Phase I evaluation of the television assisted prompting system to increase completion of home exercises among stroke survivors

Abstract

Purpose. Effective delivery of dysphagia exercises requires intensive repetition, yet many brain injury survivors demonstrate difficulty adhering to home programmes. The Television Assisted Prompting (TAP) system provides a novel method to deliver intensive in-home therapy prompts. Specific research questions compared the effectiveness of the TAP system to typical practice on programme adherence, satisfaction and caregiver burden.

Method. A within-participant alternating treatment design with random assignment of treatment condition compared exercise programme adherence across TAP and typical practice delivery conditions, replicated across three participants. Data included quantitative programme completion rates, satisfaction survey reports and caregiver burden questionnaire results, as well as qualitative interview findings.

Results. A large treatment effect was demonstrated for two participants; exercise programme completion rates increased by 6–17 times typical practice levels with the TAP system. TAP supported sustained practice over the course of the experiment for the third participant despite minimal differences between conditions. Participants reported high satisfaction and endorsed the TAP system. There was no significant change in caregiver burden.

Conclusion. The TAP system provided a novel assistive tool to support home programme completion of intensive exercise regimens for clients with cognitive impairment and care providers with significant burden. Future research must ensure continued development of a reliable and intuitive system.

Keywords:

• Assistive technology for cognition
• stroke
• exercise adherence
• home programmes
• home health

Acknowledgements

The authors wish to thank the patients, care providers, and therapists for their participation in this study, and Jason Prideaux for technical design and support.

Declaration of interest: This work was completed as Dr. Lemoncello's dissertation study at the University of Oregon. The contents of this manuscript were developed under a grant from the US Department of Education, NIDRR grant number H133S070076, awarded to Life Technologies, LLC. Drs. Sohlberg and Fickas are the co-founders of Life Technologies. The TAP system is not a commercial product, and this study was initiated to understand the conditions that enhance home compliance in order to inform development of future technology. However, those contents do not necessarily represent the policy of the Department of Education.