A Critical Review Of The Task Related Training (TRT) Mobile App Prototype And Its Suitability For The Delivery Of TRT Locomotor Circuit Class Training For People With Stroke In An Inpatient Hospital Setting In Singapore: A Physiotherapy Perspective
Mohamed Noor, Nurzahidah
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Background: Stroke is the leading cause of adult disability worldwide (Tetzlaff et al., 2020), and can result in locomotor disability, impacting functional independence and participation (Knox et al., 2018). As a result, identifying interventions that reduce locomotor disability while increasing functional independence is critical. The rise of digital health has resulted in a plethora of mobile technology-based innovations that open up new avenues for stroke rehabilitation (Henson et al., 2019). By facilitating physical, cognitive, and social activity, the use of tablet technology and mobile apps provides a platform for increasing the variety (Rinne et al., 2016), dose (Stütz et al., 2017) and intensity (Norouzi-Gheidari et al., 2012) of stroke rehabilitation in the hospital and community setting (White et al., 2015). Mobile apps have the potential to support the delivery of evidenced based interventions like task-related circuit class training (CCT) which has been shown to be more effective than conventional physiotherapy in improving walking speed, walking endurance and some aspects of balance in people with stroke (English et al., 2017). The physiotherapy department at Jurong Community Hospital (JCH), National University Health System in Singapore, wanted to see if their current stroke CCT programme could be delivered digitally to keep up with technological advancements. The purpose of this critical review was to determine the suitability of Task Related Training (TRT), an app in its early prototype stage, to support locomotor CCT for stroke patients at JCH. Method: This critical review used 1) a think-aloud usability method to assess the usability and suitability of the TRT app prototype from a physiotherapy perspective, and (2) comparator methods that critiqued the app's content using motor learning and task-related training principles, and tasks reported in the CCT literature for people with stroke. Results: Initial user testing revealed that the TRT app was well-received in terms of usability and suitability. Examining the app's content revealed that it is closely aligned with motor learning and TRT principles, as well as the tasks in the CCT evidence base. From the perspective of a physiotherapy user, the TRT App has the potential to support the delivery of the JCH CCT programme. Conclusion: Future directions should see designers of rehabilitation technology consider the recommendations outlined in this review and conduct future iterative user testing with physiotherapists, therapy associates and people with stroke in Singapore. Near-live encounters with the device over extended periods of time in the CCT context would also be important. Future research should also look at validating the device's efficacy for delivering locomotor CCT programmes in people with stroke.