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Clinical Applications of EMA: Delivery of Self-directed Rehabilitation

Ji Chung
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Stroke rehabilitation is entering a transformative era, thanks to a groundbreaking study by the New York University Occupational Therapy Department in collaboration with the esteemed clinicians at NYU Rusk Rehabilitation. The research leverages the innovative Ecological Momentary Assessment (EMA) platform, Expiwell, to track and improve adherence to a home-based self-directed upper extremity (UE) training program, which is critical for community-dwelling stroke survivors.

The Challenge for Stroke Survivors

Post-stroke, individuals commonly face the daunting challenge of upper extremity weakness or paralysis, particularly on the side opposite the brain injury (contralateral side). Traditional recovery methods have heavily relied on in-person therapy sessions, but what happens when those sessions end, or access is limited?

Introducing Remote Rehabilitation

The study conducted by NYU researchers delves into this very issue. It explores remote rehabilitation's viability and effectiveness in enhancing functional use of the upper extremity at home. This approach not only aligns with modern healthcare trends but also addresses the current need for accessible and continuous patient care.

Overcoming Obstacles in Remote Training Adherence

Patient adherence to remote home-based rehabilitation programs is fraught with challenges. The study identifies key hurdles such as reduced motivation, musculoskeletal complications, and persistent fatigue. Utilizing EMA through Expiwell has proven instrumental in encouraging participants to maintain daily self-directed training regimens.

The EMA Approach to Rehabilitation

Participants were engaged in a rigorous personalized arm training regimen, dedicating one hour per day, five days a week, over a four-week span. Each day, participants received EMA surveys on their smartphones, inquiring about various aspects of their training, including frequency, duration, intensity, motivation levels, and any adverse events experienced. This real-time data collection is crucial for tailoring patient-specific training programs and offering immediate support.

Shared Decision-Making and Patient Engagement

A key objective of the study is to assess the role of shared decision-making and EMA in promoting active engagement in UE self-training. The findings aim to empower stroke patients in their recovery journey, making rehabilitation a collaborative effort between clinicians and patients.

Expiwell's Role in Stroke Recovery

Expiwell stands at the forefront of innovation in stroke recovery, offering an effective platform for UE rehabilitation. The company is committed to supporting individuals on their path to regaining independence and improving their quality of life.

Access the Full Study

For a deeper understanding of this pioneering approach to stroke rehabilitation, refer to the original research article: Kim, G. J., et al. (2023). Protocol for a remote home-based upper extremity self-training program for community-dwelling individuals after stroke. Contemporary Clinical Trials Communications, 33, 101112.

https://www.sciencedirect.com/science/article/pii/S2451865423000583

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