mHealth Intervention Applications for Adults Living With the Effects of Stroke: A Scoping Review

Abstract

Objective To conduct a scoping review of mobile health (mHealth) application (app) interventions to support needs of adults living with the effects of stroke reported in the literature. Data Sources PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Scopus were systematically searched for peer-reviewed publications. Articles were published between January 2007 and September 2020 and met predefined inclusion and exclusion criteria. Study Selection Articles included were written in English language, involved adults older than 18 years, and described an mHealth app specifically tested and/or developed as an intervention for someone with stroke to be used remotely and/or independently without constant provider supervision or assistance. Articles were excluded if they focused on acute management of stroke only, focused on primary prevention, were animal studies, were not an app for smartphone or tablet, and did not describe an empirical study. Data Extraction Two researchers independently screened titles and abstracts for inclusion. The full-text articles were then reviewed for eligibility by the research team. Data were extracted and verified by a third reviewer. Data Synthesis The search yielded 2123 studies and 49 were included for data extraction. The findings reveal that a global surge of studies on mHealth apps for people with stroke have emerged within the past 2 years. Most studies were developed for persons with stroke in the United States and the primary content foci included upper extremity function (31.5%); lower extremity function (5.3%); general exercise, physical activity, and/or functional mobility (23.7%); trunk control (5.3%); medical management and secondary prevention (26.3%); language and speech skills (20.5%); cognitive skills (7.9%); general disability and activities of daily living (5.3%); and home safety (2.6%). Of the included studies, a majority were preliminary in nature, with 36.7% being categorized as pilot or feasibility trials and 24.4% discussing initial design, development, and/or refinement. Conclusions Results from this study reveal that the number of apps specifically developed for people with stroke and described in the scientific literature are growing exponentially. The apps have widely varied content to meet the needs of persons with stroke; however, the studies are generally preliminary in nature, focusing on development, usability, and initial pilot testing. This review highlights the need for additional research and development of mHealth apps targeted for adults with stroke. Development should consider the various and complex needs of people living with the effects of chronic stroke, while large-scale trials are needed to build on the existing evidence.

Moving Towards Equity With Digital Health Innovations for Stroke Care

“…A scoping review that evaluated mHealth for all phases of stroke care found that most studies were underpowered and were pilot and feasibility studies and case series (with no mHealth studies using stroke as a primary outcome). 27,28…”

“…A scoping review that evaluated mHealth for all phases of stroke care found that most studies were underpowered and were pilot and feasibility studies and case series (with no mHealth studies using stroke as a primary outcome). 27,28 The Stroke Riskometer is one of the few digital applications that has been scientifically evaluated and is endorsed by the World Stroke Organization and World Federation of Neurology. 29 The Stroke Riskometer derives from the Framingham stroke prediction algorithm with additional risk factors based on the INTERSTROKE study (eg, diet, non-White race, stress level, and alcohol consumption).…”

Evaluation of a Newly Developed Smartphone App for Risk Factor Management in Young Patients With Ischemic Stroke: A Pilot Study

“…An easily to implement and cost-efficient approach to support risk factor management, especially in younger patients with stroke might be mobile health (mHealth) (11)(12)(13). The mHealth is defined as the use of mobile and wireless technologies, such as smartphones and tablets, to support the achievement of health objectives.…”

Improving public health through the development of local scientific capacity and training in rehabilitation in LMICs: A proof-of-concept of collaborative efforts in Parakou, Benin

“…Educational programs and dedicated workshops should be developed to inform the local healthcare professionals about the concept of level of evidence and clinical recommendations. The utilization of new affordable technologies (e.g., mHealth) may provide an alternative to the above-mentioned restrictions of rehabilitation or may supplement the present rehabilitation programs ( 13 ). mHealth has the potential to significantly benefit LMICs by overcoming a shortage of healthcare professionals, advancing rehabilitation, and reducing health inequalities through increased access to rehabilitation.…”