Usability of the TCI Mobile app as a complement to the Constraint-Induced Therapy protocol

Participants: This preliminary study included patients with stroke and physical therapists (PTs). Inclusion criteria for patients were ≥6 months of chronicity, access to a mobile device and the internet, and a score < 17 on the mini mental state examination and excluded if they had a neurological, orthopedic, and/or respiratory disorders unrelated to stroke or severe visual impairment. PTs who had experience with constraint-induced therapy (CIT), a mobile device, and internet access were included. Interventions: TCI Mobile is an application used during CIT application. It encourages engagement with homework through push notifications, enables self-monitoring of daily activities, provides performance feedback, and compares assessment results. Patients and PTs used the application for 4 consecutive days during application of the CIT protocol, and then completed an interview. Main Outcome Measures: The User Mobile Application Rating Scale (uMARS) includes three subscales: objective and subjective quality and perceived impact, with scores ranging from 1 (inadequate) to 5 (excellent). It was previously validated to assess mobile health applications and had excellent internal consistency (alpha = 0.90) and good test-retest reliability.

Results: Ten participants (6 women and 4 men) with stroke were included. They had an average age of 58 years and approximately 67% had dominant hand hemiparesis. Their average chronicity time was 89 months (range 8-264 months). The four PT participants (3 women and 1 man) (average age, 40 years). uMARS data were analyzed using means and standard deviation. Patients’ average objective and subjective quality scores and perceived impact were 4.37±0.53, 4.75±0.56, and 4.92±0.54, respectively. PTs’ average objective and subjective quality scores and perceived impact were 4.27±0.10, 4.44±0.38, 3.67±1.34, respectively.