Enhancing Fracture Aftercare Through a Human-Centered Mobile App

Design

Matthias Maszuhn, Felix Jansen, Frerk M

uller-von Aschwege and Andreas Hein

OFFIS e. V., Escherweg 2, Oldenburg, Germany

Keywords:

Fracture Aftercare, Physiotherapy Support, Mobile Health App, Human-Centered Design, Patient

Compliance, Rehabilitation Technology, User Experience Questionnaire.

Abstract:

The rehabilitation process after fractures is crucial for achieving full recovery and maintaining patients’ quality

of life, yet it faces growing obstacles due to demographic changes and healthcare resource shortages. This pa-

per proposes a mobile app prototype for physiotherapy aftercare, integrating features like exercise assistance,

load monitoring, and collaborative documentation to enhance patient support and accessibility. Employing a

Human-Centered Design approach, requirements were gathered initially through a comprehensive literature re-

view, followed by the creation of user personas. Final requirements were then reﬁned through semi-structured

interviews with physiotherapists and clinical staff. The prototype was subsequently evaluated in a user study

with 16 participants using the Think-Aloud method and the User Experience Questionnaire (UEQ). Results in-

dicated high user satisfaction with features such as education, exercise guidance, and progress tracking, though

minor usability improvements were identiﬁed. By providing real-time feedback, clear progress tracking, and

personalized guidance, the app aims to improve patient compliance with rehabilitation protocols, ensuring

more consistent engagement throughout the recovery process. Future iterations will focus on expanding func-

tionality and validating the solution across diverse demographics, emphasizing its potential to signiﬁcantly

improve rehabilitation outcomes.

1 INTRODUCTION

Effective fracture aftercare is essential for restoring

full mobility. This can prevent long-term complica-

tions and signiﬁcantly improve the patients’ quality of

life. However, the ongoing demographic shift, includ-

ing an aging population and fewer health insurance

contributors, is making access to necessary physio-

therapy increasingly challenging. Additionally, there

is a growing shortage of skilled professionals in the

healthcare sector, further aggravating these issues. By

2035, an estimated 1.8 million jobs in the german

healthcare sector may remain unﬁlled due to stafﬁng

shortages (Kreuzenbeck et al., 2023).

Moreover, access to necessary aftercare is partic-

ularly challenging for patients in rural areas or those

with limited mobility. In these regions, healthcare fa-

cilities and physiotherapy practices may be far from

patients’ homes, making it difﬁcult to maintain regu-

lar in-person appointments (Barton et al., 2021). For

patients with mobility issues, traveling to therapy ses-

sions can be a signiﬁcant barrier to consistent rehabil-

itation.

One potential solution to address the shortage of

healthcare professionals and the accessibility of phys-

iotherapy is the integration of digital medical prod-

ucts, such as mobile apps and telehealth platforms,

into aftercare practices (Grodon et al., 2024). In addi-

tion to features designed for healthcare professionals,

such as documentation and remote monitoring, apps

can also offer patient-centered functions (Schaaff and

Kittel, 2023). These features may include personal-

ized rehabilitation exercises, real-time guidance, and

interactive support to enhance the recovery experi-

ence. By reducing the need for in-person appoint-

ments, digital solutions can help alleviate the strain

on healthcare providers while maintaining or even im-

proving the quality and accessibility of fracture after-

care for patients.

Digital aftercare solutions also provide patients

with enhanced transparency about their own recov-

ery progress. Features such as progress tracking, per-

sonalized dashboards, and data summaries allow pa-

tients to actively monitor their improvements over

time. This level of insight not only increases patient

engagement and motivation but also builds conﬁdence

by allowing them to see the results of their rehabilita-

tion efforts (Lang et al., 2022).

Furthermore, a digital system allows for faster re-

sponse to complications during the treatment process

Maszuhn, M., Jansen, F., Aschwege, F. M. and Hein, A.

Enhancing Fracture Aftercare Through a Human-Centered Mobile App Design.

