mHealth technologies used to capture walking and arm use behavior in adult stroke survivors: a scoping review beyond measurement properties

Camila Torriani-Pasin; Marika Demers; Janaine C Polese; Lauri Bishop; Eric Wade; Susanne Hempel; Carolee Winstein

doi:10.1080/09638288.2021.1953623

mHealth technologies used to capture walking and arm use behavior in adult stroke survivors: a scoping review beyond measurement properties

Disabil Rehabil. 2022 Oct;44(20):6094-6106. doi: 10.1080/09638288.2021.1953623. Epub 2021 Jul 23.

Authors

Camila Torriani-Pasin^{1

2}, Marika Demers², Janaine C Polese³, Lauri Bishop², Eric Wade⁴, Susanne Hempel⁵, Carolee Winstein^{2

6}

Affiliations

¹ School of Physical Education and Sport, University of São Paulo, São Paulo, Brazil.
² Biokinesiology and Physical Therapy, Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, CA, USA.
³ Department of Physiotherapy, Faculdade Ciências Médicas de Minas Gerais, Belo Horizonte, Brazil.
⁴ Department of Mechanical Engineering, California Polytechnic State University, San Luis Obispo, CA, USA.
⁵ Southern California Evidence Review Center, University of Southern California, Los Angeles, CA, USA.
⁶ Department of Neurology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.

PMID: 34297652
DOI: 10.1080/09638288.2021.1953623

Abstract

Purpose: We aimed to provide a critical review of measurement properties of mHealth technologies used for stroke survivors to measure the amount and intensity of functional skills, and to identify facilitators and barriers toward adoption in research and clinical practice.

Materials and methods: Using Arksey and O'Malley's framework, two independent reviewers determined eligibility and performed data extraction. We conducted an online consultation survey exercise with 37 experts.

Results: Sixty-four out of 1380 studies were included. A majority reported on lower limb behavior (n = 32), primarily step count (n = 21). Seventeen studies reported on arm-hand behaviors. Twenty-two studies reported metrics of intensity, 10 reported on energy expenditure. Reliability and validity were the most frequently reported properties, both for commercial and non-commercial devices. Facilitators and barriers included: resource costs, technical aspects, perceived usability, and ecological legitimacy. Two additional categories emerged from the survey: safety and knowledge, attitude, and clinical skill.

Conclusions: This provides an initial foundation for a field experiencing rapid growth, new opportunities and the promise that mHealth technologies affords for envisioning a better future for stroke survivors. We synthesized findings into a set of recommendations for clinicians and clinician-scientists about how best to choose mHealth technologies for one's individual objective.Implications for RehabilitationRehabilitation professionals are encouraged to consider the measurement properties of those technologies that are used to monitor functional locomotor and object-interaction skills in the stroke survivors they serve.Multi-modal knowledge translation strategies (research synthesis, educational courses or videos, mentorship from experts, etc.) are available to rehabilitation professionals to improve knowledge, attitude, and skills pertaining to mHealth technologies.Consider the selection of commercially available devices that are proven to be valid, reliable, accurate, and responsive to the targeted clinical population.Consider usability and privacy, confidentiality and safety when choosing a specific device or smartphone application.

Keywords: mHealth; scoping review; smartphone applications; stroke; wearable sensors.

Publication types

Review
Research Support, Non-U.S. Gov't

MeSH terms

Adult
Arm
Humans
Reproducibility of Results
Stroke*
Survivors
Telemedicine*
Walking