Hyosun Kweon

Spinal cord injury (SCI) causes diverse physical impairments due to damage to the central nervous system. Among these, mobility limitation is one of the most prominent sequelae, directly affecting ...

Background: Artificial intelligence (AI)–based gait analysis systems are increasingly applied in rehabilitation settings for objective and quantitative assessment of gait function. However, despite their potential, clinical adoption remains limited due to insufficient consideration of usability, user experience, and integration into actual clinical workflows. Objective: This study aimed to conduct a formative evaluation of a prototype AI-based gait analysis system (MediStep M). Methods: A mixed methods formative usability evaluation was conducted with 5 licensed physical therapists. Qualitative data were collected through focus group interviews, and quantitative usability was measured using the system usability scale (SUS). A scenario-based usability assessment was applied to identify user interface challenges, workflow issues, and potential design improvements. Results: Participants identified major usability barriers, including limited accessibility of the power button, absence of battery status indicators, burdensome manual calibration, and insufficient clinical detail in the gait analysis reports. They also emphasized the need for wireless operation, improved portability, and integration with hospital electronic medical record systems. The mean SUS score was 57 (grade D), indicating suboptimal usability and the need for iterative design refinements. Conclusions: Although AI-based gait analysis systems hold promise for enhancing rehabilitation outcomes, key usability challenges must be resolved before clinical implementation. Improvements in hardware portability, automated calibration, data management, and user interface design are essential to ensure safety, efficiency, and clinical applicability. These findings provide evidence-based insights to guide iterative development and promote user-centered innovation in AI-based rehabilitation technologies.

Background: The usability of software as a medical device plays a critical role in ensuring patient safety, clinical effectiveness, and treatment adherence. Particularly in tablet-based cognitive rehabilitation software, poor usability can increase the risk of user errors, cognitive overload, and low engagement, which may diminish therapeutic outcomes. Despite the growing integration of cognitive rehabilitation software in clinical settings, few studies have systematically evaluated its usability using structured human factor methodologies. Objective: This study aimed to conduct a formative evaluation of a tablet-based cognitive rehabilitation software by identifying potential user errors, interface design issues, and opportunities for improving the user experience and user interface (UI). Methods: Following the International Electrotechnical Commission (IEC) 62366-1 framework for usability engineering, a formative evaluation was conducted using a combination of cognitive walkthrough (CW) and the System Usability Scale (SUS). CW was used to identify interaction breakdowns and potential use-related problems through scenario-based expert evaluation. The SUS was administered to quantitatively assess perceived usability. Five occupational therapists with experience in cognitive rehabilitation participated in the formative evaluation. Results: A total of 14 usability issues were identified across 6 task scenarios. Common problems included difficulty locating buttons, insufficient feedback during task completion, and inconsistent UI behavior. Key improvement areas included keypad layout, visibility of task progress, and accessibility of help content. The mean SUS score was 73.5 (SD 11.4), indicating an acceptable usability level (grade of B–). The lowest scores were related to system complexity and interface integration, suggesting a need to optimize UI flow and content hierarchy. Conclusions: The combined use of CW and the SUS enabled the identification of both objective and perceived usability challenges in the cognitive rehabilitation software. Findings emphasize the importance of user-centered design and formative evaluation in the early stages of software development. Recommendations such as improving information visibility, reducing unnecessary steps, and enhancing system feedback may contribute to safer and more effective digital cognitive interventions. However, given the small and homogeneous participant sample and the controlled test environment, these findings should be interpreted as preliminary. This study highlights the practical application of the IEC 62366-1 framework in evaluating software as a medical device and demonstrates its utility in guiding iterative user experience and UI improvements in cognitive rehabilitation contexts.

BACKGROUND Artificial intelligence (AI)–based gait analysis systems are increasingly applied in rehabilitation settings for objective and quantitative assessment of gait function. However, despite their potential, clinical adoption remains limited due to insufficient consideration of usability, user experience, and integration into actual clinical workflows. OBJECTIVE This study aimed to conduct a formative evaluation of a prototype AI-based gait analysis system (MediStep M). METHODS A mixed methods formative usability evaluation was conducted with 5 licensed physical therapists. Qualitative data were collected through focus group interviews, and quantitative usability was measured using the system usability scale (SUS). A scenario-based usability assessment was applied to identify user interface challenges, workflow issues, and potential design improvements. RESULTS Participants identified major usability barriers, including limited accessibility of the power button, absence of battery status indicators, burdensome manual calibration, and insufficient clinical detail in the gait analysis reports. They also emphasized the need for wireless operation, improved portability, and integration with hospital electronic medical record systems. The mean SUS score was 57 (grade D), indicating suboptimal usability and the need for iterative design refinements. CONCLUSIONS Although AI-based gait analysis systems hold promise for enhancing rehabilitation outcomes, key usability challenges must be resolved before clinical implementation. Improvements in hardware portability, automated calibration, data management, and user interface design are essential to ensure safety, efficiency, and clinical applicability. These findings provide evidence-based insights to guide iterative development and promote user-centered innovation in AI-based rehabilitation technologies.

