Mobile Health Applications for Acute Stroke Rehabilitation: An Updated Narrative Review

ABSTRACTObjective: Information technology and mobile devices are potentially beneficial and useful in the management of patients who have had stroke, including recognition, translation, assessment, and rehabilitation. The objective of this study was to determine the effectiveness of mobile applications in the rehabilitation of stroke survivors.Methods: A literature search appraising the effectiveness of mobile applications in the rehabilitation of stroke survivors was performed on PubMed, Embase, Science Citation Index Expanded-SCIE, and EBSCO-CINAHL from their inception until May 28th, 2017. Two reviewers independently screened the literature according to eligibility criteria, evaluated study quality, and collected data from the articles included.Results: Of the 3574 articles screened, 12 studies met the eligibility criteria of the systematic review. Of these, 2 studies were randomized controlled trials and the remaining 10 were before-after studies, of which only 2 had control groups. The mobile applications encompassed 5 rehabilitation areas, 5 in physical function, 4 in language function, 2 in cognitive function, and 1 risk factor reduction. Of these 12 studies, 9 reported significant improvements in function, while in 3 studies the descriptive statistics indicated favorable changes after intervention.Conclusions: Although the use of mobile applications in the rehabilitation of stroke survivors was effective, it is clear from this systematic review that more research is needed to verify their effectiveness.

Section Editor: Graeme J. Hankey MD, FRCP Care pathways are structured care plans that are used by the different members of the multidisciplinary team and are usually implemented to manage more than one aspect of patient care (eg, diagnosis, investigation, acute stroke treatment). When used within a case management framework, care pathways can assist health care professionals with clinical decision-making, and they aim to promote organized and efficient patient care that is based on the best-available research evidence and clinical guidelines.1,2 A care pathway can take the form of a printed or electronic document, and it often replaces the patient’s case record for the duration of the hospital stay. Many hospitals have adopted this tool, often as one of the components of a continuous quality improvement scheme, with an aim to improve the quality of stroke care, reduce variation of standards, minimize resource utilization, and educate health care staff.3,4 But is there sufficient evidence to support the use of care pathways for the management of stroke patients? The first Cochrane review of in-hospital care pathways for stroke found some evidence that care pathways may increase the use of certain investigations and reduce the likelihood of urinary tract infections and readmission to hospital.5 However, this benefit …

Mobile Health (mHealth) applications are transforming stroke rehabilitation, through personalized care and datadriven insights. These applications employ AI-driven algorithms, tele-rehabilitation, wearable technologies, and gamification to enhance recovery process. The objective of this mini review is to explore the transformative role of Mobile Health (mHealth) applications in stroke rehabilitation, highlighting its capacity to transcend geographical barriers and establish extensive support networks connecting stroke survivors, caregivers, and healthcare professionals. Particularly in developing countries like Pakistan, where healthcare resources may be limited, mHealth offers a viable solution to bridge the gap in stroke care. By facilitating access to rehabilitation services, mHealth can significantly improve outcomes for stroke survivors in these regions. This integration of mobile technology with stroke rehabilitation not only promises personalized and more effective rehabilitation but also presents a unique blend of technology and compassion. This evolution in healthcare holds the potential to redefine stroke recovery, marking a significant milestone in the journey towards more inclusive, efficient, and compassionate care solutions.

EEG based brain computer interfaces (BCIs) have been proven to be effective in priming recovery in stroke rehabilitation. Due to the non-stationary nature of the EEG signal, cross-sessional BCI applications generally suffer from performance issues, which not only reduce the training efficiency but also deteriorate the entire system stability, especially with increased false positive outputs. However, it is very inefficient to train BCI models everyday for long-term recurrent applications like rehabilitation training. In this paper, we preliminarily investigated the feasibility of two methods for suppressing false positive outputs and fast re-calibrating online application in long-term recurrent scenarios. Biased-classification and moving-average methods were proposed to mitigate the gap between offline model generation and online application. The proposed two methods were evaluated on EEG data from one participant with chronic stroke during six weeks of rehabilitation training using BCI-controlled exoskeleton. Two proposed configuration methods were introduced and evaluated on the recorded EEG data in a simulated online paradigm. The result showed that the proposed online classification filtering methods were able to improve classification performance by considerably suppressing false positive outputs in rehabilitation applications. The proposed methods contributed in improving the online BCI performance and streamlining the re-calibration BCI process in recurrent long-term BCI applications.

