Effect of mobile application types on stroke rehabilitation: a systematic review (original) (raw)
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Journal of Rehabilitation Medicine, 2022
G lobally, stroke is a major cause of disability (1). Furthermore, as a consequence of improved medical care, with decreasing mortality rates and an ageing population, the number of people living with the consequences of stroke is likely to increase (2-4). Although most stroke survivors' recovery takes place largely during the first 3-6 months, the impact of the stroke and the need for rehabilitation may continue for years (2, 5). Long-term consequences, such as physical, cognitive, social and emotional deficits, can result in dependence and reduced participation in everyday life (3, 6, 7). Stroke severity can be categorized as mild, moderate, or severe in relation to cognitive, motor, sensory, and speech-related impairments (8).
Smartphone App in Stroke Management: A Narrative Updated Review
Journal of Stroke
The spread of smartphones and mobile-Health (m-health) has progressively changed clinical practice, implementing access to medical knowledge and communication between doctors and patients. Dedicated software called Applications (or Apps), assists the practitioners in the various phases of clinical practice, from diagnosis to follow-up and therapy management. The impact of this technology is even more important in diseases such as stroke, which are characterized by a complex management that includes several moments: primary prevention, acute phase management, rehabilitation, and secondary prevention. This review aims to evaluate and summarize the available literature on Apps for the clinical management of stroke. We described their potential and weaknesses, discussing potential room for improvement. Medline databases were interrogated for studies concerning guideline-based decision support Apps for stroke management and other medical scenarios from 2007 (introduction of the first iPh...
2019
BACKGROUND Monitoring the functional status of post-stroke patients after they transition home is significant for rehabilitation. Mobile health (mHealth) technologies may provide an opportunity to reach and follow patients post-discharge. However, the feasibility and validity of functional assessments administered by mHealth technologies are unknown. OBJECTIVE We aimed to evaluate the feasibility, validity, and reliability of functional assessments administered by videoconference through a smartphone-based application compared to telephone administration in post-stroke patients after rehabilitation hospitalization. METHODS A randomized controlled trial was conducted in a rehabilitation hospital in Southeast China. Participants were randomly assigned to either a videoconference follow-up (VFU, n=60) or a telephone follow-up (TFU, n=60) group. We measured the functional status of participants in each group at 2-week and 3-month follow-up periods. Half of the participants in each group...
RecoverNow: A mobile tablet-based therapy platform for early stroke rehabilitation
PLOS ONE, 2019
Introduction Stroke survivors frequently experience a range of post-stroke deficits. Specialized stroke rehabilitation improves recovery, especially if it is started early post-stroke. However, resource limitations often preclude early rehabilitation. Mobile technologies may provide a platform for stroke survivors to begin recovery when they might not be able to otherwise. The study objective was to demonstrate the feasibility of RecoverNow, a tablet-based stroke recovery platform aimed at delivering speech and cognitive therapy. Methods We recruited a convenience sample of 30 acute stroke patients to use RecoverNow for up to 3 months. Allied health professionals assigned specific applications based on standard of care assessments. Participants were encouraged to take home the RecoverNow tablets upon discharge from acute care. The study team contacted participants to return for a follow-up interview 3 months after enrollment. The primary outcome of interest was feasibility, defined using 5 facets: recruitment rate, adherence rate, retention rate, the proportion of successful follow-up interventions, and protocol deviations. We tracked barriers to tabletbased care as a secondary outcome. Results We successfully recruited 30 of 62 eligible patients in 15 weeks (48% recruitment rate). Participants were non-adherent to tablet-based therapy inside and outside of acute care, using RecoverNow for a median of 12 minutes a day. Retention was high with 23 of 30 patients participating in follow-up interviews (77% retention rate) and all but 3 of the 23 interviews (87%) were successfully completed. Only 2 major protocol deviations occurred: one enrollment failure and one therapy protocol violation. Barriers to tablet-based care were frequently
Stroke Patient Rehabilitation A Pilot Study of an Android-Based Game
Background. Cerebral vascular accidents (strokes) are the primary cause of disability worldwide and the second leading cause of death both in the Philippines and internationally. In recent years, a number of computer-based applications have been developed to assist in the stroke recovery process. Aim. This article discusses an Android-based tablet game, FINDEX, that aids in the rehabilitation process of stroke survivors with impaired fine motor skills. Method. FINDEX was designed and developed in the Philippines. The game contains assessment and monitoring support for tracking the patient's progress in terms of fine finger dexterity, for example, finger control, isolation and coordination, and range of motions. The baselines for data comparison and analysis were gathered through an initial test with subjects with normal hand function. Three stroke survivors then participated in a pilot study, using the game for a total of nine testing sessions. Results. Objective measures showed that patients' dexterity did in fact improve, although it is not possible to draw strong conclusions because of the small sample size. In subsequent interviews, patients indicated that they believed that the games helped in their recovery and said that they preferred playing with the game over performing the standard therapeutic activities. Conclusion. The development of this game and the preliminary findings from the pilot study suggest that games may indeed be effective instruments for therapy.