People with disabilities often experience limited participation in community-based exercise activities aimed at promoting health. The concept that “Exercise is Medicine” is widely acknowledged across societies and historical periods. However, there is a notable discontinuity between hospital-based and community-based health promotion efforts for people with disabilities. This article discusses multi-ministerial research and development (R&D) efforts in South Korea to address this issue, emphasizing the need for transitional strategies to successfully bridge the service gap. As the first collaborative multi-ministerial R&D initiative between the sports and clinical ministries in South Korea, this project focuses on community-based rehabilitation exercises through three major components: (1) Smart Exercise Equipment, (2) Disability-based Exercise Programs and Services, and (3) Data Continuity on Health Information. A standardized community rehabilitation exercise dataset was also developed to evaluate activities of daily living, primarily categorized into physiological outcomes during exercises, clinical assessments, and lifelog data measurements. The National Rehabilitation Center, under the Ministry of Health & Welfare and serving as the leading ministry, is dedicated to developing a rehabilitation exercise Living Lab that integrates these three components in collaboration with other ministries. This initiative aims to benefit people with disabilities by enhancing their health through data-driven rehabilitation exercise services. Furthermore, clinicians and community rehabilitation exercise providers could improve services by utilizing this standardized dataset, facilitating comparisons of clinical records through a public service platform.

Background: Musculoskeletal disorders significantly impair physical function and quality of life, necessitating systematic rehabilitation. Electrically powered orthopedic exercisers, such as continuous passive motion devices, are widely used to enhance joint mobility and muscle recovery. However, existing devices often lack advanced functionalities and user-specific adaptability, limiting their effectiveness. To address these shortcomings, the Rebless Pro was developed as a novel device supporting active and passive exercises with personalized treatment programs. Objective: This study aimed to conduct a formative usability evaluation of the Rebless Pro prototype using focus group interviews (FGIs) and satisfaction surveys with health care professionals specializing in rehabilitation medicine. The goal was to identify areas for improvement to enhance the safety, usability, and information clarity of the device. Methods: Usability evaluation was performed at the National Rehabilitation Center with 10 participants (5 physiatrists and 5 physical therapists) who had prior experience using similar devices. FGIs were conducted to collect qualitative insights into user experiences, while satisfaction surveys provided quantitative data on ease of use of the user interface and identifiability and understanding of information. Data collection focused on identifying risk factors and usability challenges. Results: Three key areas for improvement were identified: (1) product upgrades to ensure patient safety, including adjustments to exercise speed and resistance; (2) hardware and software improvements to improve usability, including adjustments to the location of the emergency button and improvements to the graphical user interface elements; and (3) improvements to the user manual, including detailed contraindications, patient criteria, and clearer operating instructions. Although the mean score of physiatrists (mean 4.463, SD 0.298) was higher than that of physical therapists (mean 4.114, SD 0.829) in terms of the ease of use of the user interface, the difference was not statistically significant (P=.69). Similarly, in the category of identifiability and understanding of information, higher scores were again reported by physiatrists (mean score 4.467, SD 0.506) than by physical therapists (mean 3.733, SD 0.894), but this difference was also not statistically significant (P=.22). Conclusions: Usability evaluation provided actionable insights into improving the Rebless Pro’s safety, usability, and information clarity. To further refine the device, iterative usability evaluations involving both health care professionals and patients are recommended. These efforts are expected to contribute to the development of a safe, effective, and user-friendly electrically powered orthopedic exerciser suitable for commercialization.

BACKGROUND The usability of software as a medical device plays a critical role in ensuring patient safety, clinical effectiveness, and treatment adherence. Particularly in tablet-based cognitive rehabilitation software, poor usability can increase the risk of user errors, cognitive overload, and low engagement, which may diminish therapeutic outcomes. Despite the growing integration of cognitive rehabilitation software in clinical settings, few studies have systematically evaluated its usability using structured human factor methodologies. OBJECTIVE This study aimed to conduct a formative evaluation of a tablet-based cognitive rehabilitation software by identifying potential user errors, interface design issues, and opportunities for improving the user experience and user interface (UI). METHODS Following the International Electrotechnical Commission (IEC) 62366-1 framework for usability engineering, a formative evaluation was conducted using a combination of cognitive walkthrough (CW) and the System Usability Scale (SUS). CW was used to identify interaction breakdowns and potential use-related problems through scenario-based expert evaluation. The SUS was administered to quantitatively assess perceived usability. Five occupational therapists with experience in cognitive rehabilitation participated in the formative evaluation. RESULTS A total of 14 usability issues were identified across 6 task scenarios. Common problems included difficulty locating buttons, insufficient feedback during task completion, and inconsistent UI behavior. Key improvement areas included keypad layout, visibility of task progress, and accessibility of help content. The mean SUS score was 73.5 (SD 11.4), indicating an acceptable usability level (grade of B–). The lowest scores were related to system complexity and interface integration, suggesting a need to optimize UI flow and content hierarchy. CONCLUSIONS The combined use of CW and the SUS enabled the identification of both objective and perceived usability challenges in the cognitive rehabilitation software. Findings emphasize the importance of user-centered design and formative evaluation in the early stages of software development. Recommendations such as improving information visibility, reducing unnecessary steps, and enhancing system feedback may contribute to safer and more effective digital cognitive interventions. However, given the small and homogeneous participant sample and the controlled test environment, these findings should be interpreted as preliminary. This study highlights the practical application of the IEC 62366-1 framework in evaluating software as a medical device and demonstrates its utility in guiding iterative user experience and UI improvements in cognitive rehabilitation contexts.