36-fold higher estimate of deaths attributable to red meat intake in GBD 2019: is this reliable?

There is an urgent need for individuals with mild to moderate COVID-19 pneumonia to learn and apply the recommended interventions for pulmonary rehabilitation. In the health literature, various studies showed that mobile health (m-health) applications play an important support role in managing health and coping with diseases. However, there is no m-health application yet for pulmonary rehabilitation specifically designed for COVID-19 patients. This chapter reports the development of “Covid Breathe” and its evaluation in terms of feasibility, safety, and effectiveness. A hundred patients with mild to moderate pneumonia were randomly assigned to control and intervention groups. While 88% of the patients reported being very satisfied with the m-health application, no statistical difference in patient satisfaction between the groups was reported. Nevertheless, there was a statistically significant improvement in Modified Borg Scale, Dyspnea Score, and Hospital Anxiety and Depression Scale parameters. The usage of this m-health app is therefore recommended for pulmonary rehabilitation.

Using Mobile Technologies to Improve Women's Health

Background: The proliferation of digital technologies and the widespread adoption of smartphones have catalyzed a profound transformation in healthcare delivery, particularly through mobile fitness and health applications. Initially emerging in the early 2000s, these applications have evolved since the 2010s into multifaceted platforms offering nutrition planning, exercise motivation, health monitoring, and social interaction functionalities. The COVID-19 pandemic significantly accelerated this trend, as the global demand for home-based exercise solutions and remote health monitoring surged, resulting in a substantial increase in application usage. These tools hold considerable potential to enhance quality of life, foster health consciousness, and alleviate the burden on healthcare systems. However, challenges persist regarding user expectation alignment, data security assurance, and the maintenance of long-term user engagement. Methods: This study employed a qualitative research design, utilizing document analysis to examine mobile fitness and health applications available in the Google Play Store and Apple App Store between 2020 and 2025, specifically those with user ratings between 4.5 and 5.0. The analysis focused on the post-pandemic status of these applications, user demographics, market size, health-promoting impacts, and common challenges encountered. Data sources included peer-reviewed academic publications, industry reports, and official statistical databases. The collected data were subjected to systematic content analysis, and contemporary literature findings were compared with prevailing trends in the digital health sector. Results: Based on the findings, the distribution of health and fitness mobile applications indicates that the majority of the applications are free (%73.2), and their total number of downloads (1,244,678,160) is significantly higher compared to paid applications (%88.43). Regarding publication years, applications released between 2020 and 2025 (%51.6) stand out in terms of total downloads. In terms of rating ranges, the highest proportion (%22.9) corresponds to applications rated 4.8, which have been downloaded 389,387,020 times. Concerning gender targeting, most applications are unisex (%70.6), while applications targeting women (%22.9) and men (%6.5) are relatively limited. When comparing applications released before and after the COVID-19 pandemic, those published after the pandemic (%52.3) account for a higher share of total downloads. Categorized by download numbers, 29.4% of the applications have reached 10 million or more downloads. In terms of content type, the largest share (%62.7) belongs to the Fitness and Health category. Analysis of total downloads between free and paid applications shows a dominance of free applications (%88.43). Regarding revenue, most applications (%69.23) generate monthly income between 0–100,000 TL, while only 30.77% achieve 100,000 TL or more. The first published application in the health and fitness category was Adidas Running: Run Tracker on November 23, 2010, and the most recent application is Vizzta, released on March 11, 2025. Overall, these findings indicate a significant increase in the use of health and fitness applications in recent years, with free and unisex applications playing a key role in user preferences. Conclusion: Mobile fitness and health applications occupy a strategically significant position in promoting quality of life and advancing digital health literacy. Nevertheless, there remains a need for strategic innovations to address sustained user retention, data privacy safeguards, and seamless integration into healthcare systems. Additionally, the integration of these applications with wearable technologies, coupled with personalized service delivery through advanced data analytics, presents promising opportunities to enhance user experience and interaction.

