Aim: To examine the emerging field of digital technologies and map available evidence on acceptability, feasibility, and effectiveness for using self-directed, or carer-assisted, digital interventions in inpatient stroke rehabilitation.
Design: A scoping review.
Methods: Following Arksey and O’Malley’s framework, a systematic search of MEDLINE, Embase, CINAHL, and Google Scholar was conducted up to October 25, 2024. Eligible studies included adult stroke survivors undergoing inpatient rehabilitation who have been prescribed a self-directed digital program aimed at enhancing capabilities, opportunities, and/or motivation for engagement (COM-B framework). Data were extracted by one researcher and checked by two others. Quality was assessed by validated checklists. Results were synthesised narratively.
Results: Thirteen moderate to high quality studies (15 papers), from 10 countries, involving 860 participants, were included (7 pilot randomised control trials, 4 feasibility studies, 1 non-randomised trial, and 1 observational study). Digital interventions varied and included upper limb exergaming/robotics devices (n=4) and tablet/smartphone applications (n=9) with exercise videos. Acceptability and feasibility outcomes were overall positive with high retention rates, good adherence rates with no adverse events. Facilitators to adoption included timetabling self-management, involving carers and offering additional support to patients with more severe impairments associated with stroke.
Conclusion: Our findings suggest that self-directed and carer-assisted digital interventions may be feasible and acceptable in inpatient stroke rehabilitation.
Key Practice points: Clinicians should consider utilising digital interventions to promote patient engagement with self-directed activity on rehabilitation wards. Future research should explore most effective implementation strategies and the impact of digital interventions on long-term patient outcomes.