title: Study of the usability of spaced retrieval exercise using mobile devices for Alzheimer's disease rehabilitation.
abstract: BACKGROUND
  Alzheimer's disease (AD) is an irreversible brain disease that slowly destroys memory and thinking skills, and eventually the ability to carry out the simplest daily tasks. Recent studies showed that people with AD might actually benefit from physical exercises and rehabilitation processes. Studies show that rehabilitation would also add value in making the day for an individual with AD a little less foggy, frustrating, isolated, and stressful for as long as possible.
  
  
  OBJECTIVE
  The focus of our work was to explore the use of modern mobile technology to enable people with AD to improve their abilities to perform activities of daily living, and hence to promote independence and participation in social activities. Our work also aimed at reducing the burden on caregivers by increasing the AD patients' sense of competence and ability to handle behavior problems.
  
  
  METHODS
  We developed ADcope, an integrated app that includes several modules that targeted individuals with AD, using mobile devices. We have developed two different user interfaces: text-based and graphic-based. To evaluate the usability of the app, 10 participants with early stages of AD were asked to run the two user interfaces of the spaced retrieval memory exercise using a tablet mobile device.
  
  
  RESULTS
  We selected 10 participants with early stages of AD (average age: 75 years; 6/10, 60% males, 4/10, 40% females). The average elapsed time per question between the text-based task (14.04 seconds) and the graphic-based task (12.89 seconds) was significantly different (P=.047). There was also a significant difference (P<.001) between the average correct answer score between the text-based task (7.60/10) and the graphic-based task (8.30/10), and between the text-based task (31.50/100) and the graphic-based task (27.20/100; P<.001). Correlation analysis for the graphic-based task showed that the average elapsed time per question and the workload score were negatively correlated (-.93, and -.79, respectively) to the participants' performance (P<.001 and P=.006, respectively).
  
  
  CONCLUSIONS
  We found that people with early stages of AD used mobile devices successfully without any prior experience in using such devices. Participants' measured workload scores were low and posttask satisfaction in fulfilling the required task was conceivable. Results indicate better performance, less workload, and better response time for the graphic-based task compared with the text-based task.
authors.affiliation: School of Computer Engineering and Information Technology, German Jordanian University, Amman, Jordan. ahmad.zmily@gju.edu.jo.
authors.forename: Ahmad
authors.identifier: http://orcid.org/0000-0003-0210-7445
authors.initials: A
authors.lastname: Zmily
authors.forename: Yaser
authors.identifier: http://orcid.org/0000-0002-1757-8672
authors.initials: Y
authors.lastname: Mowafi
authors.forename: Ehab
authors.identifier: http://orcid.org/0000-0003-2391-4246
authors.initials: E
authors.lastname: Mashal
keywords: Alzheimer disease; Alzheimer disease rehabilitation; mobile human computer interaction; spaced retrieval exercise; usability study