Modern smartphones and tablet PCs provide connections to the Internet via cellular networks or Wireless Local Area Networks (WLAN). The same devices also provide several wireless interfaces, such as Bluetooth for Wireless Personal Area Networks (WPANs). These interfaces create many novel possibilities for Mobile Health or Telehealth application developers to create systems providing versatile and adaptive environment for health monitoring and assisted living. In this paper, we provide a literature review based comparative analysis of current state-of-the-art mobile health applications and services. In addition, we propose and implement a mobile health platform, Smart Environment for Assisted Living (SEAL), in which smart home and mobile health functionalities are integrated into an open and adaptive Platform. The main attributes of our novel SEAL Platform are adaptivity, user-centered design, accessibility, transparency, safety, security, and privacy. Moreover, we will present some new ideas that will be used in our future research work.

Knee osteoarthritis (KOA) is a leading cause of disability worldwide, and limited access to physiotherapy presents major barriers to evidence-based management. Mobile health (mHealth) applications can help address these challenges by supporting self-management, rehabilitation, and patient education. However, most existing applications lack robust evidence and demonstrate low adherence. Co-design approaches involving both patients and healthcare professionals may improve usability, engagement, and clinical integration. This study quantitatively examined user perspectives to inform the subsequent co-design and development of an mHealth application for KOA management; the application itself was not developed or evaluated in this study. A cross-sectional survey was conducted in Slovenia using a structured questionnaire, developed from previous studies and piloted with experts, to assess functional preferences, aesthetic preferences, perceived barriers, and perceived benefits of an mHealth application. Responses were rated on 5- or 10-point Likert scales and analysed using descriptive statistics and independent-sample t-tests. A total of 164 patients with symptomatic KOA and 136 healthcare professionals completed the survey. Both groups identified exercise videos, goal setting and progress tracking, written communication with a physiotherapist, and educational content as essential app components, with no significant differences in functional preferences (p > 0.05). However, patients placed greater importance on aesthetic features, including visual clarity (M = 4.59 vs. 4.12, p = 0.001), layout organisation (M = 4.41 vs. 4.09, p = 0.039), and design appeal (M = 4.60 vs. 4.32, p = 0.035). Healthcare professionals reported greater perceived barriers, particularly limited technical literacy and poor internet connectivity, while patients rated motivational and practical benefits, autonomy, convenience, and information accuracy significantly higher (all p < 0.05). The findings highlight the critical importance of participatory co-design approaches that systematically integrate clinical expertise and patient experience in developing digital rehabilitation tools. Although patients and healthcare professionals demonstrated convergence in their evaluation of core functional requirements, their differing perspectives on aesthetic qualities, perceived barriers, and perceived benefits highlight the need to balance user engagement with clinical robustness. These results provide an empirical foundation for designing user-centred and clinically integrated mHealth applications for KOA rehabilitation and contribute to the growing evidence base guiding digital health innovation, implementation, and policy for musculoskeletal rehabilitation.

Background: Digital technology innovation is believed to increase the effectiveness of the health system's response to epidemics. Some of the potential benefits of mobile Health (mHealth) appli-cations for managing the coronavirus 2019 (COVID-19) pandemic have been explored. This study aimed to determine the trend of using mobile health applications during the COVID-19 pandemic in Surakarta, Central Java. Subjects and Method: This study was descriptive study conducted in Surakarta, Central Java, from February to August 2021. A sample of 184 subjects aged 15 to 64 years was selected in this study. Data were collected using a questionnaire through an online survey. Data were presented in descriptive-analytical form based on the characteristics of gender, age, occupation, and education. Results: The majority of study subjects were women (84.78%), with an average age (Mean= 20.61; SD= 0.12). As many as 55.98% had used the COVID-19 mobile health application. 51.45% were satisfied with the COVID-19 mobile health application service used. As many as 60.19% of the subjects felt it was faster to get information about COVID-19. 73.78% of the study subjects reported the mobile health application could improved knowledge about preventing transmission of COVID-19. As many as 71.84% reported that the application could assist in implementing health protocols. Conclusion: The mobile health COVID-19 application accelerates the dissemination of health information, increases knowledge about preventing transmission of COVID-19 and implementation of health protocols. Keywords: mobile health, COVID-19, application, prevention. Correspondence: Aris Widiyanto. School of Health Sciences Mamba’ul ‘Ulum Surakarta, Surakarta, Central Java. Email: widiyanto.aris99@gmail.com. Mobile: +628139209095. Journal of Health Promotion and Behavior (2021), 06(02): 104-111 https://doi.org/10.26911/thejhpb.2021.06.02.03

