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Published on: September 23, 2018
Self-directed and caregiver-assisted technology-based interventions in inpatient stroke rehabilitation: A scoping
Dina Pogrebnoy1,2,3, Jennifer Ra Jones2,4, Shahad Alsawaf2
1Department of Physiotherapy, Western Health, St Albans, VIC, Australia.
Abstract:
ObjectiveTechnology-based interventions may enhance self-directed or caregiver-assisted activity during inpatient stroke rehabilitation, yet effective implementation strategies for technology-based tools remain unclear. This scoping review synthesises existing evidence on acceptability, feasibility and effectiveness of technology-based interventions in inpatient stroke rehabilitation, and maps barriers and enablers to implementation through the Capability, Opportunity, Motivation and Behaviour model.Data sourcesComprehensive searches of MEDLINE, Embase, CINAHL and Google Scholar were conducted through to December 2025.Review methodsStudies involving adult stroke survivors using self-directed technology-based interventions during inpatient rehabilitation were included. Arksey and O'Malley's scoping review framework guided data extraction. Analysis focused on acceptability, feasibility, effectiveness and behaviour change strategies.ResultsEighteen high-moderate quality studies (20 papers) from 13 countries, involving 1081 participants, were included (10 pilot randomised controlled trials, 6 feasibility studies, 1 non-randomised and 1 observational study). Interventions were upper limb exergaming or robotics devices (n = 4) and tablet/smartphone applications with exercise videos (n = 14). Acceptability, feasibility and effectiveness outcomes were reported in 12 studies (63%), with rates of recruitment, safety and retention being reported in eight (67%), eight (67%) and six (50%) studies, respectively. All studies reported on at least one construct relating to barriers or enablers. Key enablers were caregiver involvement and additional support for more impaired individuals. Common barriers were stroke-related impairments and reduced staffing.ConclusionThis review offers an integrated overview of the acceptability, feasibility and effectiveness of technology-based interventions in inpatient stroke rehabilitation, with identified strategies to support clinicians with implementation. Further research is needed on long-term outcomes.
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