Telerehabilitation Following Stroke: Development of Training Content and Evaluation of an App-Based Training Program.
Carina Ziller, Szabina Gäumann, Silya Lüscher and 9 others
PMID 41915681WHAT IT FOUND
Patients with moderate-to-severe stroke rated a new app-based exercise program as user-friendly, but adherence to the exercises was low during the one-week test.
Therapists liked the system, yet the study cannot show whether it improves recovery.
Key findings
01Patients rated the usability of the app as high, with an average System Usability Scale score of 86.6 out of 100, which was slightly higher than the therapists' average score of 83.3.
02Adherence to the training protocol was moderate overall, but varied significantly between patients, with some consistently using the activity tracker while failing to complete the planned exercises or blood pressure measurements.
03Blood pressure measurement required the most assistance from study personnel, and the activity tracker was perceived as somewhat bothersome by some patients.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The sample size was very small (8 patients), limiting the generalizability of the findings. The intervention period was only one week, which is insufficient to determine long-term adherence or clinical outcomes. Patients were required to own a smartphone or tablet, which likely selected for a group with higher baseline digital literacy than the general stroke population. The study did not measure clinical outcomes such as motor recovery or quality of life, so it cannot determine if the program is effective. Adherence data was collected during a transition phase where patients were also receiving regular inpatient therapy, which may have affected their motivation to engage with the study-specific exercises.
Declared interests
One author is the lead developer and founder of the software application used in the study. The study was funded by the Canton Aargau, Department of Health and Social Care.
The easy way to misread this
Do not interpret the high usability scores as evidence that the program improves physical function or that patients will consistently do the exercises. The study only tested whether the app was easy to use and whether patients could navigate it for one week; it did not measure recovery outcomes, and adherence to the actual exercise component was low and variable.
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