Perseverance with technology-facilitated home-based upper limb practice after stroke: a systematic mixed studies...

Area of Science:

• Neurorehabilitation
• Biomedical Engineering
• Health Sciences

Background:

• Technology is increasingly explored to support stroke survivors' recovery through home-based upper limb practice.
• Understanding factors influencing perseverance is crucial for optimizing technology-facilitated rehabilitation.

Purpose of the Study:

• To explore factors influencing perseverance with technology-facilitated home-based upper limb practice after stroke.
• To develop a conceptual framework for perseverance in this context.

Main Methods:

• A systematic mixed studies review with sequential exploratory synthesis was conducted.
• Included studies focused on adult stroke survivors with upper limb disability using technology for home practice (≥3 times/week for ≥4 weeks).
• Qualitative data explored user perceptions; quantitative data assessed adherence and dropouts.

Main Results:

• Forty-two studies were included (6 qualitative, 28 quantitative, 8 mixed methods).
• A three-stage conceptual framework for perseverance was developed: 'getting in the game,' 'sticking with it,' and 'continuing or moving on.'
• Adherence varied (13-140%), with lower adherence noted for more frequent or longer prescribed sessions.

Conclusions:

• A framework for perseverance in technology-facilitated home-based upper limb practice is proposed.
• This framework can guide clinicians and researchers in designing strategies to enhance practice adherence and technology use.
• Further research is needed to validate the clinical utility of this framework.