JMIR Publications

ABSTRACT

Background:

The prevalence of stroke is high in both males and females, and it rises with age. Stroke often leads to sensor and motor issues, such as hemiparesis affecting one side of the body. Post-stroke patients require torso stabilization exercises, but maintaining proper posture can be challenging due to their condition.

Objective:

Our goal was to develop the Postural SmartVest, an affordable wearable technology that leverages a smartphone's built-in accelerometer to monitor sagittal and frontal plane changes while providing visual, tactile, and auditory feedback to guide patients in achieving their best-at-the-time posture during rehabilitation.

Methods:

To design the Postural SmartVest, we conducted brainstorming sessions, therapist interviews, gathered requirements, and developed the first prototype. We employed this initial prototype in a feasibility study with individuals without hemiparesis (n=40, avg. age 28.4). They used the prototype during one-hour seated sessions. Their feedback led to a second prototype, which we utilized in a pilot study with a post-stroke patient. After adjustments and a kinematic assessment using the Vicon® Gait Plug-in system, the third version became the Postural SmartVest. We assessed the Postural SmartVest in a within-subject experiment with post-stroke patients (n=40, avg. age 57.1) and therapists (n=20, avg. age 31.3) during rehabilitation sessions. Participants engaged in daily activities, including walking and upper limb exercises, without and with app feedback.

Results:

The Postural SmartVest comprises a modified off-the-shelf athletic lightweight compression tank top with a transparent pocket designed to hold a smartphone running a customizable Android™ app securely. This app continuously monitors sagittal and frontal plane changes using the built-in accelerometer sensor, providing multisensory feedback through audio, vibration, and color changes. Patients reported high ratings for weight, comfort, dimensions, effectiveness, ease of use, stability, durability, and ease of adjustment. Therapists noted a positive impact on rehabilitation sessions and expressed their willingness to recommend it. A t-test showed a significant difference (p<0.001) between the number of the best-at-the-time posture positions patients could maintain in two stages, without feedback (M=13.1, STD=7.12) and with feedback (M=4.2, STD=3.97), demonstrating the effectiveness of the solution in improving posture awareness.

Conclusions:

The Postural SmartVest aids therapists during post-stroke rehabilitation sessions and assists patients in improving their posture during these sessions