TOS Connect
Created to support patients in long-term physio recovery, this project was evaluated with specialist Thoracic Outlet Syndrome (TOS) physiotherapists and their patients.
Increased patient rehabilitation exercise completions by 37%.
Increased patient symptom reporting from 1.2 to 4.6 instances per week, leading to better treatment by physios.
Feb 2024 - July 2025
Situation:
Long-term physiotherapy recovery often takes patients years to complete, even with specialist support.
Complication:
Patients struggle to communicate complex symptoms and adhere to exercise routines between physio sessions, limiting their recovery.
Resolution:
An app that empowers patients to record their symptoms and follow recovery exercise routines, communicating their progress with their physio.
Contents:
Business approach: Design and trial app to establish product value (through improved patient recovery). Product to be marketed as a subscription to specialist physio practices with different seat package options.
Team: Nureesah Hendricks Physiotherapy (Client & co-founder), University of Cape Town, Life Vincent Pallotti Hospital.
Role: UX/UI Designer, co-founder
Project Timeline
Understanding the Users
Patient interview | personas and pain points
In-depth interviews were conducted with six patients and three physiotherapists.
Key patient findings:
• Experience pain in shoulders, neck, and arms
• These symptoms are difficult to recall due to frequency and variety
• Experience demotivation
Key physio findings:
• Struggle to get patients to complete exercises
• Difficulty monitoring patient progress
Want to better understand Thoracic Outlet Syndrome?
Read more about TOS here
Personas and pain points
The Goal:
Assist patients in improving exercise adherence and technique, and improve symptom recording between physio sessions.
Allow physiotherapists to clearly prescribe exercises to their patients and to monitor patient symptoms between sessions.
The Product
Initial product ideation used several “How might we” questions to explore different ways to:
Motivate patients to complete their exercises more regularly, help patients to record their symptoms, and help physios to prescribe exercises to their patients.
You can view the ideation process work here.
User flow diagrams
In focusing on the symptom logging flow, I came to understand the importance of sequencing inputs. By having the patient select the type of pain first, descriptors not related to the pain type can be filtered out, reducing cognitive load.
Starting the Design
Paper wireframes | Digital wireframes | Usability studies
Iterating on ways to include core functionalities, including logging symptoms, doing exercise routines, and tracking daily progress.
Patient digital wireframes
Usability Studies
Patient findings
1 Some patients struggled to locate certain sections of the homepage as it is too cluttered with information.
2 Some users wanted to be able to add different doses for medication logs.
Physio findings
1 Physios wanted to be able to prescribe sets of exercises to patients for convenience.
2 Physios wanted a search function for all of the listed exercises.
Refining the Design
Mockups | High-fidelity prototype | Accessibility
Patient Mockups
Logging a Symptom
Select pain type.
Specify affected areas,
Confirm onset time, pain score, descriptors and causes.
Add comments,
Confirm.
Physiotherapist Mockups
High-fidelity prototype
Click to view the high-fidelity prototype.
Accessibility considerations
1 Single-hand use
Many users may have temporary, permanent, or situational mobility issues, (for instance wanting to check correct technique while completing exercises) and so the app is designed to be easy to use with a single-hand input.
2 Clear information logging
The process of logging requires users to provide around 6-11 informational inputs, so to reduce cognitive load, the series is broken up into subcategories to avoid overwhelming the user.
3 Video and Text descriptions
The different exercise descriptions make accessing correct technique easy for users. For instance, users can play the video recording while doing their exercises, or just listen to the audio description.
KPIs and Findings
A System Usability Scale (SUS) was used in the initial two rounds of user testing (wireframe and high fidelity prototypes). Findings indicate that the app was much improved in the second iteration.
Product build learnings:
Early coordination with developers was key to uncovering overlooked areas, allowing me to deal with concerns before commencing the build.
1 Prioritise Features by Impact vs. Complexity
A low-impact, high-complexity CMS for physios to add their own exercises was held back, while a critical 3D shoulder model was sourced cost-effectively via university partnership.
2 Consider edge cases
Developers noted poor UI performance on smaller screens. Some flows were tweaked, ensuring better functionality across devices.
Consideration was given to edge cases like poor internet connectivity, prioritising text descriptions of exercise routines above video demonstrations.
3 Establish Robust Feedback Loops
In-person biweekly meetings and Jira task tracking ensured issues were addressed, keeping the app’s build organized and on schedule.
Three physios trialed the product with 8 patients over 2 months. Findings included:
37,5% increase in patient exercise completions.
from 56% to 78% of prescribed exercises were completed. Physios noted patients exhibited improved exercise technique.
3,8x increase in patient symptom reporting.
From 2.4 instances to 9.2 instances between physio sessions. Physios noted that the improved data helped to diagnose their patients conditions better, improving the treatment they could provide.
Going forward
Takeaways | Next steps | Feedback
Takeaways
Impact
The TOS Connect app forms part of a research study to be trialed with several specialist physiotherapists and their patients. On trialing the prototype, physiotherapists have expressed interest in incorporating it into their treatment routine for TOS patients, believing it will lead to improved patient recovery rates.
The medium term vision for the product is to tap into the team’s international network of TOS specialists to increase the user base for the app.
A further consideration is to expand the app to cover other chronic conditions with similar physiotherapist/patient contact, such as fibromyalgia, rheumatoid arthritis, chronic fatigue syndrome, etc.
Learnings
The value of framing the problem by understanding it from both patients and physio perspectives became increasingly apparent through the research process. From learning how other patients experience TOS (and therefore contextualising my personal experience), to understanding the perspective of the specialist physiotherapists that see TOS patients daily, I was able to design a product that considered a wide group of user needs.
From coordination with development teams, I have come to understand how they see the product and what was missing from their side, including how app users are managed, common issues that users could face that I had not forseen, and how data privacy is achieved.
Next steps
1 Interface optionality for physios
Look at translating the design for larger format devices for convenience of dealing with multiple patients in a session.
2 Technical use cases
The team is currently focusing on technical use-case scenarios such as what happens if a patient changes physios, how physios can add their own exercises to the database, etc.
Feedback
“The user-friendly interface and comprehensive features will undoubtedly improve TOS outcomes by facilitating better patient adherence to treatment plans and allow for more informed, data-driven adjustments to therapy.”
-Nureesah Hendricks,
Specialist Physiotherapist
Interested in the full client feedback?
Read their testimonial here.
Let’s collaborate!
Hey, thanks for taking the time to review my work.If you have an idea that we could collaborate on, or want to know more about my process, feel free to drop me a message!