DOI: 10.5220/0013307500003911

Paper published under CC license (CC BY-NC-ND 4.0)

In Proceedings of the 18th International Joint Conference on Biomedical Engineering Systems and Technologies (BIOSTEC 2025) - Volume 2: HEALTHINF, pages 219-227

ISBN: 978-989-758-731-3; ISSN: 2184-4305

219

(Ebrahimian et al., 2022). With real-time monitoring

and continuous data collection, healthcare providers

can quickly identify any deviations from the expected

recovery trajectory. As patient data - such as pain lev-

els, mobility progress, or exercise compliance - are

updated regularly, clinicians can intervene at an ear-

lier stage if issues arise, reducing the risk of compli-

cations. This immediate access to up-to-date informa-

tion ensures that treatment adjustments can be made

swiftly, and patients can receive timely support.

For a complete and swift recovery following a

fracture, the exercises patients perform at home are

just as crucial as the in-person physical therapy ses-

sions. While therapy sessions provide essential guid-

ance and supervised practice, consistent at-home ex-

ercises have the most signiﬁcant impact on recov-

ery outcomes. However, many patients feel uncertain

about whether they remember the exercises correctly

or are performing them with proper technique once

they return home from a therapy session. This lack of

conﬁdence and fear of re-injury can hinder adherence

to prescribed exercises and, consequently, slow down

the rehabilitation process.

Overall, an effective app for fracture aftercare

must be designed to be intuitively usable regardless

of the patients technological knowledge. This en-

sures accessibility for both younger users and older

patients who may have less experience with digital

tools. Given the extended duration of the recovery

process, it is equally important to ensure patient moti-

vation to engage with the app consistently throughout

the entire aftercare period. Unlike recreational apps

such as games, medical apps are typically used out

of necessity rather than for enjoyment, resulting in a

lower tolerance for frustration. If features do not work

as expected, users may quickly abandon the app, un-

dermining its intended beneﬁts. Therefore, it is cru-

cial to focus on delivering an app that not only meets

but also simpliﬁes patients’ needs, offering all essen-

tial functions required for a seamless and effective re-

habilitation journey.

2 RELATED WORK

The fundamental need for and beneﬁts of therapy sup-

port apps were identiﬁed by Benignus et al. (Be-

nignus et al., 2022), with potential features already

explored and evaluated in various publications. The

ﬁndings by Kim et al. (Kim et al., 2022) on the de-

velopment of a health app with exercise support indi-

cate that self-guided exercise and maintaining motiva-

tion pose signiﬁcant challenges for users. Other apps,

such as those developed by Krainer et al. (Krainer

Figure 1: The ﬁgure shows the four phases of the Human-

Centered Design process. Phases three and four are re-

peated twice: the prototype is ﬁrst improved based on expert

feedback, and the second version is then evaluated in a user

study.

et al., 2022) for stroke rehabilitation and by Kim et

al. (Kim et al., 2022) for supporting self-guided exer-

cises, include features that could also be relevant for

a post-trauma surgical therapy app. Features such as

exercise support, appointment scheduling, and patient

education were well-received and positively evaluated

by participants in these studies. For some of these

features, studies have already shown their impact on

therapeutic outcomes, such as Wittink et al.’s (Wittink

and Oosterhaven, 2018) study on patient education.

Studies, such as the one conducted by Kalmet et

al. (Kalmet et al., 2018), investigate the role of track-

ing and adjusting weight-bearing during rehabilita-

tion. Their ﬁndings suggest that carefully monitored

weight-bearing protocols can lead to improved recov-

ery outcomes by allowing patients to gradually ap-

ply weight, thus enhancing daily activities and qual-

ity of life without increasing pain or complications.

This underscores the potential of integrating weight-

bearing tracking as a feature in therapy support tools.

Health apps, in particular, bear the risk of being

overly complex, incorporating features that patients

may ﬁnd confusing or structured to align with medi-

cal professionals’ needs but unintuitive for users. (An

et al., 2023) A key challenge in developing health ap-

plications is tailoring them to the individual needs of

the users. Therefore, it is important to include pa-

tients as the future users of such systems in the de-

sign process. The potential of applying the Human-

Centered Design (HCD) approach to health apps has

already been explored by Altman et al. (Altman et al.,

2018), who demonstrated how this methodology can

drive innovation, improve user experience, and create

HEALTHINF 2025 - 18th International Conference on Health Informatics

220

Figure 2: The ﬁgure shows the four main views in the prototype: a) The main screen when starting the app shows new

notiﬁcations as well as a history of the physical load at the fracture, the next physiotherapy assessment and the next training

exercise. b) The training overview shows a more detailed explanation of the next exercise along with the material needed and

a progress bar to track how many exercises should still be done. c) The calendar shows the next physiotherapy session or the

next clinical monitoring. It also contains a function to request assessments with the clinic or physiotherapy. d) The history

gives a more detailed look at the current and past physical load compared to the felt pain that can be recorded by the patient.

patient-focused solutions tailored to addressing com-

plex healthcare challenges.

