Usability Of A Web-based Application For The Clinical Implementation Of Blood Flow Restriction Exercise

Accumulating evidence indicates that exercise with blood flow restriction (BFR) is an effective strategy for increasing muscle size and strength in a variety of clinical populations. However, a lack of standardized methods for implementing exercise with BFR present a major barrier to its use by practitioners. PURPOSE: To perform preliminary usability testing of a novel web-based implementation support tool for physical therapists. METHODS: A web-based application was developed to guide physical therapists through the steps of medically screening potential BFR candidates, selecting appropriate equipment for performing BFR, and determining safe and effective exercising cuff pressures. Usability of the application was evaluated in five licensed physical therapists using a mixed methods approach. User-based evaluations were conducted in which participants used the application to implement exercise with BFR in three hypothetical patients in a randomized order. Time to completion was analyzed across scenarios using a one-way repeated measures ANOVA. Perceived usability of the application was evaluated by comparing System Usability Scale (SUS) scores to industry standards with a one-sample t-test. Lastly, semi-structured interviews were conducted and analyzed using thematic analysis. RESULTS: All patient scenarios resulted in successful implementation of exercise with BFR. Time to completion was 2.3 ± 1.2 min and did not vary by scenario order (p = 0.09). There was a total of 11 incidents during the completion of patient scenarios which consisted of minor navigation issues (4), data input issues (2), and difficulty interpreting recommendations (5). Composite SUS scores (94 ± 5) were greater than the reported industry mean (p < 0.01). Participants reported that the web-based application was efficient to use (100%), improved their confidence when implementing exercise with BFR (60%), and would make practitioners more likely to utilize exercise with BFR in clinical practice (100%). CONCLUSION: Our web-based application provided an effective and efficient tool for aiding physical therapists in the implementation of exercise with BFR. Accordingly, this tool could help to increase the accessibility of this modality in clinical settings and improve the safety and effectiveness of its implementation. Michigan Tech Health Research Institute