Implementing a self-management mobile app for spinal cord injury during inpatient rehabilitation and following community discharge: A feasibility study

Abstract

Objective: To determine the feasibility of implementing and evaluating a self-management mobile app for spinal cord injury (SCI) during inpatient rehabilitation and following community discharge.

Design: Pilot feasibility study.

Setting: Rehabilitation hospital and community.

Participants: Inpatients from rehabilitation hospital following admission for their first SCI.

Intervention: A mobile app was developed to facilitate self-management following SCI. The app consisted of 18 tools focusing on goal setting, tracking various health aspects, and identifying confidence regarding components of self-management. In-person training and follow-up sessions were conducted during inpatient rehabilitation and follow-up calls were provided after participants were discharged into the community.

Main outcome measures: Participants completed outcome measures at baseline, community discharge, and 3-months post discharge. This study focused on feasibility indicators including recruitment, retention, respondent characteristics, adherence, and app usage. Additionally, participants’ self-management confidence relating to SCI (e.g. medication, skin, bladder, pain) was evaluated over time.

Results: Twenty participants (median age 39, IQR: 31 years, 85% male) enrolled in the study. Participants’ Spinal Cord Injury Independence Measure (SCIM-III) median score was 23 and IQR was 33 (range: 7–84), which did not correlate with app usage. Retention from admission to discharge was 85% and 70% from discharge to 3-months post discharge. Individuals in the study who used the app entered data an average of 1.7x/day in rehabilitation (n = 17), and 0.5x/day in the community (n = 7). Participants’ bowel self-management confidence improved between admission and discharge (P < 0.01).

Conclusions: Feasibility indicators support a larger clinical trial during inpatient rehabilitation; however, there were challenges with retention and adherence following community discharge.

Keywords:

• Mobile app
• Self-management
• Spinal cord injury
• Rehabilitation
• Feasibility

Acknowledgement

The authors wish to acknowledge Gurkaran Singh for his help in preparing and editing the manuscript. WBM acknowledges his CIHR New Investigator award.

Disclaimer statements

Funding This work was supported by Rick Hansen Institute: [Grant Number G2015-11].

Conflicts of interest Jared Adams helped to develop the technology and is an employee of Self Care Catalysts; however, all efforts were made to minimize this conflict of interest.

Correction Statement

This article has been republished with minor changes. These changes do not impact the academic content of the article.