The proposed system aims to integrate features

such as exercise assistance, load monitoring, collab-

orative documentation, progress tracking, and edu-

cational content into a single app that supports pa-

tients throughout the therapy process while remain-

ing intuitive and user-friendly. It prioritizes ease of

use to accommodate patients with varying levels of

technological proﬁciency, reducing the risk of frus-

tration or disengagement. By maintaining simplicity

and focusing on essential functions, the system seeks

to empower users without overwhelming them, ensur-

ing they can navigate the app conﬁdently and stay en-

gaged throughout their rehabilitation journey. While

several rehabilitation mobile apps have been devel-

oped, many of which incorporate user-centered ap-

proaches, a comprehensive system integrating all nec-

essary features for effective postoperative care fol-

lowing a fracture is still not widely available. This

work aims to explore and address this potential gap.

A Human-Centered Design approach helps to ensure

that the app effectively addresses the real needs of its

users.

3 CONTRIBUTION

In a previous work, we proposed a comprehensive

mobile application to connect healthcare profession-

als and patients. (Maszuhn et al., 2024) This system

included three main features:

1. A recording and assessment system for perform-

ing at-home physiotherapy exercises

2. A load measurement system that can monitor the

weight-bearing and warn patients if they exceed

their current limit. For example, this could be

achieved by integrating sensory insole data into

our app.

3. A shared documentation tool where all stakehold-

ers involved in the aftercare process can collabo-

rate to access and update treatment-related data

In this work we want to focus more on the pa-

tient side of our app. Our goal is to identify the key

features for an aftercare app that would beneﬁt the

recovery process the most. Another incentive is to

ﬁnd additional useful features that we didn’t think of

yet. For this we conduct a usability study where we

present a simple prototype of the patient app with ba-

sic navigation and functionality to the participants.

It also contains placeholders for the aforementioned

Enhancing Fracture Aftercare Through a Human-Centered Mobile App Design

221

features, i.e., the training assistance system and the

load measurement system to give participants a ba-

sic idea of how they work. The participants are then

asked to share their thoughts while navigating through

the app using the Think-Aloud method and complete

the user experience questionnaire (UEQ).

In summary, this work aims to answer the follow-

ing questions regarding the app:

1. How well do the provided functions align with the

users’ expectations? (In this work we do explicitly

not cover the app’s design)

2. In what ways do the functions and content avail-

able in the mock-up support therapy in physio-

therapy care, and what additional features could

be beneﬁcial?

3. What are users’ intentions and motivations re-

garding the use of the app for therapeutic pur-

poses?

4 METHODS

In this work, we applied the Human-Centered Design

(HCD) approach to guide the development process of

our prototype, adhering to the ’Human-centred de-

sign for interactive systems’ standard in ISO 9241-

210. (International Organization for Standardization,

2019). HCD is a design methodology that focuses on

understanding the needs, preferences, and limitations

of end-users at every stage of the design process, en-

suring that the ﬁnal product is intuitive, effective, and

tailored to the user’s experience. This methodology is

structured into four iterative phases as shown in Fig-

ure 1: understanding and specifying the context of

use, specifying user requirements, creating a design

solution, and evaluating the design.

The foundation for the prototype’s core functions

was established in an earlier study, in which initial

features were explored and outlined. Additionally, an

extensive review of current developments in exercise

assistance and weight-bearing was conducted. In the

second phase, we gathered requirements by creating

personas representing typical patient groups using the

app and use case scenarios. We also conducted semi-

structured interviews with the project’s physiothera-

pists and clinical staff to further reﬁne these require-

ments.

The requirements were then implemented in a

mock-up using the design software ”Figma”. Dur-

ing development, the design was guided by Nielsen’s

heuristics, Apple’s ’Human Interface Guidelines,’ and

comparable existing applications. The prototype was

developed across two iterations. In the ﬁrst evalua-

tion, an expert review was conducted using selected

Nielsen heuristics. The feedback from the expert

evaluation informed revisions for the second iteration,

leading to an updated design. The second version of

the mock-up underwent a ﬁnal evaluation with poten-

tial users, which is described in more detail in sec-

tion 5. This assessment employed the Think-Aloud

method alongside the User Experience Questionnaire

(UEQ) to collect both qualitative and quantitative in-

sights.

