Wearable Technology to Increase Activity During Idle-Time Post-Stroke: User Experience While Inpatient and At-Home

Research Objectives: Describe user experiences with a wearable system that 1) provides prompts to exercise during patient idle time in an inpatient rehabilitation (IPR) setting and 2) monitors patient upper extremity (UE) activity in both IPR and home settings.

Design: Feasibility study.

Setting: IPR and at-home.

Participants: Convenience sample of first-time stroke survivors were recruited in the acute phase of recovery (N=19) with follow-up at home 2-to-6 months post IPR discharge (N=6).

Interventions: Participants wore off-the-shelf wearable sensors with integrated accelerometers (worn on both wrists), which paired with a smartphone that scheduled delivery of haptic cues to motivate idle time exercise. Exercise sessions progressed in difficulty based on user feedback and were scheduled for 30-minute durations, 3 times per day during idle-time between therapy sessions. UE activity was monitored for 8 hours per day (including the 1.5 hours of cued exercise time). During follow-up at home, participants wore the devices for two days of passive UE activity monitoring.

Main Outcome Measures: User perceived satisfaction was evaluated using the Quebec User Evaluation of Satisfaction with assistive Technology (QUEST), usability of the devices was assessed using the System Usability Scale (SUS), and user motivation was evaluated with the Intrinsic Motivation Inventory (IMI). IMI is further subcategorized into dimensions of perceived choice, value/usefulness, perceived competence, effort/importance, interest/enjoyment, and pressure/tension. Surveys were completed after a minimum of three days of use during IPR and after two days of use at home.

Results: We used one sample, one-tailed t-test to determine if average QUEST, SUS, and IMI scores met passability criteria. Participants’ perceived satisfaction, motivation, and usability with the devices were passable both in IPR (p < 0.001) and home (p < 0.045) settings.

Conclusions: Survivors of stroke found Souvenir to be usable, motivating, and satisfying both in IPR and home settings, suggesting use of this technology is feasible during early stages of stroke recovery. Further study is needed to test the efficacy of progressive exercises using this technology.

Author(s) Disclosures: None.