RT Journal Article
SR Electronic
T1 What is the feasibility and patient acceptability of a digital system for arm and hand rehabilitation after stroke? A mixed-methods, single-arm feasibility study of the ‘OnTrack’ intervention for hospital and home use
JF BMJ Open
JO BMJ Open
FD British Medical Journal Publishing Group
SP e062042
DO 10.1136/bmjopen-2022-062042
VO 12
IS 9
A1 Fusari, Gianpaolo
A1 Gibbs, Ella
A1 Hoskin, Lily
A1 Lawrence-Jones, Anna
A1 Dickens, Daniel
A1 Fernandez Crespo, Roberto
A1 Leis, Melanie
A1 Crow, Jennifer
A1 Taylor, Elizabeth
A1 Jones, Fiona
A1 Darzi, Ara
YR 2022
UL http://bmjopen.bmj.com/content/12/9/e062042.abstract
AB Objectives Arm weakness is common after stroke; repetitive activity is critical for recovery but people struggle with knowing what to do, volume, and monitoring progress. We studied the feasibility and acceptability of OnTrack, a digital intervention supporting arm and hand rehabilitation in acute and home settings.Design A mixed-method, single-arm study evaluating the feasibility of OnTrack for hospital and home use. An independent process evaluation assessed the intervention’s fidelity, dose and reach. Amendments to the protocol were necessary after COVID-19.Setting Acute stroke services and home settings in North West London.Participants 12 adults with a stroke diagnosis <6 months previously (first or recurrent) requiring arm rehabilitation in hospital and/or home.Intervention 12 weeks using the OnTrack system comprising arm tracking and coaching support for self-management.Primary and secondary outcome measures Recruitment, retention and completion rates; compliance and adherence to the intervention; reasons for study decline/withdrawal.Intervention fidelity and acceptability, evaluated through an independent process evaluation.Patient measures including activity baseline, healthcare activation, arm function and impairment collected at baseline, week 7 and week 14 of participation to assess suitability for a randomised controlled trial (RCT).Results 181 individuals screened, 37 met eligibility criteria, 24 recruited (65%); of these, 15 (63%) were recruited before COVID-19, and 9 (37%) during. 12 completed the intervention (50%). Despite COVID-19 disruptions, recruitment, retention and completion were in line with prestudy expectations and acceptable for a definitive trial. Participants felt the study requirements were acceptable and the intervention usable. Fidelity of delivery was acceptable according to predetermined fidelity markers. Outcome measures collected helped determine sample size estimates and primary outcomes for an RCT.Conclusions The intervention was found to be usable and acceptable by participants; study feasibility objectives were met and demonstrated that a definitive RCT would be viable and acceptable.Trial registration number NCT03944486.Data are available on reasonable request. All data relevant to the study are included in the article or uploaded as online supplemental information. All data relevant to the study are included in the article or uploaded as online supplemental information. Additional data relevant to the study are available on reasonable request and should be directed to the corresponding author.