Evaluation of usability, feasibility and acceptance of the digital training diary Trainingslog for individuals with axSpA: a mixed-method study

TL;DR

A digital training diary called Trainingslog was tested for people with axial spondyloarthritis and physiotherapists, showing good usability and feasibility but lower acceptance due to being web-based rather than an app.

Contribution

The study evaluates a user-centered digital training diary for axSpA management, highlighting the importance of app-based delivery for better acceptance.

Findings

The Trainingslog showed good usability (SUS scores of 82.5 for PTs and 77.0 for axSpA individuals) and feasibility (uMARS scores of 4.2 and 4.1).

Acceptance was lower than expected, with users preferring an app version over the web-based platform.

Only 59.86% of training entries matched between the Trainingslog and paper diary, indicating room for improvement in data consistency.

Abstract

Physical activity (PA), including regular exercise, is essential for the successful management of axial spondyloarthritis (axSpA). To promote a physically active lifestyle, a digital training diary (Trainingslog) was developed in an user-centered approach by the Swiss Ankylosing Spondylitis Association (SVMB). A training diary promotes PA through feedback, goal setting and self-monitoring, which can also be used for PA counselling by physiotherapists (PT). Usability, feasibility and acceptance are essential for the successful implementation of a mobile Health Intervention such as the Trainingslog. The study objective is to evaluate the usability, feasibility and acceptance of the Trainingslog for individuals with axSpA and PTs.

A mixed-methods design was performed among potential end-users of the Trainingslog. Quantitative data was collected by use of questionnaires (System Usability Scale (SUS, 0-100 scale), user version of the Mobile App Rating Scale (uMARS, 5 point scale)) and number of training entries. Subsequently, qualitative data was gathered through semi-structured online focus groups or individual interviews.

11 PTs (9 women, mean age 52.5 [SD 15.6]) and 10 individuals with axSpA (6 women, mean age 48 [SD 13.4]) participated. The quantitative data showed mean SUS scores for usability of 82.5 [SD 21.76] for PTs and 77.0 [SD 9.34] for individuals with axSpA. The mean uMARS sector B scores for feasibility were 4.2 [SD 0.49] for PTs and 4.1 [SD 0.38] for individuals with axSpA. Acceptance, as indicated by the uMARS results (mean score > 3 in Sectors E and F for both groups), was given. But there was a lower-than-expected agreement in the training entries, with 59.86% of entries matching between the Trainingslog and the paper diary. The qualitative analysis unveiled that while usability and feasibility were good, acceptance was lower, primarily due to the use of a web-based link instead of an app version.

The Trainingslog showed a good usability and feasibility, while the acceptance was lower than expected. Acceptance could be increased by offering the Trainingslog as an app-based version, along with implementing additional recommendations for enhancement. Consequently, the Trainingslog has the potential to be applied in PA counselling by PTs or as a self-monitoring tool for individuals with axSpA.

The online version contains supplementary material available at 10.1186/s41927-025-00463-5.

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