Yes / Background: Evidence indicates that post − stroke rehabilitation improves function, independence and quality of
life. A key aspect of rehabilitation is the provision of appropriate information and feedback to the learner.
Advances in information and communications technology (ICT) have allowed for the development of various
systems to complement stroke rehabilitation that could be used in the home setting. These systems may increase
the provision of rehabilitation a stroke survivor receives and carries out, as well as providing a learning platform that
facilitates long-term self-managed rehabilitation and behaviour change. This paper describes the application of an
innovative evaluative methodology to explore the utilisation of feedback for post-stroke upper-limb rehabilitation in
the home.
Methods: Using the principles of realistic evaluation, this study aimed to test and refine intervention theories by
exploring the complex interactions of contexts, mechanisms and outcomes that arise from technology deployment
in the home. Methods included focus groups followed by multi-method case studies (n = 5) before, during and after
the use of computer-based equipment. Data were analysed in relation to the context-mechanism-outcome
hypotheses case by case. This was followed by a synthesis of the findings to answer the question, ‘what works for
whom and in what circumstances and respects?’
Results: Data analysis reveals that to achieve desired outcomes through the use of ICT, key elements of computer
feedback, such as accuracy, measurability, rewarding feedback, adaptability, and knowledge of results feedback, are
required to trigger the theory-driven mechanisms underpinning the intervention. In addition, the pre-existing
context and the personal and environmental contexts, such as previous experience of service delivery, personal
goals, trust in the technology, and social circumstances may also enable or constrain the underpinning
theory-driven mechanisms.
Conclusions: Findings suggest that the theory-driven mechanisms underpinning the utilisation of feedback from
computer-based technology for home-based upper-limb post-stroke rehabilitation are dependent on key elements
of computer feedback and the personal and environmental context. The identification of these elements may
therefore inform the development of technology; therapy education and the subsequent adoption of technology
and a self-management paradigm; long-term self-managed rehabilitation; and importantly, improvements in the
physical and psychosocial aspects of recovery. / This paper is part of the SMART programme of research funded by Engineering and Physical Sciences Research Council (EPSRC).
| Identifer | oai:union.ndltd.org:BRADFORD/oai:bradscholars.brad.ac.uk:10454/10993 |
| Date | 22 April 2014 |
| Creators | Parker, J., Mawson, S., Mountain, Gail, Nasr, N., Zheng, H. |
| Source Sets | Bradford Scholars |
| Language | English |
| Detected Language | English |
| Type | Article, Published version |
| Rights | © 2014 Parker et al.; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. |
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