Accepted for/Published in: JMIR mHealth and uHealth
Date Submitted: Nov 28, 2019
Date Accepted: Feb 7, 2020
Mobile Health Application for Collection of Functional Outcomes after Inpatient Stroke Rehabilitation: Pilot Randomized Controlled Trial
ABSTRACT
Background:
Monitoring the functional status of post-stroke patients after they transition home is significant for rehabilitation. Mobile health (mHealth) technologies may provide an opportunity to reach and follow patients post-discharge. However, the feasibility and validity of functional assessments administered by mHealth technologies are unknown.
Objective:
We aimed to evaluate the feasibility, validity, and reliability of functional assessments administered by videoconference through a smartphone-based application compared to telephone administration in post-stroke patients after rehabilitation hospitalization.
Methods:
A randomized controlled trial was conducted in a rehabilitation hospital in Southeast China. Participants were randomly assigned to either a videoconference follow-up (VFU, n=60) or a telephone follow-up (TFU, n=60) group. We measured the functional status of participants in each group at 2-week and 3-month follow-up periods. Half of the participants in each group were followed by face-to-face, home visit assessments as the gold standard. Validity was assessed by comparing any score differences between VFU and home visit assessments, as well as TFU and home visit assessments. Reliability was assessed by computing agreements between VFU and home visit assessments, as well as TFU and home visit assessments. Feasibility was evaluated by levels of completion, satisfaction, comfort, and confidence in the 2 groups.
Results:
Scores obtained by videoconference were similar to those of the home visit assessment. However, most scores collected by telephone administration were higher than those of the home visit assessment. The agreement between VFU and home visit assessments was higher than agreement between TFU and home visit assessments at all follow-up periods. In the TFU group, completion rates were 95% and 82% at 2-week and 3-month follow-up points, respectively. In the VFU group, completion rates were 95% and 80% at 2-week and 3-month follow-up points, respectively. There were no differences in the completion rates between the 2 groups at all follow-up periods (P=.21,P=.17). Patients in the VFU group perceived higher confidence than those in the TFU group at both 2-week and 3-month follow-up periods (P=.04). The VFU group demonstrated higher satisfaction than the TFU group at 3-month follow-up.
Conclusions:
Videoconference assessment of functional status demonstrates higher validity and reliability than telephone assessment. Compared to patients in the TFU group, patients in the VFU group perceived higher confidence at all follow-up periods and higher satisfaction at 3-month follow-up, while both methods demonstrated high completion rates. Clinical Trial: Trial Registration: chictr.org.cn ChiCTR1900027626; http://www.chictr.org.cn/edit.aspx?pid=44831&htm=4
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