5 USER STUDY PROCEDURE

Figure 3: Left side: From the menu, patients can access fea-

tures such as educational content, shared documents, and

questionnaires. Right side: The education view, which

received the most positive feedback, provides information

about fractures and tips for aftercare.

We recruited a total of 16 participants for our study - 8

males and 8 females, with an average age of 27 years

(σ ± 8). We recognize that the average age of patients

tends to be higher. However, patient demographics

are generally divided into two groups: fractures in

older individuals, often caused by falls, and fractures

in younger individuals, typically resulting from sports

injuries. Our study thus focuses on sports-related in-

juries, anticipating that younger users are generally

more comfortable using apps. The participants had to

be at least 18 years of age, be ﬂuent in German and ex-

perienced either a fracture or ligament tear followed

by physiotherapy within the past ten years. To min-

imize potential bias, standardized information about

the study and project was provided to the participants,

with an option to answer speciﬁc questions verbally.

Each session was conducted individually in a con-

HEALTHINF 2025 - 18th International Conference on Health Informatics

222

trolled laboratory setting over a two-week period. The

study moderator as well as a note-taker were present

to observe and record ﬁndings. Participants were pro-

vided with a modern smartphone pre-installed with

the prototype. The smartphone screen was mirrored

to the moderator at all times and the screen was addi-

tionally recorded to allow an analysis afterwards.

Using the simultaneous Think-aloud method, par-

ticipants were encouraged to share both positive and

negative feedback about the mock-up at any point.

This method also helped us to understand the interac-

tion with the prototype better and to prevent interpre-

tation errors. At the beginning of each session, partic-

ipants had ﬁve minutes to freely explore the prototype

and familiarize themselves with its interface and fea-

tures. Following this, the participants were asked to

navigate through the prototype to simulate the com-

pletion of ten typical tasks within our app. The spe-

ciﬁc tasks, listed in 6.2, were designed to cover all

major areas of the prototype, ensuring comprehensive

feedback on each feature and section of the interface.

During the tasks we did not interact with the partic-

ipants other than telling them when they ﬁnished a

task.

After completing the tasks, participants provided

overall feedback on the prototype, reﬂecting on which

app views and features they found most beneﬁcial for

their therapy experience. They also suggested addi-

tional functionalities that could enhance rehabilita-

tion. To conclude the session, participants ﬁlled out

the User Experience Questionnaire (UEQ). The UEQ

comprises 26 bipolar items, grouped into six fac-

tors: Attractiveness, Clarity, Efﬁciency, Controllabil-

ity, Stimulation, and Novelty (Laugwitz et al., 2008).

Attractiveness comprises six items, while the remain-

ing factors each include four items, collectively as-

sessing various aspects of user experience.

6 RESULTS

6.1 Think-Aloud Method

The Think-aloud method was evaluated using ”sum-

marizing qualitative content analysis” (Mayring and

Fenzl, 2019), which is a systematic approach used to

condense and analyze textual data by focusing on the

core content while reducing redundant information.

The categories were deﬁned deductively from the re-

search questions and the participants’ statements were

assigned to the relevant research questions where pos-

sible. The categories included statements related to:

• speciﬁc views of the prototype

• missing functions

• the overall structure of the prototype

• the participants’ intention to use the app in case of

future therapy

In the overall evaluation, statements were grouped

that rated one or more functions, or the entire project,

as positive, effective, or useful. This was the case for

all 16 participants; however, some limitations regard-

ing the intent to use were also noted. None of the

participants made negative comments about the fun-

damental system or its functions; only limitations re-

garding intended use were noted. Not all participants

commented on each individual function or view in the

prototype when evaluating speciﬁc features, but each

participant could comment on multiple features.

6.1.1 Evaluation of Speciﬁc Views

Figure 4: The graphic shows the six most positively rated

views in the app. All comments gathered with the Think-

aloud method regarding a view being ”good” or ”useful”

were grouped here.

Positive statements that were mentioned multiple

times and could be attributed to speciﬁc functions are

shown in Figure 4. Only statements that explicitly de-

scribe one of the functions are included and only func-

tions evaluated by more than seven participants are

presented in the ﬁgure. The information section (Fig-

ure 3) received the most positive feedback (N=12).

