Impact of a 3D animation-based mobile self-exercise program on physical function and rehabilitation adherence in individuals with spinal cord injury: a prospective pilot study

PURPOSE: This pilot study aimed to evaluate the feasibility, safety, and preliminary effects of a 12-week self-exercise program delivered via a three-dimensional (3D) animation-based mobile application for individuals with spinal cord injury (SCI). MATERIALS AND METHODS: Fifteen manual wheelchair users with SCI participated in a progressive 12-week intervention. The program utilised a smartphone application featuring 3D animated exercises designed to enhance motor learning and rehabilitation adherence. Primary outcomes included adherence rates, user satisfaction, and physical function (muscle strength, arm circumference). Secondary outcomes included metabolic markers and health-related quality of life (HRQoL). RESULTS: The intervention demonstrated high feasibility, with an 81.0% adherence rate and a satisfaction score of 39.8/50. Significant improvements were observed in upper extremity strength, including elbow flexors, extensors, and grip strength (p < 0.001). However, no significant changes were found in cardiometabolic markers or HRQoL. This divergence likely reflects the strategic focus of the protocol on musculoskeletal strengthening rather than intensive cardiorespiratory conditioning. No serious adverse events occurred; minor events, such as transient muscle soreness (28.6%), resolved spontaneously. CONCLUSION: A 3D animation-based mobile exercise program is a feasible and well-accepted tool for SCI rehabilitation, showing significant potential for enhancing upper extremity strength. While metabolic and quality-of-life changes were limited - potentially due to the specificity and short duration of the intervention - the high adherence and safety profiles suggest this platform is a reliable tool for long-term rehabilitation. Further investigation through large-scale randomised controlled trials is warranted to optimise multi-modal protocols.