RecoverNow: A mobile tablet-based therapy platform for early stroke rehabilitation

Abstract

IntroductionStroke 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.MethodsWe 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 tablet-based care as a secondary outcome.ResultsWe 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 encountered by study participants with many expressing the assigned applications were either too easy or too difficult.ConclusionsAcute stroke patients are interested in attempting tablet-based stroke rehabilitation and are easily recruited early post-stroke. However, tablet-based therapy may be challenging due to patient, device and system-related barriers. Reducing the frequency of common barriers will be essential to keeping patients engaged in tablet-based therapy.

mHealth Intervention Applications for Adults Living With the Effects of Stroke: A Scoping Review

“…Patients in the acute setting prefer to focus on communication and hand therapies, are willing to begin within days of their stroke, and may require assistance with the tablets. Pugliese et al 24 N=30 Unblinded single-group prospective cohort Canada RecoverNow Language/speech, upper extremity function, and cognitive skills The study objective was to demonstrate the feasibility of RecoverNow, a tablet-based stroke recovery platform aimed at delivering speech and cognitive therapy. Patients with acute stroke are interested in attempting tablet-based stroke rehabilitation and are easily recruited early post stroke.…”

“…Eighteen studies (36.7%) were categorized as pilot, feasibility, or proof-of-concept trials. 9 , 10 , 12 , 13 , 14 , 17 , 24 , 30 , 33 , 36 , 37 , 38 , 42 , 45 , 47 , 52 , 56 , 57 In general, the studies had relatively small sample sizes, where 23 studies (46.9%) had ≤20 participants, 9 , 10 , 11 , 12 , 15 , 16 , 22 , 25 , 26 , 27 , 28 , 32 , 34 , 35 , 36 , 38 , 41 , 43 , 44 , 45 , 47 , 50 , 57 22 studies (44.9%) had between 21 and 100 participants, 13 , 14 , 17 , 18 , 19 , 20 , 21 , 23 , 24 , 29 , 30 , 31 , 33 , 40 , 42 , 46 , 49 , 51 , 52 , 53 , 54 and 4 studies (8.2%) had >100 participants (see table 1 ).…”

“…The 49 articles described 38 apps with content that varied in focus. The apps focused on upper extremity function (n=12; 31.5%) 9 , 12 , 17 , 18 , 23 , 24 , 27 , 28 , 29 , 36 , 43 , 44 , 49 , 50 , 51 , 55 ; lower extremity function (n=2; 5.3%) 12 , 51 ; general exercise, physical activity, and/or functional mobility (n=9; 23.7%) 12 , 31 , 37 , 39 , 41 , 42 , 46 , 47 , 51 , 54 ; trunk control (n=2; 5.3%) 51 , 53 ; medical management and secondary prevention (n=10; 26.3%) 13 , 14 , 15 , 16 , 33 , 39 , 40 , 43 , 44 , 48 , 51 , 52 , 54 , 56 ; language and speech skills (n=8; 20.5%) 19 , 20 , 21 , 22 , 23 , 24 , 25 , 34 , 35 , 38 , 45 ; cognitive skills (n=3; 7.9%) 23 , 24 , 26 ; gene...…”

Advanced Statistical Analysis of 3D Kinect Data: Mimetic Muscle Rehabilitation Following Head and Neck Surgeries Causing Facial Paresis

“…Telerehabilitation in medicine is gaining significant popularity [ 1 ] as a very promising tool offering a convenient way to work with patients online. A mobile tablet-based therapy platform for early stroke rehabilitation is described in [ 2 ]. A systematic review of Mobile Health Applications in rehabilitation was made by [ 3 ].…”

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

“…Stroke is one of the leading causes of mortality and disability [1]. Many stroke survivors experience one or a wider range of deficits that requires post-stroke rehabilitation [2]. Stroke rehabilitation involves a sustained and coordinated effort from a large team, including the patient and his or her goals, family and other caregivers [3].…”