In contrast to varied therapy approaches, mirror therapy (MT) can be used even in completely plegic stroke survivors, as it uses visual stimuli for producing a desired response in the affected limb. MT has been studied to have effects not just on motor impairments but also on sensations, visuospatial neglect, and pain after stroke. This paper attempts to systematically review and present the current perspectives on mirror therapy and its application in stroke rehabilitation, and dosage, feasibility and acceptability in stroke rehabilitation. An electronic database search across Google, PubMed, Web of Science, etc., generated 3871 results. After screening them based on the inclusion and exclusion criteria, we included 28 studies in this review. The data collected were divided on the basis of application in stroke rehabilitation, modes of intervention delivery, and types of control and outcome assessment. We found that most studies intervened for upper limb motor impairments post stroke. Studies were equally distributed between intervention in chronic and acute phases post stroke with therapy durations lasting between 1 and 8 weeks. MT showed definitive motor and sensory improvements although the extent of improvements in sensory impairments and hemineglect is limited. MT proves to be an effective and feasible approach to rehabilitate post-stroke survivors in the acute, sub-acute, and chronic phases of stroke, although its long-term effects and impact on activities of daily living need to be analysed extensively.

Purpose: The study aims is to examine the determinants that impact the level of public interest in utilizing mobile health (m-health) applications in Semarang City, Indonesia. Our specific objective is to identify the critical factors that facilitate or impede the public's adoption of these applications.Methods: This study objective was pursued using a comprehensive approach. A study model was developed utilizing the Unified Theory of Acceptance and Use of Technology (UTAUT) as its foundation. This model encompasses essential variables including performance expectancy, effort expectancy, social influence, facilitating conditions, price value, and perceived trust. The process of data collecting was carried out by means of a survey that was disseminated across widely used social media channels. The study was conducted using a sample size of 257 participants who are residents of Semarang City. The data that was collected underwent a thorough analysis utilizing the Partial Least Squares - Structural Equation Model (PLS-SEM) approach.Results: The research conducted in our study resulted in several significant findings. The study revealed that several factors, namely performance expectancy, social influence, price value, and perceived trust, had a notable and beneficial impact on users' inclination towards using m-health applications. On the other hand, the variables of effort expectancy and facilitating conditions did not exhibit a statistically significant influence on the level of public interest in these applications. Furthermore, a substantial correlation was found between the behavioral intention and the actual usage behavior of inhabitants of Semarang City in their adoption of m-health applications.Novelty: The research presented in this study is distinguished by its comprehensive analysis of the various factors that impact the adoption of mobile health (m-health) applications in Semarang City. Through the incorporation and expansion of variables such as price value and perceived trust, our study provides a comprehensive and nuanced comprehension of this particular occurrence by adapting and extending the UTAUT model. Our work emphasizes the importance of performance expectancy and social influence, while also suggesting the need for additional investigation into the roles of effort expectancy and facilitating conditions. Additionally, our study offers valuable information regarding the influence of age and gender as moderators in these associations. The results of this study have significant practical implications for healthcare professionals and policymakers who are interested in promoting the use of mobile health (m-health) technologies among the public. Additionally, these findings can serve as a valuable guide for future research endeavors in this particular area of study.

Bibliometric Analysis and Methodological Review of Mobile Health Services and Applications in India

Systematic reviews: When should they be updated?