seeming to be too expensive.”

    From Methods for Human-Centered eHealth Development: Narrative Scoping Review (2022) · cites this paper as [113]

  • Because major changes might be made to prototypes in an iterative development process, changes to the requirements might also be necessary to ensure that they remain in line with the prototype of the eHealth technology.

    “Third, because major changes might be made to prototypes in an iterative development process, changes to the requirements might also be necessary to ensure that they remain in line with the prototype of the eHealth technology.”

    From Methods for Human-Centered eHealth Development: Narrative Scoping Review (2022) · cites this paper as [113]

  • When shaping a multi-method or mixed methods development process, an iterative and flexible development approach is key.

    “the lessons learned illustrated that when shaping a multi-method or mixed methods development process, an iterative and flexible development approach is key [33,54,55,64,113,115].”

    From Methods for Human-Centered eHealth Development: Narrative Scoping Review (2022) · cites this paper as [113]

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Research works printed but not linked: 1

  1. [43]Moisiadis F The fundamentals of prioritising requirements 2002 Proceedings of Systems Engineering, Test & Evaluation Conference 2002 Sydney, Australia

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Authors
Rothgangel, A., Braun, S., Smeets, R., & Beurskens, A.
Affiliations
  • Zuyd University of Applied Sciences (NL)
  • Maastricht University (NL)
Corresponding author
Rothgangel, Andreas
ORCID
Venue
JMIR Rehabilitation and Assistive Technologies
Publisher
JMIR Publications Inc.
Published
2017-02-15
Volume
4
Issue
1
Pages
e2
ISSN
2369-2529 (ISSN-L)
DOI
10.2196/rehab.6761
PMC
PMC5454587
OpenAlex
W2588196152
Cited by
42
References
50
Citations by year
2026: 2 · 2025: 6 · 2024: 1 · 2023: 9 · 2022: 3 · 2021: 5 · 2020: 4 · 2019: 5 · 2018: 6 · 2017: 1
FWCI
4.10
Type
journal article
Language
en
Open access
Licence
cc-by
Locations
  • JMIR Rehabilitation and Assistive Technologies (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • Research Publications (Maastricht University) (publishedVersion, cc-by)
  • Research Publications (Maastricht University) (submittedVersion, other-oa)
Funders
European Commission
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Telemedicine and Telehealth Implementation
  • Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Treatment
  • Physical Sciences › Computer Science › Human-Computer Interaction › Usability and User Interface Design
Keywords
phantom limb pain, telerehabilitation, mirror therapy, user-centered design, decision matrix, usability evaluation, user interface design, amputation, self-management, patient interface, iterative design, stakeholder engagement, high-fidelity prototype, low-fidelity prototypes, heuristic evaluation, neuroplasticity

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