Usability of the TCI Mobile app as a complement to the Constraint-Induced Therapy protocol

Abstract

<h3>Research Objectives</h3> To investigate the usability of the TCI Mobile app by therapists and individuals with stroke. <h3>Design</h3> Cross-sectional study. <h3>Setting</h3> Functionality and Technological Innovation in Neurorehabilitation Group lab, Brazil. <h3>Participants</h3> This preliminary study included patients with stroke and physical therapists (PTs). Inclusion criteria for patients were ≥6 months of chronicity, access to a mobile device and the internet, and a score < 24 on the mini mental state examination and excluded if they had a neurological, orthopedic, and/or respiratory disorders unrelated to stroke or severe visual impairment. PTs who had experience with constraint-induced therapy (CIT), a mobile device, and internet access were included. <h3>Interventions</h3> TCI Mobile is an application used during CIT application. It encourages engagement with homework through push notifications, enables self-monitoring of daily activities, provides performance feedback, and compares assessment results. Patients and PTs used the application for 3 consecutive days during application of the CIT protocol, and then completed an interview. <h3>Main Outcome Measures</h3> The User Mobile Application Rating Scale (uMARS) includes three subscales: objective and subjective quality and perceived impact, with scores ranging from 1 (inadequate) to 5 (excellent). It was previously validated to assess mobile health applications and had excellent internal consistency (alpha = 0.90) and good test-retest reliability. <h3>Results</h3> Five participants (two women) with stroke were included. They had an average age of 48 years and approximately 67% had dominant hand hemiparesis. Their average chronicity time was 130 months (range 56-264 months). The two PT participants were women (average age, 41.5 years). uMARS data were analyzed using means and standard deviation. Patients' average objective and subjective quality scores and perceived impact were 3.92±0.73, 4.58±0.72, and 4.78±0.38, respectively. PTs' average objective and subjective quality scores and perceived impact were 4.20±0.11, 4.75±0.00, 3.92±1.06, respectively. <h3>Conclusions</h3> Therapists and people with stroke reported good objective and subjective quality and good perceived impact of the TCI mobile application, which showed good usability as an addition to the CIT protocol in both clinical and research settings. <h3>Author(s) Disclosures</h3> The authors have no conflict of interest to declare.