Use of Mobile/Tablet and Web-Based Applications to Support Rehabilitation After Stroke: A Scoping Review

Abstract

Objective: To describe and review evidence of mobile/tablet and web-based applications to support the rehabilitation process after stroke. The secondary aim was to describe participants’ stroke severity, and use of applications in relation to, respectively, the setting and phase of the rehabilitation process.
Methods: A scoping review methodology was used to identify studies, through databases such as Pub-Med, CINAHL, Embase and AMED. In addition, grey literature was searched. The studies were categorized according to Wade’s model of rehabilitation.
Results: The literature search resulted in 12,065 records. Forty-six studies were included, in which applications were used to support: assessment (n = 16); training (n = 25); discharge from hospital (n = 2); and 2 studies were targeted at supporting discharge/education/information and training. One study targeted assessment, discharge support and goal-setting. No studies were related to the element “participation” using Wade’s model of rehabilitation. Of the 46 studies, 33 studies included participants with mild to moderate stroke, and 4 studies included participants with severe stroke. In 9 studies the stroke severity was not reported. Twenty three studies included participants with chronic stroke, 16 acute and/or subacute stroke, and 5 included participants with acute and/or subacute and/or chronic stroke. In 2 studies, stroke onset was not reported. Applications were used in a rehabilitation setting (n = 21), home setting (n = 17), and both settings (n = 3). In 5 studies the setting was not reported.
Conclusion: Most studies of applications developed to support the rehabilitation process after stroke have been explorative. They primarily include participants with mild or moderate stroke and focus on a limited aspect of the rehabilitation process, e.g. assessment
or training. Future applications to support stroke rehabilitation should accommodate stroke survivors’ and significant others’ need for solutions, irrespective of stroke severity and throughout the entire rehabilitation process.

LAY ABSTRACT
Studies have shown that the integration of applications (apps) can support the rehabilitation process after stroke. However, this scoping review found that most existing app solutions have limited usability, providing only 1 aspect of support in the rehabilitation process, such as clinical assessment or a narrow focus on exercises. Furthermore, currently available app solutions mainly target stroke survivors with mild stroke. Stroke survivors and significant others express a need for more comprehensive solutions to support the entire crosssectorial rehabilitation process. Therefore, there is a need for development of app solutions that support a greater part of the stroke rehabilitation process regardless of stroke severity.