Mobile Applications for Stroke Prevention: A Survey of Physicians’ Perspectives
Journal of Mobile Technology in Medicine, 2017
Background: Little is known about the prevalence and nature of mobile application adoption in clinical practice. Aims: To explore current and potential mobile application use in primary care physicians (PCPs) for stroke prevention. Do PCPs recommend, use, or discuss mobile health applications for stroke preventative measures? Methods: Current PCPs in the New York City area specializing in Internal Medicine, Ob/Gyn, and Family Medicine were surveyed in person. The survey consisted of demographic questions and 11 questions on mobile application use. Results: Of the 86 physicians surveyed (53% female; mean age 37 years, SD 12), 74% (95% CI 65%, 84%) reported using mobile applications in patient care, whether for their own use or in recommending to patients. Experience was the most important determining factor, with 82% of physicians with less than 3 years practice experience using mobile apps, 78% of physicians with 3 to 10 years, 60% of physicians with 11 to 20 years, and 58% of physicians with greater than 20 years experience (p=0.045). Physicians reported using mobile applications to manage stroke risk factors 25% (95% CI 16%, 35%) of the time, while 77% (95% CI 68%, 86%) expressed interest in new apps to help their patients manage these risks. Lastly, 41% (95% CI 30%, 51%) of physicians surveyed strongly agreed that mobile applications are useful in providing patient care, while 49% (95% CI 38%, 59%) simply agreed and 0% disagreed. Conclusions: Most urban PCPs we surveyed believe that mobile applications belong in healthcare, with one in four using them to manage stroke risk factors.
2018
UNSTRUCTURED Stroke is the leading cause of adult disability worldwide, with 70% of survivors exhibiting residual impairments of the upper limb that require frequent in-person visits to rehabilitation clinic over several months. This study explored rehabilitation clinician’s preferences for design features to be included in an mHealth-enabled app for post-stroke upper-limb rehabilitation. Data were collected via online survey, sampling participants from Ethiopia (n = 37) and the U.S. (n = 40). Survey results indicated that Ethiopian and U.S. rehabilitation clinicians have different opinions about the importance of design features that should be included in a stroke tele-rehabilitation system which are likely due to differences in culture, the availability of human and physical resources, and how the field of rehabilitation is organized and managed. Our results, thus, indicate that mHealth technologies but must be tailored to the geographical and cultural context of the end-users.
Mobile Technology for Primary Stroke Prevention
Stroke, 2019
Background and Purpose— Feasibility of utilizing the Stroke Riskometer App (App) to improve stroke awareness and modify stroke risk behaviors was assessed to inform a full randomized controlled trial. Methods— A parallel, open-label, 2-arm prospective, proof-of-concept pilot randomized controlled trial. Participants were randomized to usual care/control or App intervention group and assessed at baseline, 3, and 6 months. The App measures stroke risk and provides information on management of risk factors. Participants were aged >19 years with at least 2 modifiable stroke risk factors identified, no prior stroke, and owned a smartphone. Results— Fifty participants (24 control, 26 App) were recruited from 148 eligible participants. Retention in the trial was 87%. Mean cardiovascular health (Life’s Simple 7) improved by 0.36 (95% CI, −2.10 to 1.38) in the App group compared with 0.01 (95% CI, −1.34 to 1.32) in controls ( P =0.6733). Conclusions— These findings support a full randomiz...
Health Informatics Journal
Stroke is the leading cause of adult disability worldwide, with 70 percent of survivors exhibiting residual impairments of the upper limb that require frequent in-person visits to rehabilitation clinic over several months. This study explored rehabilitation clinician’s preferences for design features to be included in an mHealth-enabled app for post-stroke upper limb rehabilitation. Data were collected via online survey, sampling participants from Ethiopia ( n = 69) and the United States ( n = 75). Survey results indicated that Ethiopian and US rehabilitation clinicians have different opinions about the importance of design features that should be included in a stroke tele-rehabilitation system which are likely due to differences in culture, the availability of human and physical resources, and how the field of rehabilitation is organized and managed. Our results, thus, indicate that mHealth technologies must be tailored to the geographical and cultural context of the end users.
PloS one, 2018
Stroke survivors are often left with deficits requiring rehabilitation to recover function and yet, many are unable to access rehabilitative therapies. Mobile tablet-based therapies (MTBTs) may be a resource-efficient means of improving access to timely rehabilitation. It is unclear what MTBTs have been attempted following stroke, how they were administered, and how patients experienced the therapies. The review summarizes studies of MTBTs following stroke in terms of administrative methods and patient experiences to inform treatment feasibility. Articles were eligible if they reported the results of an MTBT attempted with stroke participants. Six research databases were searched along with grey literature sources, trial registries, and article references. Intervention administration details and patient experiences were summarized. The search returned 903 articles of which 23 were eligible for inclusion. Most studies were small, observational, and enrolled chronic stroke patients. I...