Co-Designed Digital Device for Tracking Rehabilitation Dosage in a Clinical Environment After Stroke: Mixed Methods...

Area of Science:

• Rehabilitation Medicine
• Health Informatics
• Biomedical Engineering

Background:

• National Clinical Guidelines for Stroke (2023) recommend 3 hours of daily multidisciplinary therapy.
• Accurate monitoring of rehabilitation dosage is crucial for guideline adherence.
• A novel digital dosage tracking system using Near Field Communication (NFC) technology was developed.

Purpose of the Study:

• To assess the validity, feasibility, and usability of a co-designed digital tracker for logging rehabilitation dosage in stroke survivors.
• To provide an objective and low-burden solution for tracking therapy in clinical settings.

Main Methods:

• A pilot mixed-methods study with two phases: usability trial (n=9) and clinical trial (n=15).
• Usability assessed via System Usability Scale (SUS) and Intrinsic Motivation Inventory (IMI).
• Clinical trial compared digital tracker against manual therapist recordings using paired t tests, Cohen d, and Bland-Altman plots.

Main Results:

• The digital tracker demonstrated high usability (SUS score: 91.43) and user satisfaction (IMI score: 6.29/7).
• Strong agreement was found between digital and manual methods (t206=-1.60, P=.11, Cohen d=-0.06).
• Mean time discrepancy was minimal (1.23 minutes) with limits of agreement within the clinically acceptable range (±5%-10%).

Conclusions:

• The co-designed digital tracker shows agreement with manual recording methods for rehabilitation dosage.
• This technology enables objective, automated, and low-burden recording of rehabilitation dose.
• The system supports improved prescription, monitoring, and research in stroke rehabilitation.