According to the participants, the key reason for the

positive evaluation was the availability of reliable and

veriﬁed information within the app, reducing the need

for time-consuming and potentially error-prone on-

line research. The second most frequently mentioned

positive feedback was that the exercise assistance fea-

ture (Figure 2b) was highly practical (N=10). Addi-

tionally, participants noted that the exercise catalog

provided a good overview of additional exercises and

the included progress bar was seen as useful. How-

ever, they felt that more information than necessary

was displayed alongside the progress bar.

Enhancing Fracture Aftercare Through a Human-Centered Mobile App Design

223

A total of N=9 participants speciﬁcally com-

mented on the physical load history feature (Fig-

ure 2d). They noted that the timeline was consid-

ered easy to follow, and the pain tracking feature was

appreciated for promoting transparency among stake-

holders. This was followed by the function to request

appointments (N=8) (Figure 2c), notiﬁcations regard-

ing the recovery status (N=8) and the document-

sharing (N=8). Especially for the latter, the traditional

method of transferring documents via paper or CDs

was perceived as cumbersome, making this in-app

feature a positive advancement. Other sub-functions,

such as the schedule (N=5) and scar care (N=3), were

also positively mentioned multiple times.

6.1.2 Missing Functions

Following the Think-aloud method, participants were

asked if there were any features they felt were miss-

ing thus should be added. The most frequently re-

quested function was the ability to export the calen-

dar to a smartphone’s system calendar (N=5). Four

participants expressed the desire to add notes on pain

assessments and pain progression to potentially link

changes in their pain perception to speciﬁc events.

Additional features and requests were mentioned by

individual participants, but these were not included in

the further analysis due to their singularity.

6.1.3 Structure of the App

To assess the app’s structure, statements were grouped

into categories related to sorting and usability. Ten

participants responded positively to the app’s overall

structure, describing it as intuitive and aligned with

their expectations, whereas six made no remarks on

the structure. Few comments were repeated across

participants; individual opinions mostly concerned in-

ternal links between views or speciﬁc design sugges-

tions. Four participants commented on the overview

(Figure 2a), critiquing it as cluttered and overly com-

plex. For the home screen structure, participants

noted that appointments should take prominence, fol-

lowed by notiﬁcations and progress tracking. Two

participants suggested that new notiﬁcations should

be more clearly highlighted within their respective

views. Regarding the load history view (Figure 2d),

four participants mentioned that a zoom function, per-

haps via a pinch gesture, would be useful.

6.1.4 Intention of Use

Participant statements regarding their intention to use

the app were also considered. comments on the app’s

usefulness for managing their own or similar injuries

were interpreted as an intention to use. Ten partic-

ipants made statements reﬂecting an intent to use a

fully developed app with the demonstrated features.

Additionally, six participants commented on the pri-

oritization of certain features, with some mentioning

multiple functions. Four identiﬁed training support

as the most important feature, three prioritized docu-

ment sharing and informational content, and two val-

ued the contacts feature.

6.2 Task Evaluation

All sixteen participants completed all ten tasks. Be-

low are the tasks along with the number of partici-

pants who encountered difﬁculties with each. This

includes all instances where participants mistakenly

navigated to another view in the app ﬁrst The tasks

were designed to cover each area of the mock-up and

required extensive navigation.

1. Request an appointment for a check-up at the joint

practice! (N=6)

2. Look for information on possible swelling after

the operation! (N=6)

3. Turn off the notiﬁcations! (N=2)

4. Find and start the questionnaire on your general

condition! (N=1)

5. Check with whom the medical history form from

the clinic was shared! (N=1)

6. Find out the business email address of your doc-

tor! (N=0)

7. Find out what the physiotherapy schedule is for

the 3rd-6th week after the operation! (N=13)

8. Find the overview of the exercises that are already

stored in the prototype! (N=3)

9. Find the information on the care of the surgical

scar! (N=2)

10. What was the approximate weight bearing 60 days

after the operation? (N=1)

Most tasks were completed by participants within

seconds. We attribute the higher error rate on the ﬁrst

two tasks to participants still familiarizing themselves

with sections of the prototype that they hadn’t yet ex-

plored during the initial orientation phase of the study.

The highest number of issues occurred with Task

7, with thirteen participants experiencing difﬁculties.

