Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Sep 3, 2019
Open Peer Review Period: Sep 3, 2019 - Sep 11, 2019
Date Accepted: Oct 22, 2019
(closed for review but you can still tweet)
The Effectiveness of Upper-Limb Wearable Technology for Improving Activity and Participation in Adult Stroke Survivors: A Systematic Review
ABSTRACT
Background:
With advances in technology, the adoption of wearable devices has become a viable adjunct in poststroke rehabilitation. Upper-limb (UL) impairment affects up to 77% of stroke survivors impacting on their ability to carry out everyday activities. However, despite an increase in research exploring these devices for UL rehabilitation, little is known of the effectiveness.
Objective:
This review aims to assess the effectiveness of upper-limb wearable technology for improving activity and participation in adult stroke survivors.
Methods:
Randomised controlled trials (RCTs) and randomised comparable trials of UL wearable technology for poststroke rehabilitation were included. Primary outcome measures were validated measures of activity and participation as defined by the International Classification of Functioning, Disability and Health. Databases searched were MEDLINE, Web of Science (Core collection), CINAHL, and the Cochrane Library. The Cochrane Risk of Bias Tool was used to assess the methodological quality of the RCTs.
Results:
In the review, we included 11 studies with collectively 354 participants at baseline and 323 participants at final follow-up including control groups and participants post stroke. Participants' stroke type and severity varied. Only one study found significant between-group differences for systems functioning and activity (P=<0.023). The 11 included studies in this review had small sample sizes ranging from 5 – 99 participants at an average (mean) age of 57 years old. Significant between-group differences were found across one of the 11 included trials however this was assessed as being high risk due to a high dropout rate.
Conclusions:
This review has highlighted a number of reasons for insignificant findings in this area including low sample sizes and the appropriateness of the RCT methodology for complex interventions. However, technology has the potential to measure outcomes, provide feedback and engage users outside of clinical sessions. This could provide a platform for motivating stroke survivors to carry out more rehabilitation in the absence of a therapist which could maximise recovery.
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Copyright
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