ArticleFrontiers in digital health2026
Designing interfaces for digital physical ability self-assessment: a user-centered iterative approach.
Article in Frontiers in digital health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Digital physical ability self-assessments offer an accessible alternative to resource-intensive objective assessments, but their outcomes depend on how well user interfaces (UIs) support correct exercise execution and self-assessment. Methods: This study examined how UI design influences users' interpretation, execution, and self-assessment when using a digital physical ability test. Adopting an iterative, user-centered design approach, six prototype versions were developed and evaluated across four usability phases. Twenty-four working-age adults participated in think-aloud usability tests while performing a single instructionally complex test exercise (Tempo-guided chair squat). Video-recorded sessions were qualitatively analyzed to identify recurring usability breakdowns and examine how UI design shaped participants' self-assessments in relation to researchers' assessment across design iterations. Results: Iterative usability testing revealed recurring breakdowns in how participants interpreted and acted on the test exercise instructions. Key usability issues included misinterpretation of tempo cues, unclear boundaries between correct and incorrect execution, loss of repetition-count awareness, insufficient visual support during execution, overlooked safety-critical setup information, interface inconsistencies, misunderstanding of exercise-relevant concepts, and misaligned self-assessment criteria. These issues led to systematic execution errors and misjudgments of execution quality across prototype versions. Conclusion: The findings conceptualize digital physical ability self-assessment as a multi-layered interaction that places sustained cognitive and physical demands on users. The study contributes a set of transferable design principles describing the interactional support required to enable accurate physical-ability self-assessment. While grounded in a specific context, these design principles may offer insights for exercise-based UIs more broadly, although their generalizability requires further validation.
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