Participants reported that the high error rate for Task

7 was mainly due to the wording of the task and the

terminology used within the prototype. In the Edu-

cation section, there is a subsection labeled ”After the

Surgery”, which participants mistakenly referenced to

complete the task.

HEALTHINF 2025 - 18th International Conference on Health Informatics

224

Figure 5: The results were compared to a dataset released by the UEQ authors with 468 other prototypes that were evaluated

with the UEQ. An ”excellent” score implies a score in the top 10% of evaluated studies. a ”good” rating is within the top

25%, an ”above average” rating within the top 50%.

Table 1: The 26 bipolar items of the UEQ were assigned to six factors on a scale from -3 to 3.

Factor Mean (M) Standard Deviation Conﬁdence intervals (p=0.05) per factor

Attractiveness 1.740 0.667 1.413 to 2.066

Perspicuity 1.938 0.692 1.598 to 2.277

Efﬁciency 1.594 0.898 1.153 to 2.034

Dependability 1.953 0.660 1.630 to 2.276

Stimulation 1.391 0.992 0.905 to 1.876

Novelty 0.875 1.165 0.304 to 1.446

6.3 User Experience Questionnaire

For the analysis of the User Experience Questionnaire

(UEQ), the items’ seven-point scale was converted to

values ranging from -3 (extremely poor) to +3 (ex-

tremely good). Mean values were calculated, and

the standard deviation was determined. Mean values

from -0.8 to 0.8 indicate a neutral assessment of an

item or factor, values below -0.8 are considered neg-

ative, and values above 0.8 as positive. The results of

the UEQ are presented in Figure 6 and Table 1.

The prototype achieved an overall positive rat-

ing. The UEQ authors also provide a general bench-

mark for the questionnaire that allows to compare the

results with 468 other software prototypes (Schrepp

et al., 2017). Compared to this benchmark, the de-

pendability factor was rated as excellent, placing it

within the top 10% of comparative studies. Attrac-

tiveness, perspicuity, efﬁciency, and stimulation were

rated as good (with 10% of comparative studies scor-

ing better and 75% scoring worse). Only the novelty

factor fell slightly short and was assessed as above av-

erage (25% of comparative studies scoring better and

Figure 6: The six UEQ factors in comparison. The depend-

ability received the highest rating while the novelty was

rated slightly worse than the other factors.

50% scoring worse) (Figure 5). However, this is to be

expected for a prototype in the medical context as the

benchmark contains all types of software.

Enhancing Fracture Aftercare Through a Human-Centered Mobile App Design

225

7 CONCLUSION

In conclusion we presented the development of a pro-

totype for the patient interface of a comprehensive

mobile app designed for fracture aftercare. For this,

we used a Human-Centered Design approach. The re-

quirements for the app were gathered by developing

personas and typical use case scenarios and conduct-

ing interviews with the stakeholders, i.e. physiother-

apists, doctors and patients. The prototype was than

evaluated by 16 study participants who had fractures

or similar injuries requiring physiotherapy in the past.

The study highlights the signiﬁcant potential of

digital aftercare solutions to address challenges in

physiotherapy care. The proposed mobile app pro-

totype demonstrated promising features, including

training assistance, load monitoring, and a shared

documentation tool, which were positively received

by the participants. These functions align with identi-

ﬁed needs for enhancing therapy support and increas-

ing accessibility, especially for patients with mobility

issues or those in rural areas.

Feedback from participants emphasized the proto-

type’s intuitive design and practical application. High

levels of user satisfaction were reported in key ar-

eas such as attractiveness, clarity, and dependability.

While some limitations were noted, particularly re-

garding speciﬁc functionalities and task terminology,

these ﬁndings provide valuable insights for reﬁning

the app’s features. Additionally, the ability to monitor

recovery progress and offer real-time guidance fosters

transparency, engagement, and conﬁdence among pa-

tients, while also enabling timely clinical intervention

when necessary.

The study underscores the importance of involv-

ing stakeholders, especially patients, in the develop-

ment process to ensure that digital solutions meet

real-world needs. By integrating Human-Centered

Design principles and addressing identiﬁed gaps, the

app has the potential to signiﬁcantly improve after-

care experiences and outcomes. Future work will

focus on implementing additional requested features

and further validating the app with a broader patient

demographic to optimize its usability and therapeutic

impact.

