ArticleJMIR rehabilitation and assistive technologies2025
Co-Designed Digital Device for Tracking Rehabilitation Dosage in a Clinical Environment After Stroke: Mixed Methods Validity and Feasibility Study.
Article in JMIR rehabilitation and assistive technologies, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: In 2023, the National Clinical Guidelines for Stroke revised the recommended daily multidisciplinary therapy dose from 45 minutes per therapy to 3 hours of therapy overall. To monitor the achievement of these guidelines, there is a need for accurate measurement. This study introduces a novel co-designed digital dosage tracking system that uses Near Field Communication technology to log rehabilitation activities and demonstrates its feasibility and accuracy in a clinical setting through comparison with the current clinical method of manual recording. Objective: This study aimed to assess the validity, feasibility, and usability of a novel co-designed digital tracker using Near Field Communication technology to automatically log rehabilitation dosage in people with stroke history, providing an objective and low-burden solution for clinical environments. Methods: This pilot mixed methods study included 2 phases. Phase 1 involved a usability trial with 9 participants conducted at a university research center, assessing usability with the System Usability Scale (SUS) and Intrinsic Motivation Inventory (IMI). Phase 2 consisted of a clinical trial in a National Health Service stroke ward with 15 inpatients, comparing the digital tracker with manual therapist recordings for validity and feasibility using paired t tests, Cohen d, and Bland-Altman plots. An acceptable discrepancy range was set at ±5%-10%. Results: The digital tracker demonstrated high usability with a mean SUS score of 91.43 (SD 9.53) and strong user satisfaction (IMI score 6.29/7, SD 1.50). Clinical trial results showed a strong agreement between the digital and manual methods (t206=-1.60; P=.11; Cohen d=-0.06), with a small mean time discrepancy of 1.23 (SD 11.01) minutes across 207 activities. The Bland-Altman plot indicated good accuracy and consistency between methods, with limits of agreement within the clinically acceptable range. Conclusions: The co-designed digital tracker has been shown to agree with a manual method for recording rehabilitation dosage. This development presents the opportunity for objective, automated, and low-burden recording of rehabilitation dose to support prescription, monitoring, and research.
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