Haptic Nudges Increase Affected Upper Limb Movement During Inpatient Stroke Rehabilitation: Multiple-Period Randomized Crossover Study.

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dc.contributor.author Signal Nada Elizabeth June
dc.contributor.author McLaren Ruth
dc.contributor.author Rashid Usman
dc.contributor.author Vandal Alain
dc.contributor.author King Marcus
dc.contributor.author Almesfer Faisal
dc.contributor.author Henderson Jeanette
dc.contributor.author Taylor Denise
dc.date.accessioned 2020-11-11T19:29:02Z
dc.date.available 2020-11-11T19:29:02Z
dc.date.issued 2020-7-29
dc.identifier.citation JMIR mHealth and uHealth 8(7):e17036 29 Jul 2020
dc.identifier.issn 2291-5222
dc.identifier.uri http://hdl.handle.net/2292/53527
dc.description.abstract BACKGROUND:As many as 80% of stroke survivors experience upper limb (UL) disability. The strong relationships between disability, lost productivity, and ongoing health care costs mean reducing disability after stroke is critical at both individual and society levels. Unfortunately, the amount of UL-focused rehabilitation received by people with stroke is extremely low. Activity monitoring and promotion using wearable devices offer a potential technology-based solution to address this gap. Commonly, wearable devices are used to deliver a haptic nudge to the wearer with the aim of promoting a particular behavior. However, little is known about the effectiveness of haptic nudging in promoting behaviors in patient populations. OBJECTIVE:This study aimed to estimate the effect of haptic nudging delivered via a wrist-worn wearable device on UL movement in people with UL disability following stroke undertaking inpatient rehabilitation. METHODS:A multiple-period randomized crossover design was used to measure the association of UL movement with the occurrence of haptic nudge reminders to move the affected UL in 20 people with stroke undertaking inpatient rehabilitation. UL movement was observed and classified using movement taxonomy across 72 one-minute observation periods from 7:00 AM to 7:00 PM on a single weekday. On 36 occasions, a haptic nudge to move the affected UL was provided just before the observation period. On the other 36 occasions, no haptic nudge was given. The timing of the haptic nudge was randomized across the observation period for each participant. Statistical analysis was performed using mixed logistic regression. The effect of a haptic nudge was evaluated from the intention-to-treat dataset as the ratio of the odds of affected UL movement during the observation period following a "Planned Nudge" to the odds of affected limb movement during the observation period following "No Nudge." RESULTS:The primary intention-to-treat analysis showed the odds ratio (OR) of affected UL movement following a haptic nudge was 1.44 (95% CI 1.28-1.63, P<.001). The secondary analysis revealed an increased odds of affected UL movement following a Planned Nudge was predominantly due to increased odds of spontaneous affected UL movement (OR 2.03, 95% CI 1.65-2.51, P<.001) rather than affected UL movement in conjunction with unaffected UL movement (OR 1.13, 95% CI 0.99-1.29, P=.07). CONCLUSIONS:Haptic nudging delivered via a wrist-worn wearable device increases affected UL movement in people with UL disability following stroke undertaking inpatient rehabilitation. The promoted movement appears to be specific to the instructions given. TRIAL REGISTRATION:Australia New Zealand Clinical Trials Registry 12616000654459; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=370687&isReview=true.
dc.format.medium Electronic
dc.language eng
dc.relation.ispartofseries JMIR mHealth and uHealth
dc.rights Items in ResearchSpace are protected by copyright, with all rights reserved, unless otherwise indicated. Previously published items are made available in accordance with the copyright policy of the publisher.
dc.rights.uri https://researchspace.auckland.ac.nz/docs/uoa-docs/rights.htm
dc.rights.uri https://creativecommons.org/licenses/by/4.0/
dc.subject 1109 Neurosciences
dc.subject Clinical
dc.subject Clinical Medicine and Science
dc.subject Rehabilitation
dc.subject Stroke
dc.subject Clinical Trials and Supportive Activities
dc.subject Clinical Research
dc.subject Stroke
dc.subject Science & Technology
dc.subject Life Sciences & Biomedicine
dc.subject Health Care Sciences & Services
dc.subject Medical Informatics
dc.subject stroke
dc.subject rehabilitation
dc.subject physical activity
dc.subject movement
dc.subject disability
dc.subject technology
dc.subject upper limb
dc.subject wearable
dc.subject haptic
dc.subject nudge
dc.subject THERAPY
dc.subject TECHNOLOGY
dc.subject DISABILITY
dc.subject USABILITY
dc.subject RECOVERY
dc.subject BEHAVIOR
dc.subject DEVICES
dc.subject COSTS
dc.title Haptic Nudges Increase Affected Upper Limb Movement During Inpatient Stroke Rehabilitation: Multiple-Period Randomized Crossover Study.
dc.type Journal Article
dc.identifier.doi 10.2196/17036
pubs.issue 7
pubs.begin-page e17036
pubs.volume 8
dc.date.updated 2020-10-15T02:27:48Z
dc.rights.holder Copyright: The authors en
pubs.author-url http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000555923400001&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=6e41486220adb198d0efde5a3b153e7d
pubs.publication-status Published
dc.rights.accessrights http://purl.org/eprint/accessRights/OpenAccess en
pubs.subtype research-article
pubs.subtype Journal Article
pubs.elements-id 809460
dc.identifier.eissn 2291-5222
pubs.number ARTN e17036

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