A Co-designed Digital Device for Tracking Rehabilitation Dosage After Stroke: Validity and Feasibility Study in a Clinical Environment

Why are you incompetently measuring dosage rather than results? Your mentors and senior researchers are that blitheringly stupid?

Send me personal hate mail on this: oc1dean@gmail.com. I'll print your complete statement with your name and my response in my blog. Or are you afraid to engage with my stroke-addled mind? No excuses are allowed! You're medically trained; it should be simple to precisely state EXACTLY WHY you aren't measuring results with NO EXCUSES! Your definition of competence in stroke is obviously much lower than stroke survivors' definition of your competence! Swearing at me is allowed, I'll return the favor. Don't even attempt to use the excuse that brain research is hard.

“What's measured, improves.” So said management legend and author Peter F. Drucker 

The latest here:

 A Co-designed Digital Device for Tracking Rehabilitation Dosage After Stroke: Validity and Feasibility Study in a Clinical Environment

Fiona Boyd1 MEng; Gillian Sweeney2* PhD; Mark Barber3* MD; Elaine Forrest2* MD; Mark Dunlop4* PhD; Andrew Kerr1* PhD 1Department of Biomedical Engineering University of Strathclyde Glasgow GB 2South Lanarkshire Stroke and Neuro Team Udston Hospital NHS Lanarkshire Hamilton GB 3Dept of Medicine for the Elderly Monklands Hospital NHS Lanarkshire Airdrie GB 4Department of Computer and Information Sciences University of Strathclyde Glasgow GB *these authors contributed equally

Corresponding Author: Fiona Boyd MEng Department of Biomedical Engineering University of Strathclyde Wolfson Centre 106 Rottenrow Glasgow GB 

 Abstract

Background:

In 2023, the National Clinical Guidelines(This should be protocols; more provable incompetence!) for Stroke revised the recommended daily multidisciplinary therapy dose from 45 minutes to 3 hours.(WHAT INCOMPETENCE; MEASURING DOSAGE RATHER THAN RECOVERY RESULTS! I'd fire all of you!) 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 utilises Near Field Communication (NFC) 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 (NFC) technology to automatically log rehabilitation dosage in stroke patients, providing an objective and low-burden solution for clinical environments.

Methods:

This pilot mixed-methods study included two phases. Phase 1 involved a usability trial with nine participants conducted at a university research centre, assessing usability with the System Usability Scale (SUS) and Intrinsic Motivation Inventory (IMI). Phase 2 consisted of a clinical trial in an NHS stroke ward with 15 inpatients, comparing the digital tracker with manual therapist recordings for validity and feasibility using paired t-tests, Cohen's 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 (t(207)=-1.55, P=.12, Cohen’s D=-0.06), with a small mean time discrepancy of 1.18 minutes (SD = 10.98) across 208 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. Clinical Trial: ClinicalTrials.gov: NCT05981729 IRAS ID No. 329156