Mobile Health Applications for Acute Stroke Rehabilitation: An Updated Narrative Review

 So, such lousy research that nothing specific was found that gets survivors recovered!

Mobile Health Applications for Acute Stroke Rehabilitation: An Updated Narrative Review

• Francesca Santoro, 
• Vincenzo Di Lazzaro & 
• Fabio Pilato 

• 6 Accesses

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Abstract

Purpose of Review

This review aims to synthesize current evidence on the use of mobile applications (Apps) for post-stroke rehabilitation, focusing on measurable clinical outcomes related to motor, language, balance, and functional recovery.

Recent Findings

Several mobile Apps have been recently developed for post-stroke rehabilitation. Many studies show significant improvements in validated outcomes such as motor performance, speech intelligibility, and functional independence. Features like gamification, feedback, and virtual or augmented reality enhance engagement and adherence. Overall, app-based interventions appear effective(It's a binary question; effective? Y/N? And your research proved you were total failures in helping survivors!) and feasible both in clinical and home settings.

Summary

From databases search, we found 18 relevant studies from 782 records. We examined study design, functionalities, and reported outcomes. The selected Apps addressed upper-limb rehabilitation, gait and balance training, language recovery, neglect therapy, and physical activity promotion. Significant improvements were consistently observed across validated measures, and immersive virtual or augmented reality systems produced measurable gains in motor performance, user engagement, and quality of life. We found that most interventions were tested in chronic, home-based contexts, and only a few studies were performed in an early acute–subacute inpatient setting, and this field should be better evaluated in future studies.

Validity of the Utrecht scale for evaluation of rehabilitation-participation restrictions scale in a hospital-based stroke population 3 months after stroke

It should just be a binary question: Are you 100% recovered? Yes/No

The no answer then directly leads to an objective damage diagnosis which directly leads to EXACT REHAB PROTOCOLS  that fix such damage. You don't have that yet? Why not? Is your hospital not working toward that solution? Incompetence in action. 

See the Utrecht Scale here:

Utrecht Scale for Evaluation of Rehabilitation-Participation

The latest here:

Validity of the Utrecht scale for evaluation of rehabilitation-participation restrictions scale in a hospital-based stroke population 3 months after stroke

Joris A. de Graaf

,

Eline J. Volkers

,

Vera P.M. Schepers

,

Johanna M.A. Visser-Meily

&

Marcel W.M. Post

Received 09 Mar 2021, Accepted 10 Jul 2021, Published online: 27 Jul 2021

• Download citation
• https://doi.org/10.1080/10749357.2021.1956047
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ABSTRACT

Background: 

The Utrecht Scale for Evaluation of Rehabilitation-Participation Restrictions scale (USER-P-R) is a promising patient-reported outcome measure, but has currently not been validated in a hospital-based stroke population.  

Objective:

 To examine psychometric properties of the USER-P-R in a hospital-based stroke population 3 months after stroke onset. 

Methods:C

ross-sectional study including 359 individuals with stroke recruited through 6 Dutch hospitals. The USER-P-R, EuroQol 5-dimensional 5-level questionnaire (EQ-5D-5 L), Patient Reported Outcomes Measurement Information System 10-Question Global Health Short Form (PROMIS-10), modified Rankin Scale (mRS) and two items on perceived decrease in health and activities post-stroke were administered in a telephone interview 3 months after stroke. The internal consistency, distribution, floor/ceiling effects, convergent validity and discriminant ability of the USER-P-R were calculated.  

Results: 

Of all participants, 96.9% were living at home and 50.9% experienced no or minimal disabilities (mRS 0–1). The USER-P-R showed high internal consistency (α = 0.90) and a non-normal left-skewed distribution with a ceiling effect (21.4% maximum scores). A substantial proportion of participants with minimal disabilities (mRS 1) experienced restrictions on USER-P-R items (range 11.9–48.5%). The USER-P-R correlated strongly with the EQ-5D-5 L, PROMIS-10 and mRS. The USER-P-R showed excellent discriminant ability in more severely affected individuals with stroke, whereas its discriminant ability in less affected individuals was moderate. 

Conclusions: 

The USER-P-R shows good measurement properties and provides additional patient-reported information, proving its usefulness as an instrument to evaluate participation after 3 months in a hospital-based stroke population.

 

Cross-validation of the factorial validity of the stroke impact scale 3.0 in patients with stroke

You can check it out here.  Stroke Impact Scale 3.0

To me this is totally wrong way to measure it. It is a binary question. ARE YOU 100% RECOVERED? YES/NO?

 Cross-validation of the factorial validity of the stroke impact scale 3.0 in patients with stroke

American Journal of Occupational Therapy (AJOT) , Volume 75(2) , Pgs. 7502205070.

NARIC Accession Number: J86222.  What's this?
ISSN: 0272-9490.
Author(s): Lee, Shih-Chieh ; Lin, Gong-Hong ; Huang, Yi-Jing ; Huang, Sheau-Ling ; Chou, Chia-Yeh ; Chiang, Hsin-Yu ; Hsieh, Ching-Lin.
Publication Year: 2021.
Number of Pages: 10.

Abstract: 

Study examined the underlying structure of the Stroke Impact Scale 3.0 (SIS-3.0), a promising outcome measure of health-related quality of life (HRQOL) for clients with stroke, by comparing the currently available eight- and four-domain structures simultaneously. This was a secondary data analysis of responses to the SIS-3.0 from a previous psychometric validation study. In that study, 263 patients with stroke were recruited from the rehabilitation wards (inpatients) and neurology and rehabilitation clinics (outpatients) of five general hospitals in northern and southern Taiwan. Confirmatory factor analysis was used to examine the eight- and four-domain structures of the SIS-3.0. Four fit indices were considered simultaneously to examine the model fits of both structures: (1) chi-squared value adjusted for model complexity, (2) comparative fit index, (3) root mean square (RMS) error of approximation, and (4) standardized RMS residual. The eight- and four-domain structures of the SIS-3.0 were not supported by all four indices. The unidimensionality of each domain in the two structures was not supported. Neither the eight- nor the four-domain structure of the SIS-3.0 was supported, suggesting that scores may not provide valid assessments of HRQOL in clients with stroke. Further modification and validation of the SIS-3.0 are warranted. These findings suggest that the eight- and four-domain scores of the SIS-3.0 may not be valid. Therefore, until more supporting evidence is developed, these scores should be interpreted cautiously regarding clients’ HRQOL; alternatively, other measures could be used.
Descriptor Terms: DAILY LIVING, FUNCTIONAL EVALUATION, MEASUREMENTS, OCCUPATIONAL THERAPY, OUTCOMES, PERFORMANCE STANDARDS, QUALITY OF LIFE, STROKE.


Can this document be ordered through NARIC's document delivery service*?: Y.

Citation: Lee, Shih-Chieh , Lin, Gong-Hong , Huang, Yi-Jing , Huang, Sheau-Ling , Chou, Chia-Yeh , Chiang, Hsin-Yu , Hsieh, Ching-Lin. (2021). Cross-validation of the factorial validity of the stroke impact scale 3.0 in patients with stroke.  American Journal of Occupational Therapy (AJOT) , 75(2), Pgs. 7502205070. Retrieved 5/18/2021, from REHABDATA database.
 

One more time

This is going to have to be your mantra for your post-stroke exercises. This goes back to my programming background - binary, data is either on or off. Is your recovery complete enough for you? If not then you need to practice one more time. The problem with using binary to count is that 1,000,000,000 tries in binary is only 512 in decimal. And that is probably never going to be enough to induce neuroplasticity to help you.