Accepted for/Published in: JMIR Rehabilitation and Assistive Technologies
Date Submitted: Oct 29, 2024
Open Peer Review Period: Nov 11, 2024 - Jan 6, 2025
Date Accepted: Feb 25, 2025
(closed for review but you can still tweet)
A Co-designed Digital Device for Tracking Rehabilitation Dosage After Stroke: Validity and Feasibility Study in a Clinical Environment
ABSTRACT
Background:
In 2023, the National Clinical Guidelines for Stroke revised the recommended daily multidisciplinary therapy dose from 45 minutes to 3 hours. To monitor the achievement of these guidelines there is a need for accurate measurement. This study introduces a novel co-designed digital dosage tracking system that utilises Near Field Communication (NFC) technology to log rehabilitation activities and demonstrates its feasibility and accuracy in a clinical setting through comparison with the current clinical method of manual recording.
Objective:
This study aimed to assess the validity, feasibility, and usability of a novel co-designed digital tracker using Near Field Communication (NFC) technology to automatically log rehabilitation dosage in stroke patients, providing an objective and low-burden solution for clinical environments.
Methods:
This pilot mixed-methods study included two phases. Phase 1 involved a usability trial with nine participants conducted at a university research centre, assessing usability with the System Usability Scale (SUS) and Intrinsic Motivation Inventory (IMI). Phase 2 consisted of a clinical trial in an NHS stroke ward with 15 inpatients, comparing the digital tracker with manual therapist recordings for validity and feasibility using paired t-tests, Cohen's D, and Bland-Altman plots. An acceptable discrepancy range was set at ±5-10%.
Results:
The digital tracker demonstrated high usability with a mean SUS score of 91.43 (SD = 9.53) and strong user satisfaction (IMI score 6.29/7, SD = 1.50). Clinical trial results showed a strong agreement between the digital and manual methods (t(207)=-1.55, P=.12, Cohen’s D=-0.06), with a small mean time discrepancy of 1.18 minutes (SD = 10.98) across 208 activities. The Bland-Altman plot indicated good accuracy and consistency between methods, with limits of agreement within the clinically acceptable range.
Conclusions:
The co-designed digital tracker has been shown to agree with a manual method for recording rehabilitation dosage. This development presents the opportunity for objective, automated and low-burden recording of rehabilitation dose to support prescription, monitoring and research. Clinical Trial: ClinicalTrials.gov: NCT05981729 IRAS ID No. 329156
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