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Cited by 42Stroke Rehabilitation and RecoveryMobile Health and mHealth ApplicationsTelemedicine and Telehealth Implementation

RecoverNow: A mobile tablet-based therapy platform for early stroke rehabilitation

Open access
Pugliese, Michael, Ramsay, Tim, Shamloul, Rany, Mallet, Karen, Zakutney, Lise, Corbett, Dale, Dukelow, Sean, Stotts, Grant +4 more·2019·PLOS ONE
DOI 10.1371/journal.pone.0210725PMC PMC6347149
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Abstract

INTRODUCTION: Stroke survivors frequently experience a range of post-stroke deficits. Specialized stroke rehabilitation improves recovery, especially if it is started early post-stroke. However, resource limitations often preclude early rehabilitation. Mobile technologies may provide a platform for stroke survivors to begin recovery when they might not be able to otherwise. The study objective was to demonstrate the feasibility of RecoverNow, a tablet-based stroke recovery platform aimed at delivering speech and cognitive therapy. METHODS: We recruited a convenience sample of 30 acute stroke patients to use RecoverNow for up to 3 months. Allied health professionals assigned specific applications based on standard of care assessments. Participants were encouraged to take home the RecoverNow tablets upon discharge from acute care. The study team contacted participants to return for a follow-up interview 3 months after enrollment. The primary outcome of interest was feasibility, defined using 5 facets: recruitment rate, adherence rate, retention rate, the proportion of successful follow-up interventions, and protocol deviations. We tracked barriers to tablet-based care as a secondary outcome. RESULTS: We successfully recruited 30 of 62 eligible patients in 15 weeks (48% recruitment rate). Participants were non-adherent to tablet-based therapy inside and outside of acute care, using RecoverNow for a median of 12 minutes a day. Retention was high with 23 of 30 patients participating in follow-up interviews (77% retention rate) and all but 3 of the 23 interviews (87%) were successfully completed. Only 2 major protocol deviations occurred: one enrollment failure and one therapy protocol violation. Barriers to tablet-based care were frequently encountered by study participants with many expressing the assigned applications were either too easy or too difficult. CONCLUSIONS: Acute stroke patients are interested in attempting tablet-based stroke rehabilitation and are easily recruited early post-stroke. However, tablet-based therapy may be challenging due to patient, device and system-related barriers. Reducing the frequency of common barriers will be essential to keeping patients engaged in tablet-based therapy.

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  • Some aphasia research highlights limitations in using technology with this population, while other research demonstrates positive outcomes in improving language skills with technology.

    “While some aphasia research highlights the limitations in using technology with this population (17, 18), other research demonstrates positive outcomes in improving language skills with technology (19–22).”

    From A Virtual, Randomized, Control Trial of a Digital Therapeutic for Speech, Language, and Cognitive Intervention in Post-stroke Persons With Aphasia (2021) · cites this paper as [17]

    The Methods (Primary outcome: Feasibility; page unavailable) state that follow-up measures were collected to assess interview feasibility, not to demonstrate efficacy or health improvement. The paper describes tablet-based therapy for communication deficits, but our copy does not report improved language skills from that therapy. I searched for language outcomes, efficacy, and before-and-after improvement. (LLM, conf=0.78)

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Authors
Pugliese, M., Ramsay, T., Shamloul, R., Mallet, K., Zakutney, L., Corbett, D., Dukelow, S., Stotts, G., Shamy, M., Wilson, K., Guerinet, J., & Dowlatshahi, D.
Affiliations
  • University of Ottawa (CA)
  • Ottawa Hospital Research Institute (CA)
  • Ottawa Hospital (CA)
  • University of Calgary (CA)
Corresponding author
Pugliese, Michael
ORCID
Venue
PLOS ONE
Publisher
Public Library of Science (PLoS)
Published
2019-01-25
Volume
14
Issue
1
Pages
e0210725
ISSN
1932-6203 (ISSN-L)
DOI
10.1371/journal.pone.0210725
PMC
PMC6347149
OpenAlex
W2907173810
Cited by
42
References
5
Citations by year
2026: 6 · 2025: 4 · 2024: 8 · 2023: 7 · 2022: 4 · 2021: 4 · 2020: 6 · 2019: 3
FWCI
2.97
Type
journal article
Language
en
Open access
Licence
Locations
  • PLoS ONE (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • uO Research (University of Ottawa) (submittedVersion, public-domain)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • University of Ottawa - Library
Funders
  • University of Ottawa
  • Canadian Institutes of Health Research
  • University of Ottawa Brain and Mind Institute
  • Canadian Partnership for Stroke Recovery
  • University of Ottawa Department of Medicine
Topics
  • Health Sciences › Medicine › Rehabilitation › Stroke Rehabilitation and Recovery
  • Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Telemedicine and Telehealth Implementation
Keywords
stroke rehabilitation, mobile health, early post-stroke recovery, speech therapy, cognitive therapy, feasibility, patient adherence, patient retention, acute stroke patients
MeSH terms
Stroke Rehabilitation, Adult, Aged, Aged, 80 and over, Female, Humans, Male, Middle Aged, Patient Discharge, Prospective Studies, Stroke, Mobile Applications

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