Abstract
<p class="Abstract">Mobile health (mHealth) technology represents a means through which more stroke survivors could access early stroke rehabilitation. Although rehabilitation is most effective when begun early post-stroke, limited resources (facilities, therapists) prevent survivors from initiating therapy. Furthermore, the coupling of an aging population with advances in acute therapy has led to an increase in the absolute number of individuals suffering from and surviving strokes which in turn has put further strain on already scarce rehabilitation resources. There is an urgency to conduct high-quality research exploring cost-effective and creative mHealth devices for early rehabilitation in the acute setting. Mobile technology allows therapists to prescribe apps based on standard cognitive/physical assessments in the acute setting, remotely monitor patient progress across individual carepaths, and update prescribed therapies based on patient feedback and recovery. Recognition of the growing problem of accessing early stroke rehabilitation, and the possibilities offered by mHealth technology led to the development of the RecoverNow platform for stroke rehabilitation in the acute setting. RecoverNow is a custom built, tablet-based stroke rehabilitation platform that houses a variety of previously existing apps with activities analogous or identical to exercises in speech language and/or occupational therapy. While RecoverNow represents how mobile technology can be utilized to address a growing public health issue, the feasibility, acceptability and efficacy of tablet-based stroke rehabilitation are unknown. Studies with the goal of establishing feasibility of early tablet-based stroke rehabilitation are needed and, if appropriate, a randomized controlled trial to establish efficacy.</p>
Highlights
The platform is a custom Android launcher limiting the patient to a list of tailored therapeutic apps that can be swapped in and out by therapists, depending on patient rehabilitation needs (Figure 1)
In the years to come, the stroke community will be tasked with solving an increasingly important problem: how can early stroke rehabilitation be made accessible to a continuously growing population of stroke survivors when resources are already unable to cope with current needs? Globally in 2010, 16.9 million individuals suffered a first ever stroke and there were 33 million stroke survivors representing increases of 68% and 84% respectively since 1990 [1]
Patients experience significant down-time during their acute care stay, spending more than 50% of their time resting in bed and only 13% of time engaging in recovery [13]
Summary
Mobile health technology may be able to provide a solution to increase the availability of early stroke rehabilitation through relatively economically-efficient means. There have been a number of studies exploring the feasibility and effectiveness of various tablet-based stroke therapies and stakeholder perspectives on their usage [14]-[18]. These studies are typically small pilot studies of varying quality, they reflect the growing interest in tablets as a means of providing therapy. Medical tests and other acute care activities, patients could independently engage in their prescribed rehabilitation activities. Their progress could be monitored remotely, and regimes adjusted to reflect their current state – all without a bedside visit. How to go about harnessing the power of mHealth technology to provide tablet-based stroke rehabilitation is dependent on close collaboration between software developers and stroke rehabilitation experts
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