Active-Feet: home-based exercise training by using a m-Health-based platform in children with idiopathic toe walking. (Preprint)
Authors: Membrilla-Mesa Miguel , Heredia-Jiménez Jose , Di Caudo Carla , Serrano-Garcia Maria Almudena , Archilla Bonilla Yolanda , Ruiz-Zafra Angel , Benghazi-Akhlaki Kawtar , Noguera-Garcia Manuel , Ortiz de Andres Alberto , Perez-Garcia Simon , Pozuelo-Calvo Rocio 
Published: June 2024

BACKGROUND

Physical exercise and stretching programs are the best initial options to treat idiopathic toe walking (ITW). These kinds of programs are designed to improve the flexibility and strength of lower limb muscles, which enhance the range of motion of the ankle allowing to reach a normal gait pattern. In the paediatric population, one of the major limitations reported is the low adherence to follow the rehabilitation treatment or the lack of follow up. In this sense, children using mHealth tools could play an active and central role in their treatment of ITW and, at the same time, mobile applications would allow daily monitoring by the healthcare professional.

OBJECTIVE

The present study aims to develop and evaluate a m-Health platform for individuals with ITW.

METHODS

This study describes the context study, content preparation and the m-Health platform design as well as subsequent evaluation using a self-administered satisfaction questionnaire. In addition, feasibility and acceptance test of a home-based exercise program was carried out by using a comprehensive mobile app intended to improve walking in children with ITW.

RESULTS

Initially, it was discussed the main features of the Active-Feet platform focusing on the main goal, to help children with ITW to follow the rehabilitation program. A set of 3D avatars consisting of animated characters was designed. The characters were attractive and capable enough in order to guide children with ITW in the performance of the exercises. Posterior muscle chain stretching exercises were chosen following the main guidelines and recommendations. Active-Feet development process was carried out over five stages: requirements specification, platform design, platform Implementation, platform deployment and alpha testing of the app. Healthcare professionals using the final version of Active-Feet App could track the compliance to the rehabilitation program, customized and reviewing the execution of the exercises. Patients using Active-Feet platform could visualize themselves while performing the exercises and the communication with the physician or therapist could be performed by using the chat.
The final version of Active-Feet App was evaluated considering both parents, and children's perspective. Twenty patients assessed the app for two weeks and answered the questionnaires specially designed. The usefulness, acceptance, and impact of Active-Feet App for the home-based treatment as well as the ability to persuade children with ITW to follow the exercises program was assessed. According to the findings, 80% of the users stated the App in a positive way.

CONCLUSIONS

This study describes the development process and testing of Active-Feet, a mHealth-based platform designed to offer a treatment for ITW children. After the long process an attractive easy to use platform for ITW was developed for the first time.