The Feasibility and User Experience of a Program of Progressive Cued Activity to Promote Functional Upper Limb Activity in the Inpatient Rehabilitation Setting with Follow-Up at Home.

Abstract

Although upper limb impairment is one of the most common deficits post-stroke and contributes substantially to diminished functional independence, many survivors receive low dosages of upper limb task training in the inpatient setting. This study evaluates the feasibility and user experience of a progressive-challenge cued activity program, delivered via wearable technology, to promote upper limb activity in an inpatient rehabilitation facility (IRF) post-stroke. Participants (N = 30) wore our wearable system Souvenir, which provided vibrotactile cues to prompt activity in the more-involved arm during idle time. Compliance with the program was high (94% in the IRF), and the system successfully prompted increased activity, as evidenced by significantly higher post-cue response rates compared to pre-cue activity rates (mean difference = 35.1%, t(28) = 9.398, p < 0.001). User experience was positive, with participants reporting high usability, satisfaction, and motivation. Follow-up data collected in unstructured home settings (n = 23) demonstrated continued high compliance (96%) and favorable user experience. These findings suggest that Souvenir and its cued activity program can effectively convert idle time into therapeutic activity while minimizing caregiver burden. Future research should focus on enhancing user engagement and evaluating the clinical efficacy of this approach in improving functional outcomes post-stroke.