REFERENCES

Altman, M., Huang, T. T., and Breland, J. Y. (2018). Design

thinking in health care. Preventing Chronic Disease,

15:E117. Accessed: 2024-07-28.

An, Q., Kelley, M., Hanners, A., and Yen, P. (2023). Sus-

tainable development for mobile health apps using the

human-centered design process. JMIR Formative Re-

search, 7:e45694.

Barton, B., Boonyasai, R. T., and Hahn, C. (2021). 2019 na-

tional healthcare quality and disparities report: Chart-

book on rural healthcare. Accessed: 2024-11-19.

Benignus, C., Buschner, P., Meier, M. K., and Beckmann,

J. (2022). Sinn und unsinn von patienten-apps in der

endoprothetik. Die Orthop

adie, 51(9):703–707.

Ebrahimian, E. T., Taylor, M. L., et al. (2022). Factors inﬂu-

encing the effectiveness of remote patient monitoring

interventions: a realist review. BMJ Open, 12(7).

Grodon, J., Tack, C., Eccott, L., and Cairns, M. C. (2024).

Patient experience and barriers of using a mhealth

exercise app in musculoskeletal (msk) physiotherapy.

PLOS Digital Health, 3(10):e0000626.

International Organization for Standardization (2019). Iso

9241-210: Ergonomics of human-system interaction

– part 210: Human-centred design for interactive sys-

tems. Technical report, International Organization for

Standardization. ISO standard document, available

through ISO or its authorized distributors.

Kalmet, P., Meys, G., van Horn, Y., et al. (2018). Permissive

weight bearing in trauma patients with fracture of the

lower extremities: prospective multicenter compara-

tive cohort study. BMC Surgery, 18:8.

Kim, M., Kim, Y., and Choi, M. Mobile health platform

based on user-centered design to promote exercise for

patients with peripheral artery disease. 22(1):206.

Krainer, D., Wohofsky, L., and Schubert, P. Design re-

quirements for a (tele-) rehabilitation platform: Re-

sults from a participatory process. In dHealth 2022,

pages 224–231. IOS Press.

Kreuzenbeck, C., Schwendemann, H., and Thiede,

M. (2023). Herausforderungen der babyboomer-

generation – probleme und l

osungsans

atze im gesund-

heitswesen. In Kreuzenbeck, C., Schwendemann, H.,

and Thiede, M., editors, Die Herausforderungen der

Generation Babyboomer f

ur das Gesundheitswesen,

pages 3–11. Springer, Berlin, Heidelberg. Accessed:

2024-07-22.

Lang, S., McLelland, C., MacDonald, D., and Hamilton, D.

(2022). Do digital interventions increase adherence to

home exercise rehabilitation? a systematic review of

randomised controlled trials. Archives of Physiother-

apy, 12:24.

Laugwitz, B., Held, T., and Schrepp, M. (2008). Construc-

tion and evaluation of a user experience questionnaire.

volume 5298, pages 63–76.

Maszuhn, M., M

uller-von Aschwege, F., Jansen, F., Hein,

A., Knol, H., Snowdon, D., Buscherm

ohle, M., Barth,

D., Haag, L., Wohlers, N., et al. (2024). Bridging gaps

in fracture rehabilitation: A mobile solution proposal

for comprehensive recovery. In BIOSTEC (2), pages

646–653.

Mayring, P. and Fenzl, T. (2019). Qualitative Inhalts-

analyse, pages 633–648. Springer Fachmedien Wies-

baden, Wiesbaden.

Schaaff, K. and Kittel, A. (2023). Schritt halten mit der digi-

talen transformation durch individualisierte lernumge-

bungen. In Kreuzenbeck, C., Schwendemann, H., and

HEALTHINF 2025 - 18th International Conference on Health Informatics

226

Thiede, M., editors, Die Herausforderungen der Gen-

eration Babyboomer f

ur das Gesundheitswesen, pages

25–41. Springer, Berlin, Heidelberg. Accessed: 2024-

07-22.

Schrepp, M., Hinderks, A., and Thomaschewski, J. (2017).

Construction of a benchmark for the user experience

questionnaire (ueq). International Journal of Interac-

tive Multimedia and Artiﬁcial Intelligence, 4:40–44.

Wittink, H. and Oosterhaven, J. Patient education and

health literacy. 38:120–127.

Enhancing Fracture Aftercare Through a Human-Centered Mobile App Design

227