Table 1 presents the baseline demographics of participants who were involved in the study.
Table 1
Subject demographics at baseline
subject | age | MMSE | FMA | MAL14 | Self -Efficacy | MRS | BBT (affected) | BBT (un affected) | Time since stroke (months) | Time since rehabilitation (months) |
1 | 64 | 26 | 63 | 7.2 | 6.4 | 2 | 16 | 29 | 58 | 20 |
2 | 52 | 29 | 62 | 5.6 | 10.0 | 2 | 65 | 81 | 6 | 4 |
3 | 63 | 28 | 62 | 5.6 | 8.5 | 3 | 32 | 59 | 13 | 6 |
4 | 65 | 27 | 32 | 5.0 | 5.9 | 3 | 0 | 57 | 24 | 21 |
5 | 65 | 30 | 62 | 4.5 | 7.4 | 3 | 19 | 63 | 14 | 9 |
6 | 70 | 29 | 33 | 4.7 | 10.0 | 2 | 2 | 68 | 7 | 3 |
7 | 21 | 30 | 55 | 4.7 | 6.1 | 2 | 20 | 32 | 110 | 57 |
8 | 62 | 30 | 64 | 7.1 | 7.5 | 2 | 45 | 64 | 24 | .5 |
9 | 56 | 30 | 65 | 7.9 | 9.7 | 2 | 48 | 54 | 3 | 1 |
10 | 63 | 30 | 35 | 5.1 | 7.3 | 3 | 36 | 60 | 5 | 4 |
MMSE; Mini-Mental State Examination (0–30) |
FMA; Fugl-Meyer Assessment (0–66) |
MAL14; Motor Activity Log-14 (0–10) |
Self-Efficacy; Self-efficacy for Exercise Scale (0–10) |
MRS; Modified Rankine Score (0–6) |
BBT; Box and Block Test |
AIM 1: to determine if the addition of concurrent visual feedback, via a tablet computer, will increase adherence to an upper limb home exercise program in people with stroke
Overall, a significant effect was observed in 4 out of the 10 cases (participants 1, 5, 7, 10), as demonstrated by 2 successive data points occurring outside the 2 SD band during the intervention phase, meaning that these participants performed a significantly greater amount of exercise when they were using the tablet computer to provide feedback. These results are represented in Fig. 1.
Furthermore, one participant (participant 9) showed a statistically significant reduction in performance at follow-up when the tablet computer was removed (Fig. 2). Participant 1 also demonstrated a statistically significant increase in exercise during the follow-up period.
Nine participants reported that they enjoyed the tablet computer and found it beneficial in terms of giving feedback and improving engagement. Participant 1 reported that he did not like the experience of using the tablet computer as he felt like he was being watched, despite this discomfort, he still self-reported a perception that being recorded improved his adherence.
AIM 2: to assess the feasibility of use of upper limb accelerometry as a method of monitoring upper limb activity
Accelerometry acceptability was measured via the System Usability Scale. The mean score for the System Usability Scale was 96.5 out of 100, indicating a high level of usability.
The accelerometer devices provided objective data representing exercise times. However, there were several problems in terms of data collection. Issues that arose included missing data (participants 4, 9, 10); despite reportedly charging the devices, data were missing during the last three days of exercise in Participants 4 and 9. One device malfunctioned during the final week for Participant 10. Two participants forgot to put devices on and/or off (participants 2 and 5), on one occasion for each participant. A further two participants forgot to charge the accelerometers (participants 1 and 7), and participant 7 had no recorded data after day 15. Two participants were unable to put the device on the non-affected wrist without assistance (participants 4 and 6).
There were no issues with accelerometry utility or data collection in participants 3 and 8.