Ms Dawn Simpson1, Dr Matthew Schmidt2, Dr Marie-Louise Bird3, Professor Stuart Smith4, Dr Michele Callisaya1
1Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia, 2School of Health Science, University of Tasmania, Hobart, Australia, 3Department of Medicine, University of British Columbia, Vancouver, Canada, 4Southern Cross University, Coffs Harbour, Australia
Background: In stroke rehabilitation intensity of exercise practice is important in to improve function. Patient access to services and specialised clinicians can be limited in rural and remote populations, and innovative approaches are required to improve exercise adherence and motivation at home. We aimed to determine whether use of an activity monitor combined with an app/SMART device could increase exercise in the home. Additionally, we assessed if a therapist could remotely monitor, progress exercises and provide the patient with feedback remotely.
Methods: We formed a novel partnership between industry and therapists to develop sensor and app technology. Ten community dwelling people with stroke were recruited to a 4 week exercise intervention. An activity monitor was set up in the participant’s home and participants were taught how to use the app and device. A therapist remotely monitored the daily program, updated exercise targets, and sent weekly personalised feedback. Outcome measures included adherence to the prescribed exercise program (%), patient satisfaction about the system (physical activity enjoyment scale, system usability scale and perceived benefit of activity), and physical function (short performance physical battery, 2 minute sit-to-stand test).
Results: Participants (mean age 71.5 years [range 55-88 years], 55% male) performed exercise on 96% of the days set. There was a mean adherence with the exercise repetitions prescribed of 104% [range 86% to 123%]. Participants rated the system usability as high (mean score 69/100), enjoyment moderate to high (mean score 86/126) and rated perceived benefit of the system positively.
Conclusions: We found that delivering an exercise program via an internet app and sensor-based system feasible to use for both the therapist and the patient. The technology assisted delivery and progression of therapy remotely. The connection of patients and therapists with this system facilitated motivation in exercise and was efficient to deliver.
Dawn is a PhD candidate at the Menzies Institute for Medical research in Hobart, Tasmania. Her PhD project focuses on sedentary behaviour and physical activity after stroke, and what factors may influence these behaviours. She is a physiotherapist, with 19 years clinical experience, predominantly working in rehabilitation, with a particular interest in stroke rehabilitation.