Since your doctors have known forever that stroke survivors aren't getting the required number of hours of therapy. They should have competently created action observation videos and mirror therapy protocols in the last decade. That is assuming they were competent at all.
action observation (130 posts to May 2011)
mirror therapy (121 posts to October 2012)
Effect of mobile application types on stroke rehabilitation: a systematic review
Journal of NeuroEngineering and Rehabilitation volume 20, Article number: 12 (2023)
Abstract
Background
Stroke is a significant contributor of worldwide disability and morbidity with substantial economic consequences. Rehabilitation is a vital component of stroke recovery, but inpatient stroke rehabilitation programs can struggle to meet the recommended hours of therapy per day outlined by the Canadian Stroke Best Practices and American Heart Association. Mobile applications (apps) are an emerging technology which may help bridge this deficit, however this area is understudied. The purpose of this study is to review the effect of mobile apps for stroke rehabilitation on stroke impairments and functional outcomes. Specifically, this paper will delve into the impact of varying mobile app types on stroke rehabilitation.
Methods
This systematic review included 29 studies: 11 randomized control trials and 18 quasi-experimental studies. Data extrapolation mapped 5 mobile app types (therapy apps, education apps, rehab videos, reminders, and a combination of rehab videos with reminders) to stroke deficits (motor paresis, aphasia, neglect), adherence to exercise, activities of daily living (ADLs), quality of life, secondary stroke prevention, and depression and anxiety.
Results
There were multiple studies supporting the use of therapy apps for motor paresis or aphasia, rehab videos for exercise adherence, and reminders for exercise adherence. For permutations involving other app types with stroke deficits or functional outcomes (adherence to exercise, ADLs, quality of life, secondary stroke prevention, depression and anxiety), the results were either non-significant or limited by a paucity of studies.
Conclusion
Mobile apps demonstrate potential to assist with stroke recovery and augment face to face rehabilitation, however, development of a mobile app should be carefully planned when targeting specific stroke deficits or functional outcomes. This study found that mobile app types which mimicked principles of effective face-to-face therapy (massed practice, task-specific practice, goal-oriented practice, multisensory stimulation, rhythmic cueing, feedback, social interaction, and constraint-induced therapy) and education (interactivity, feedback, repetition, practice exercises, social learning) had the greatest benefits.
Protocol registration PROPSERO (ID CRD42021186534). Registered 21 February 2021
Background
Stroke continues to be a leading cause of worldwide disability and morbidity amongst all cardiovascular diseases [1]. From 1990 to 2019, strokes had a global rise in prevalence reaching 101 million people and causing a loss of 143 million disability-adjusted life years [1] at a cost of billions of dollars per year to North American economies [2, 3]. Stroke rehabilitation includes an organized interdisciplinary team approach to stroke specific therapy, and is a critical component of recovery and successful re-integration into society [4]. Compared with other acute stroke interventions, stroke rehabilitation has been found to be as effective or superior to thrombolysis or aspirin [5, 6]. On a per dollar value, the clinical benefits of stroke rehabilitation have been shown to outweigh its costs significantly [7].
Current Canadian Stroke Best Practices and American Heart Association guidelines state that inpatient stroke rehabilitation should provide task-specific therapy (defined as physiotherapy, occupational therapy, and speech and language therapy), for at least 3 h per day of 5 days per week [8, 9]. Evidence supports that more therapy results in improved outcomes [10]. Unfortunately, many institutions struggle to provide this rehabilitation intensity. A 2018 Canadian study found inpatients in a stroke rehabilitation participated in 8.5 h per week of therapy, much below the guideline recommendations of 15 h per week [11]. Outside of therapy, stroke rehabilitation inpatients spend most of their days sedentary [11,12,13]. There are numerous barriers for meeting current stroke rehabilitation guidelines, including insufficient staff, timing mismatch with other patient activities such as investigations for stroke work-up (CTs, echocardiograms, Holter monitors), and a rise in the number of patients requiring stroke rehabilitation [14, 15].
Mobile applications (apps) for stroke rehabilitation have become an emerging area of interest because of their mobility, multi-functional capabilities such as reminders and videos, and their ability to give patients autonomy over therapy [16,17,18]. A 2018 systematic review defined several mobile apps for stroke rehabilitation with the potential to be clinically effective [19]. For example, there are mobile apps designed as games to improve finger dexterity, programs to increase exercise adherence, home exercise programs for upper limb rehabilitation, and mirror therapy for facial paresis [16,17,18, 20]. Mobile apps can target different aspects of stroke rehabilitation. The purpose of this study is to review the effect of mobile apps for stroke rehabilitation on stroke-related impairments and functional outcomes. Specifically, this paper will delve into the effect of varying mobile app types on stroke rehabilitation outcomes.
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