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Abstract

Objective:

To determine whether patients with stroke receiving rehabilitation for upper limb deficits using smart technology (video and reminder functions) demonstrate greater adherence to prescribed home exercise programmes and better functional outcomes when compared with traditional paper-based exercise prescription.

Design:

Randomized controlled trial comparing upper limb home exercise programmes supported by video and automated reminders on smart technology, with standard paper-based home exercise programmes.

Setting:

A community rehabilitation programme within a large metropolitan health service.

Subjects:

Patients with stroke with upper limb deficits, referred for outpatient rehabilitation.

Interventions:

Participants were randomly assigned to the control (paper-based home exercise programme) or intervention group (home exercise programme filmed on an electronic tablet, with an automated reminder). Both groups completed their prescribed home exercise programme for four weeks.

Main measures:

The primary outcome was adherence using a self-reported log book. Secondary outcomes were change in upper limb function and patient satisfaction.

Results:

A total of 62 participants were allocated to the intervention (n = 30) and control groups (n = 32). There were no differences between the groups for measures of adherence (mean difference 2%, 95% CI −12 to 17) or change in the Wolf Motor Function Test log transformed time (mean difference 0.02 seconds, 95% CI −0.1 to 0.1). There were no between-group differences in how participants found instructions (p = 0.452), whether they remembered to do their exercises (p = 0.485), or whether they enjoyed doing their exercises (p = 0.864).

Conclusions:

The use of smart technology was not superior to standard paper-based home exercise programmes for patients recovering from stroke.

This trial design was registered prospectively with the Australian and New Zealand Clinical Trials Register, ID: ACTRN 12613000786796. http://www.anzctr.org.au/trialSearch.aspx

Keywords

Stroke rehabilitation home exercise programme upper extremity occupational therapy technology

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References

National Stroke Foundation. Concise Guidelines for Stroke Management, 2010.

National Stroke Foundation. National Stroke Audit Rehabilitation Services, 2012. Available at: https://strokefoundation.com.au/~/media/strokewebsite/resources/treatment/nsf_audit-report_2012_web2.ashx?la=en (accessed 22 November 2016).

Turton

Fraser

The use of home therapy programmes for improving recovery of the upper limb following stroke. Br J Occupat Ther 1990; 53(11): 457–462.

Chaiyawat

Kulkantrakorn

Effectiveness of home rehabilitation program for ischemic stroke upon disability and quality of life: A randomized controlled trial. Clin Neurol Neurosurg 2012; 114(7): 866–870.

Chen

Neufeld

Feely

Skinner

CS.

Factors influencing compliance with home exercise programs among patients with upper-extremity impairment. Am J Occup Ther 1999; 53(2): 171–180.

Pickering

Fitton

Ballinger

Fazakarley

Ashburn

Self reported adherence to a home-based exercise programme among people with Parkinson’s disease. Parkinsonism Relat Disord 2013; 19(1): 66–71.

Jurkiewicz

Marzolini

Adherence to a home-based exercise program for individuals after stroke. Top Stroke Rehabil 2011; 18(3): 277–284.

Stroke-Rehab.com. Stroke rehab exercises, 2015. Available at: http://www.stroke-rehab.com/stroke-rehab-exercises.html (accessed 22 November 2016).

Hill

Perri-Moore

Kuang

Bray

Ngo

L DA

Z-T.

Automated pictographic illustration of discharge instructions with Glyph: Impact on patient recall and satisfaction. J Amer Med Inform. Epub ahead of print May 27, 2016. DOI: 10.1093/jamia/ocw019

10.

Schoo

AMM

Morris

QMB.

The effects of mode of exercise instructions on compliance with a home exercise program in older adults with osteoarthritis. Physiotherapy 2004; 91(2): 79–86.

11.

Miller

Litva

Gabbay

Motivating patients with shoulder and back pain to self-care: Can a videotape of exercise support physiotherapy?

Physiotherapy 2009; 95(1): 29–35.

12.

Sheetal

Mokgobadibe

VN.

The effect of a written and pictorial home exercise prescription on adherence for people with stroke. Hong Kong Occupat Ther Ass 2015; 26: 33–41.

13.

Mander

80% of internet users own a smartphone, 2015. http://www.globalwebindex.net (accessed 5 January 2015).

14.

Bosomworth

Mobile Marketing Statistics 2015, 2015. Available at: http://www.smartinsights.com (accessed 22 November 2016).

15.

Des Roches

Balachandran

Ascenso

Tripodis

Swathi

Effectiveness of an impairment-based individualized rehabilitation program using an iPad-based software platform. Frontiers Human Neurosci. Epub ahead of print January 5 2015. DOI: 10.3389/fnhum.2014.01015

16.

Redzuan

Engkasan

Mazlan

Freddy Abdullah

SJ.

Effectiveness of a video-based therapy program at home after acute stroke: A randomized controlled trial. Arch Phys Med Rehabil 2012; 93(12): 2177–2183.

17.

Lin

Hsieh

Chen

Jang

Liu

JS.

Minimal detectable change and clinically important difference of the Wolf Motor Function Test in stroke patients. Neurorehabil Neural Repair 2009; 23(5): 429–434.

18.

Fritz

Blanton

Uswatte

Taub

Wolf

SL.

Minimal detectable change scores for the Wolf Motor Function Test. Neurorehabil Neural Repair 2009; 23(7): 662–667.

19.

Morris

Uswatte

Crago

Cook

3rd Taub

The reliability of the Wolf Motor Function Test for assessing upper extremity function after stroke. Arch Phys Med Rehabil 2001; 82(6): 750–755.

20.

Wolf

Catlin

Ellis

Archer

Morgan

Piacentino

Assessing Wolf Motor Function Test as outcome measure for research in patients after stroke. Stroke 2001; 32(7): 1635–1639.

21.

Hodics

Nakatsuka

Upreti

Alex

Smith

Pezzullo

JC.

Wolf Motor Function Test for characterizing moderate to severe hemiparesis in stroke patients. Arch Phys Med Rehabil 2012; 93(11): 1963–1967.

22.

Rowland

Cooke

Gustafsson

LA.

Role of occupational therapy after stroke. Ann Indian Acad Neurol 2008; 11: S99–S107.

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Home exercise programmes supported by video and automated reminders compared with standard paper-based home exercise programmes in patients with stroke: a randomized controlled trial