Background: Mobile health technologies offer scalable opportunities to support home-based exercise programs. However, most commercially available apps are not tailored to individuals with spinal cord injury (SCI) and have rarely been evaluated for #usability and implementation outcomes in this population. Objective: This study aims to assess the acceptability, appropriateness, #feasibility, and quality of a mobile app–based intervention designed to support exercise adherence in individuals with SCI. Methods: We conducted a convergent parallel mixed methods study using quantitative data from standardized measures and qualitative feedback from focus groups. Twelve individuals with SCI (mean age 50.5, SD 17 years; n=6, 50% male; n=8, 67% White; n=6, 50% with thoracic injuries; n=6, 50% ambulators) engaged in a customized exercise regimen using the app for 2 weeks. Acceptability, appropriateness, and #feasibility of this mobile intervention were assessed using the Acceptability of Intervention Measure, Intervention Appropriateness Measure, and #feasibility of Intervention Measure. The objective and subjective qualities, and the perceived impact, of the app-based intervention were evaluated using the User Version of the Mobile Application Rating Scale. Results: Using a cutoff score of >4 out of 5, 67% (8/12) of participants rated the app-based intervention as highly acceptable and feasible, and 50% (6/12) rated it as highly appropriate. The objective quality of the app was rated 3.57 out of 5 on the User Version of the Mobile Application Rating Scale. At the scale level, information received the highest score (mean 4.10, SD 0.52), with functionality (mean 3.51, SD 0.66) and aesthetics (mean 3.50, SD 0.70) closely following. Engagement scored lowest (mean 3.18, SD 0.72). The app’s subjective quality averaged 3.27 (SD 0.88), and its perceived impact on exercise adherence was rated 3.79 (SD 0.92). Qualitative feedback indicated that customization, access to professional support, and SCI-specific exercises were positive features. Areas for improvement included bug fixes and enhanced features to boost engagement. Conclusions: The smartphone-based intervention demonstrates adequate acceptability and #feasibility, along with high information quality and favorable #usability, for supporting exercise adherence in individuals with SCI. Improvements in engagement features are recommended to enhance sustainable implementation.

Background: Sedentary behavior is highly prevalent among older adults, with adherence to exercise being a major challenge. Exercise offers significant physical, psychological, and social benefits, but enjoyment is a key factor influencing adherence. Technology-based interventions, have shown promise in enhancing motivation and participation, demonstrating higher adherence rates compared to conventional treatments, though challenges like motivation loss and technological barriers persist. This review evaluates active videogames interventions' effectiveness in enjoyment and satisfaction. Objective: This systematic review and meta-analysis aimed to determine whether active video games are superior to other interventions in generating greater enjoyment or satisfaction. Methods: Pubmed, Cochrane, PEDro, SportDiscus, CINHAL, Web of Science and Scopus databases were searched from inception to October 2024 to identify randomized clinical trials (RCT) or crossover studies. The primary outcome was enjoyment or satisfaction, assessed using various scales, including the Physical Activity Enjoyment Scale (PACES), Intrinsic Motivation Inventory (IMI), User Satisfaction Questionnaire, and Likert-type scoring scales. Secondary outcomes included adherence rates and adverse effects. Cochrane tool (v2.0) was used to evaluate risk of bias. Results: Five studies were included in the quantitative analysis. The results indicated a significant improvement in enjoyment/satisfaction compared to control groups (SMD: 0.34; 95% CI (0.05 to 0.64); p=0.02; I2=24%), although the size effect was small. Secondary outcomes could not be analyzed due to insufficient data in the selected studies. Conclusions: Active video game interventions may improve enjoyment and satisfaction in older adults, but the evidence remains of low certainty.