Pilot RCT examining feasibility and disability outcomes of a mobile health platform for strategy training in inpatient stroke rehabilitation (iADAPT)

Background Strategy training is an intervention that may reduce disability when delivered in inpatient rehabilitation following stroke. However, shorter lengths of stay and challenges with continuity of care following discharge results in difficulties in achieving adequate intervention dosage and carryover of training. Objective We examined whether strategy training using a mobile health platform (iADAPT) is feasible during inpatient stroke rehabilitation and following discharge. Methods In this RCT, participants were randomized to receive strategy training using either the iADAPT application (n = 16) or a workbook (n = 15). Participants in both groups received 7 in-person sessions during inpatient rehabilitation and 3 remote sessions following discharge. We calculated descriptive statistics to examine acceptance, attendance, and adherence, and within-group effect sizes on satisfaction and disability. Results Participants in the iADAPT group attended fewer total intervention sessions (n = 5.5, workbook n = 9.0) but attempted a similar number of goals (n = 7.6, workbook n = 8.2). Both groups reported similar satisfaction with in-person intervention (Treatment Expectancy: iADAPT d = 0.60, workbook d = 0.47; Patient Provider Connection: iADAPT d = 0.18, workbook d = 0.31), but the mobile health group reported greater satisfaction with remote intervention (Treatment Expectancy: iADAPT d = -0.91, workbook d = -0.97; Patient Provider Connection: iADAPT d = 0.85, workbook d = -1.80). Conclusions Considering these promising feasibility metrics and the benefits of mobile health, it is worth continuing to explore the efficacy of strategy training using a mobile health platform.