iPad Technology for Home Rehabilitation after Stroke (iHOME): A Proof-of-Concept Randomized Trial

Saposnik, Gustavo; Chow, Chi-Ming; Gladstone, David J.; Cheung, Donna; Brawer, Edward; Thorpe, Kevin E.; Saldanha, A.; Dang, Alice; Bayley, Mark; Schweizer, Tom A.

doi:10.1111/ijs.12328

Cited by 27 publications

(28 citation statements)

References 26 publications

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“…Speech therapists were able to track real-time patients' progress during their follow-up clinic appointments and adjust intensity accordingly. Results from Saposnik et al (2014) and Koh et al (2016) RCTs will be of key interest in determining the feasibility and efficacy of iPads-based home rehabilitation [33,57].…”

Section: Community Rehabilitation: Role Of Ipadmentioning

confidence: 98%

iPad Use in Stroke Neuro-Rehabilitation

Ameer¹,

Ali²

2017

Preprint

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Neuro-rehabilitation services are essential in reducing post-stroke impairments, enhancing independence, and improving recovery in hospital and post-discharge. However these services are therapist-dependent and resource intensive. Patients' disengagement and boredom in stroke units are common which adversely affect functional and psychological outcomes. Novel techniques such as use of iPads™ are increasingly researched to overcome such challenges. The aim of this review is to determine the feasibility, effectiveness, acceptability, and barriers to the use of iPads™ in stroke neuro-rehabilitation. Four databases and manual literature search were used to identify published studies using the terms "iPad", "Stroke", and "neuro-rehabilitation". Studies were included in accordance with the review selection criteria. A total of 16 articles were included in the review. The majority of the studies focused on iPads use in speech and language therapy. Although of small scale, the studies highlighted that iPads are feasible, have the potential to improve rehabilitation outcomes, and can improve patient's social isolation. Patients' stroke severity and financial limitations are some of the barriers highlighted in this review. This review presents preliminary data supportive for the use of iPad technology in stroke neuro-rehabilitation. However, further research is needed to determine impact on rehabilitation goals acquisition, clinical efficacy, and cost-efficiency.

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Section: Community Rehabilitation: Role Of Ipadmentioning

confidence: 98%

iPad Use in Stroke Neuro-Rehabilitation

Ameer¹,

Ali²

2017

Preprint

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“…Ongoing studies are testing the feasibility of using mobile devices to deliver stroke rehabilitation [14, 15], with preliminary studies supporting their role in outpatient aphasia therapy [12, 16, 17]. A recent qualitative study suggested stroke survivors found such interventions helpful and acceptable [18].…”

Section: Introductionmentioning

confidence: 99%

RecoverNow: Feasibility of a Mobile Tablet-Based Rehabilitation Intervention to Treat Post-Stroke Communication Deficits in the Acute Care Setting

et al. 2016

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BackgroundApproximately 40% of patients diagnosed with stroke experience some degree of aphasia. With limited health care resources, patients’ access to speech and language therapies is often delayed. We propose using mobile-platform technology to initiate early speech-language therapy in the acute care setting. For this pilot, our objective was to assess the feasibility of a tablet-based speech-language therapy for patients with communication deficits following acute stroke.MethodsWe enrolled consecutive patients admitted with a stroke and communication deficits with NIHSS score ≥1 on the best language and/or dysarthria parameters. We excluded patients with severe comprehension deficits where communication was not possible. Following baseline assessment by a speech-language pathologist (SLP), patients were provided with a mobile tablet programmed with individualized therapy applications based on the assessment, and instructed to use it for at least one hour per day. Our objective was to establish feasibility by measuring recruitment rate, adherence rate, retention rate, protocol deviations and acceptability.ResultsOver 6 months, 143 patients were admitted with a new diagnosis of stroke: 73 had communication deficits, 44 met inclusion criteria, and 30 were enrolled into RecoverNow (median age 62, 26.6% female) for a recruitment rate of 68% of eligible participants. Participants received mobile tablets at a mean 6.8 days from admission [SEM 1.6], and used them for a mean 149.8 minutes/day [SEM 19.1]. In-hospital retention rate was 97%, and 96% of patients scored the mobile tablet-based communication therapy as at least moderately convenient 3/5 or better with 5/5 being most “convenient”.ConclusionsIndividualized speech-language therapy delivered by mobile tablet technology is feasible in acute care.

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“…In Australia, up to 76% of stroke rehabilitation facilities use these types of commercial gaming systems in their programs (Lam et al ., ). Although, the potential for utilising basic functions on the devices carried in the pockets and handbags of so many patients to augment stroke rehabilitation has received much less attention (Saposnik et al .).…”

Section: Introductionmentioning

confidence: 97%

“…Technology has been identified as a novel tool for use within stroke rehabilitation. Games and targeted applications available for devices such as the Nintendo Wii, Apple iPads and iPhones, provide potentially useful strategies that can apply learning principles of repetition, intensity, and task-oriented training (Saposnik et al, 2014). Strategies provided by these applications are consistent with recommendations of the Guidelines for Stroke Management (National Stroke Foundation, 2010) and are widely used.…”

Section: Introductionmentioning

confidence: 97%

Home exercise programs supported by video and automated reminders for patients with stroke: A qualitative analysis

Emmerson

Harding

Lockwood

et al. 2018

Aus Occup Therapy J

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iPad Technology for Home Rehabilitation after Stroke (iHOME): A Proof-of-Concept Randomized Trial

Abstract: iHOME is a randomized controlled trial assessing the feasibility, safety, and efficacy of tablet technology for home use in stroke rehabilitation. The results of this study will serve as the basis for a larger multicenter trial.

Cited by 27 publications

References 26 publications

iPad Use in Stroke Neuro-Rehabilitation

iPad Use in Stroke Neuro-Rehabilitation

RecoverNow: Feasibility of a Mobile Tablet-Based Rehabilitation Intervention to Treat Post-Stroke Communication Deficits in the Acute Care Setting

Home exercise programs supported by video and automated reminders for patients with stroke: A qualitative analysis

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