AUTHOR=DuPlessis Danielle , Lam Emily , Hotze Fanny , Khan Ajmal , Al-Hakeem Hiba , McFarland Stephanie , Hickling Andrea , Hutchison Michael , Wright F. Virginia , Reed Nick , Biddiss Elaine , Scratch Shannon E. 

TITLE=R2Play development: Fostering user-driven technology that supports return-to-play decision-making following pediatric concussion

JOURNAL=Frontiers in Rehabilitation Sciences

VOLUME=Volume 3 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/rehabilitation-sciences/articles/10.3389/fresc.2022.1051579

DOI=10.3389/fresc.2022.1051579

ISSN=2673-6861

ABSTRACT=Objective. To design a multi-domain return-to-play assessment system (R2Play) for youth athletes with concussion.
Methods. The R2Play system was developed using an overarching user-centered approach, the Design Thinking Framework, and research activities included: 1) structured brainstorming within our research team, 2) interviews with clinician and youth sports coaches, 3) building a testable prototype, and 4) interface testing through cognitive walkthroughs with clinician partners.
Results. Clinician and coach participants provided feedback on the R2Play concept, which was integrated into the design process and provided future directions for research. Feedback fell into three categories: 1) the individuals being assessed; 2) the R2Play system; and 3) the clinic environment. Examples of feedback-driven design choices included creating a “client profile” page to support clinicians in gathering a detailed client history, reducing assessment time by streamlining levelling, and increasing ecological validity by adding a background noise condition. Following refinement based on stakeholder feedback, the R2Play system was outlined in detail and a testable prototype was developed. It is made up of two parts: a clinician tablet, and a series of tablet “buttons” that display numbers and letters. Youth athletes run between the buttons to connect a “trail” in ascending alphanumeric order, 1-A-2-B, etc. Their performance across a series of levels of increasing difficulty is logged on the clinician tablet. Initial testing with five clinicians showed the system’s interface to have excellent usability with a mean score of 81% (SD = 8.02) on the System Usability Scale. 
Conclusion. Through this research, a prototype of the R2Play system was innovated and evaluated by clinician and coach stakeholders. Initial usability was excellent and directions for future iterations were highlighted. Outcomes suggest the potential benefits of using technologies to assist in complex clinical assessment, as well as utilizing a user-centered approach to design.