Background: The use of virtual reality (VR) technology in rehabilitation therapy has been growing, leading to the development of VR-based upper-limb rehabilitation softwares. To ensure the effective use of such software, usability evaluations are critical to enhance user satisfaction and identify potential usability issues. Objective: This study aims to evaluate the usability of a VR-based upper-limb rehabilitation software from the perspective of occupational therapists. Specifically, the study seeks to identify usability challenges and provide insights to improve user satisfaction. Methods: The VR-based upper-limb rehabilitation software was tailored for therapists to operate while delivering therapy to patients. Usability testing was conducted with occupational therapists from the Korean National Rehabilitation Center using cognitive walkthroughs and surveys. Participants performed tasks that simulated real clinical scenarios, including turning the device on, assisting patients with wearing the device, and shutting it down. Observers recorded user reactions during task performance, and participants completed surveys to assess the ease of use of the user interface. This mixed-methods approach provided qualitative insights into user difficulties and their root causes. Results: Usability evaluations were conducted with 6 participants. Cognitive walkthroughs revealed potential areas for improvement in the software, including (1) enhancements to the graphical user interface for ease of use, (2) refinements in the natural user interface, and (3) better user manuals for clearer product instructions. The ease-of-use score for the user interface averaged 1.58 on a 5-point scale (1=very easy to 5=very difficult). Conclusions: This study provides valuable insights into improving user satisfaction by focusing on the needs of occupational therapists who operate a VR-based rehabilitation software. Future research should explore software refinement and clinical efficacy to maximize the therapeutic potential of such technologies.

Background. People with disabilities face considerable obstacles when exercising, which precludes them from the social and health benefits of physical activity. Especially for individuals with paraplegia with spinal cord injuries, it is necessary to maintain continuous participation in physical activity even after discharge, as it helps to maintain mobility and daily living activities through upper body strength. However, the participation rate of people with disabilities in physical activity in Korea is still low, mainly due to the lack of exercise equipment and facilities. Objectives. The aim of this study is to identify aspects that can be improved for better accessibility to exercise equipment for individuals with paraplegia with spinal cord injuries and to reach a consensus on possible guidelines for accessible exercise equipment. Methods. This study reviews and evaluated the usability of four existing upper-body exercise equipment for individuals with paraplegia with spinal cord injuries. To assess usability, task performance scores and time were measured, and a survey was conducted on safety and satisfaction. Based on these results, areas for improvement were identified. Through literature review, usability results, and opinions from various stakeholders, eight requirements for universal accessibility were proposed. Results. It is necessary to consider how wheelchair users access the exercise equipment. The access method to the exercise area (facility regulations, auxiliary equipment to be provided, etc.) and placement of exercise equipment should also be considered. Information such as explanations of the exercise equipment and how to use it should be located within the wheelchair users field of vision. Considering the participation rate in sports for people with disabilities in Korea, it is necessary to explain the exact exercise equipment and exercise method. It is also necessary to consider how wheelchair users transfer from the wheelchair to the seat of the exercise equipment. Parts that require manipulation of each exercise equipment must be within the wheelchair users range of motion. Various supports or assistive devices that provide body support according to each piece of equipment are needed. In addition to the wheelchairs own brake, it is necessary to provide a fixing device so that the wheelchair does not move during the exercise. Conclusion. For people with spinal cord injuries, the arm ergometer, aerobic exercise equipment, showed higher scores in performance, stability, and satisfaction compared to other exercise equipment. Among the strength exercise equipment, shoulder press had an effect on performance, seated lat pull-down had an effect on stability, and seated chest press had an effect on satisfaction. Therefore, when selecting exercise equipment, it is necessary to recommend aerobic and strength exercise equipment according to the preferences of people with spinal cord injuries. When developing strength exercise equipment, it is necessary to consider usability evaluation factors for individuals with spinal cord injury.