Currently submitted to: JMIR Rehabilitation and Assistive Technologies
Date Submitted: May 3, 2026
Open Peer Review Period: May 12, 2026 - Jul 7, 2026
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Exercise App for Improving Outcomes in Post-Stroke Obstructive Sleep Apnea: OPEX Acceptance in a Clinical Trial
ABSTRACT
Background:
Oropharyngeal exercises have been used as a therapeutic option for treating obstructive sleep apnea (OSA) after stroke clinically and in research. They target the underlying mechanism of OSA by improving the sensorimotor function of the upper airway muscles.
Objective:
We assessed the acceptance of a new smartphone-based application titled OPEX, which aimed to deliver oropharyngeal exercises to individuals with OSA remotely via digital technology.
Methods:
This study included 30 participants from a clinical trial that assessed the feasibility and efficacy of oropharyngeal exercises for OSA after stroke compared to a sham intervention. The OPEX application was used to deliver exercises to the groups at home. After completing the exercise program, all participants were asked to complete a 13-item questionnaire and a semi-structured interview. The relationship between cognitive skills and the level of acceptance of OPEX was also explored.
Results:
Interviews with 30 participants revealed high engagement across three themes: ease of use, convenience, and motivation. Most (≈75%) described the OPEX app as intuitive and accessible, supporting independent exercise completion and consistent adherence. Participants valued its practicality in removing logistical barriers and integrating therapy into daily routines, while a few preferred occasional in-person contact for motivation. Those with higher MoCA scores (≥24) were more independent, though no significant correlation was found between cognition and app acceptance (r (28) = –.05, p = .80).
Conclusions:
This is the first study to provide evidence regarding the acceptance of the new app, OPEX, among stroke patients with OSA. Our findings provide insights into the adoption of oropharyngeal exercise apps by stroke survivors with OSA in a clinical trial context.
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