RecoverNow: A patient perspective on the delivery of mobile tablet-based stroke rehabilitation in the acute care setting.


Journal

International journal of stroke : official journal of the International Stroke Society
ISSN: 1747-4949
Titre abrégé: Int J Stroke
Pays: United States
ID NLM: 101274068

Informations de publication

Date de publication:
02 2019
Historique:
pubmed: 19 7 2018
medline: 28 11 2019
entrez: 19 7 2018
Statut: ppublish

Résumé

We previously reported the feasibility of RecoverNow (a mobile tablet-based post-stroke communication therapy in acute care). RecoverNow has since expanded to include fine motor and cognitive therapies. Our objectives were to gain a better understanding of patient experiences and recovery goals using mobile tablets. Speech-language pathologists or occupational therapists identified patients with stroke and communication, fine motor, or cognitive/perceptual deficits. Patients were provided with iPads individually programmed with applications based on assessment results, and instructed to use it at least 1 h/day. At discharge, patients completed a 19-question quantitative and open-ended engagement survey addressing intervention timing, mobile device/apps, recovery goals, and therapy duration. Over a six-month period, we enrolled 33 participants (three did not complete the survey). Median time from stroke to initiation of tablet-based therapy was six days. Patients engaged in therapy on average 59.6 min/day and preferred communication and hand function therapies. Most patients (63.3%) agreed that therapy was commenced at a reasonable time, although half expressed an interest in starting sooner, 66.7% reported that using the device 1 h/day was enough, 64.3% would use it after discharge, and 60.7% would use it for eight weeks. Sixty-seven percent of patients expressed a need for family/friend/caregiver to help them use it. Our results suggest that stroke patients are interested in mobile tablet-based therapy in acute care. 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.

Sections du résumé

BACKGROUND/AIM
We previously reported the feasibility of RecoverNow (a mobile tablet-based post-stroke communication therapy in acute care). RecoverNow has since expanded to include fine motor and cognitive therapies. Our objectives were to gain a better understanding of patient experiences and recovery goals using mobile tablets.
METHODS
Speech-language pathologists or occupational therapists identified patients with stroke and communication, fine motor, or cognitive/perceptual deficits. Patients were provided with iPads individually programmed with applications based on assessment results, and instructed to use it at least 1 h/day. At discharge, patients completed a 19-question quantitative and open-ended engagement survey addressing intervention timing, mobile device/apps, recovery goals, and therapy duration.
RESULTS
Over a six-month period, we enrolled 33 participants (three did not complete the survey). Median time from stroke to initiation of tablet-based therapy was six days. Patients engaged in therapy on average 59.6 min/day and preferred communication and hand function therapies. Most patients (63.3%) agreed that therapy was commenced at a reasonable time, although half expressed an interest in starting sooner, 66.7% reported that using the device 1 h/day was enough, 64.3% would use it after discharge, and 60.7% would use it for eight weeks. Sixty-seven percent of patients expressed a need for family/friend/caregiver to help them use it.
CONCLUSION
Our results suggest that stroke patients are interested in mobile tablet-based therapy in acute care. 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.

Identifiants

pubmed: 30019633
doi: 10.1177/1747493018790031
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

174-179

Auteurs

Karen Mallet (K)

1 Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
2 The Ottawa Hospital, Ottawa, Ontario, Canada.
3 Champlain Regional Stroke Network, Ottawa, Ontario, Canada.
4 Canadian Partnership for Stroke Recovery, Ottawa, Ontario, Canada.

Rany Shamloul (R)

1 Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
4 Canadian Partnership for Stroke Recovery, Ottawa, Ontario, Canada.

Michael Pugliese (M)

5 University of Ottawa, Ottawa, Ontario, Canada.

Emma Power (E)

6 University of Sydney, Lidcome, NSW, Australia.

Dale Corbett (D)

4 Canadian Partnership for Stroke Recovery, Ottawa, Ontario, Canada.
5 University of Ottawa, Ottawa, Ontario, Canada.
7 Brain and Mind Research Institute, University of Ottawa, Ottawa, Ontario, Canada.

Simon Hatcher (S)

5 University of Ottawa, Ottawa, Ontario, Canada.
7 Brain and Mind Research Institute, University of Ottawa, Ottawa, Ontario, Canada.

Michel Shamy (M)

1 Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
2 The Ottawa Hospital, Ottawa, Ontario, Canada.
4 Canadian Partnership for Stroke Recovery, Ottawa, Ontario, Canada.
5 University of Ottawa, Ottawa, Ontario, Canada.

Grant Stotts (G)

1 Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
2 The Ottawa Hospital, Ottawa, Ontario, Canada.
4 Canadian Partnership for Stroke Recovery, Ottawa, Ontario, Canada.
5 University of Ottawa, Ottawa, Ontario, Canada.

Lise Zakutney (L)

2 The Ottawa Hospital, Ottawa, Ontario, Canada.

Sean Dukelow (S)

4 Canadian Partnership for Stroke Recovery, Ottawa, Ontario, Canada.
8 Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Alberta, Canada.

Dar Dowlatshahi (D)

1 Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
2 The Ottawa Hospital, Ottawa, Ontario, Canada.
4 Canadian Partnership for Stroke Recovery, Ottawa, Ontario, Canada.
5 University of Ottawa, Ottawa, Ontario, Canada.
7 Brain and Mind Research Institute, University of Ottawa, Ottawa, Ontario, Canada.

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