Abstract
The purpose of this study was to identify system-level challenges during the initial phase of introducing a swallowing exercise robot for home use. Two intervention approaches were evaluated: a conventional handout-based method describing exercise procedures (Study 1) and a robot-based instructional method (Study 2). Nine young adults participated (Study 1: four; Study 2: five) and performed home-based swallowing exercises for two months. After the intervention, individual face-to-face interviews were conducted and analyzed using inductive content analysis. Study 1 identified two themes: “lack of fun” and “recognition of the necessity of swallowing exercise.” Study 2 identified five themes: “robot functions not operating smoothly,” “environment hindering exercise,” “aversion to robots,” “understanding of how to operate the robot,” and “recognition of the necessity of swallowing exercise.” Successful home implementation requires system modifications that reduce operational problems, along with improved Wi-Fi connectivity and battery management. Lack of enjoyment also emerged as a major barrier to exercise continuity. Strengthening the unique advantages of the robot-particularly through features that promote enjoyment and sustained engagement-may improve support for long-term exercise adherence.
