Home-based technologies for stroke rehabilitation: A systematic review

Abstract

Background-Many forms of home-based technology targeting stroke rehabilitation have been devised, and a number of human factors are important to their application, suggesting the need to examine this information in a comprehensive review. Objective-The systematic review aims to synthesize the current knowledge of technologies and human factors in home-based technologies for stroke rehabilitation. Methods-We conducted a systematic literature search in three electronic databases (IEEE, ACM, PubMed), including secondary citations from the literature search. We included articles that used technological means to help stroke patients conduct rehabilitation at home, reported empirical studies that evaluated the technologies with patients in the home environment, and were published in English. Three authors independently conducted the content analysis of searched articles using a list of interactively defined factors. Results-The search yielded 832 potentially relevant articles, leading to 31 articles that were included for in-depth analysis. The types of technology of reviewed articles included games, telerehabilitation, robotic devices, virtual reality devices, sensors, and tablets. We present the merits and limitations of each type of technology. We then derive two main human factors in designing home-based technologies for stroke rehabilitation: designing for engagement (including external and internal motivation) and designing for the home environment (including understanding the social context, practical challenges, and technical proficiency).

Dysphagia assessment and intervention: evaluating inclusive approaches using video

“…A systematic review by Kagohara et al (2013) considers the use of iPadV R and similar technology with a particular focus on teaching and education in individuals with developmental disabilities. Further advantages and opportunities offered by technology in rehabilitation post-stroke include the use of applications (apps) for the rehabilitation of motor skills, aphasia, also leisure and social uses (Ameer and Ali, 2017;Chen et al, 2019). Ameer and Ali (2017) comment briefly on the camera function of iPadV R for ongoing feedback and recording of progress but there is no mention of mealtimes or dysphagia.…”

Patient experience using digital therapy “Vigo” for stroke patient recovery: a qualitative descriptive study

“…Studies describe challenges with designed home therapies regarding absence of specialist presence. In clinical context, therapists support and manages patent sessions according to their goals and functional needs [5]. Home-based therapy should be customised to persons individual needs and goals to maintain motivation and interest to proceed participation in the program.…”

“…Increasing number of stroke survivors and lack of rehabilitation resources make it difficult to provide the necessary rehabilitation when needed to maximise functional recovery [1]. Smartphones and tablets with therapeutic applications could potentially provide resource-efficient rehabilitation to help with recovery and improve their independence [4,5]. Computerised home practice provides individualised treatment, accessibility for those in rural and remote locations, socioeconomic problems, and gives the opportunity for patients to have a valid home program in between or post rehabilitation stages [6][7][8][9].…”

“…Additionally, it offers autonomy for the patient, which may be lacking in traditional treatment programs [10,11]. Furthermore, patient participation in decision making causes improved health outcomes, enhanced quality of life and delivery of more cost-effective services, as well as more active patient participation in their own health care process and monitoring [5,12,13]. In the last years, the number of health applications has grown rapidly [14,15].…”

Effectiveness of a home-based exercise program among patients with lower limb spasticity post-stroke: A randomized controlled trial

“…However, most patients are unable to complete these treatments because of the prohibitive cost of the equipment, which subsequently limits their recovery [14]. Home-based rehabilitation programs, which are safe, inexpensive, and easy-to-implement, have been developed for stroke rehabilitation using different technologies [15]. Randomized trials have evaluated whether nurse-led, home-based rehabilitation programs, such as home-based physical activity incentive and education programs [16], and home-based gaming exercises [17], can positively influence recovery after stroke.…”