Online monitoring of focal spasticity treatment with botulinum toxin in people with chronic stroke or hereditary spastic paraplegia: a feasibility study.
Hans C J W Kerstens, Maarten J Nijkrake, Bert J M De Swart and 5 others
PMID 37073790WHAT IT FOUND
A smartphone app for daily spasticity self-report was feasible for hereditary spastic paraplegia, median adherence 63%, but much harder for stroke, median 20%.
Users valued graphs; clinicians wanted tailored items and integration with records.
Key findings
01Median adherence to daily self-assessments was 49% overall, 63% for people with HSP and 20% for people with stroke.
02Mean usability scores were 76 for people with spasticity, 69 for physicians and 83 for therapists on a 0-100 scale.
03Interviews found that people valued daily graphs, but wanted individually tailored items, easier access and integration with clinical records.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The study was small and not designed to test whether monitoring improves spasticity outcomes. Selection bias was serious: many eligible people did not participate, adherence was low, and response rates were especially low among people with stroke. The pandemic postponed injections and changed the intended monitoring window, so the app was not tested exactly as planned. Physicians and therapists could view patient data but could not enter their own data, which may have reduced usefulness for shared decision-making. Usability scores came only from people who responded, so the results may reflect the experiences of the most engaged users. The study did not report participant characteristics or adherence for physicians and therapists.
Declared interests
The authors declared no conflicts of interest. The supplied text does not state a funding source.
The easy way to misread this
Do not conclude the app is equally usable for people with stroke. Only 38% of stroke participants returned the usability questionnaire, median adherence was 20%, and the authors warn of selection bias.