The effectiveness of affordable technology in rehabilitation to improve mobility and physical activity: Amount (activity and mobility using technology) rehabilitation trial

C. Sherrington, L. Hassett, M. van den Berg, R. Lindley, M. Crotty, A. McCluskey, H. van der Ploeg, S. Smith, K. Schurr

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Introduction/Background: Technology may enable a higher dose of exercise to improve rehabilitation outcomes. Aim: To evaluate the effect of the addition of affordable technology to usual care on physical activity and mobility in people with mobility limitations admitted to inpatient aged and neurological rehabilitation compared to usual care alone. Material and method: A pragmatic, assessor‐blinded, parallel‐group randomised trial of 300 consenting rehabilitation inpatients. The intervention group received technology‐based exercise prescribed by a physiotherapist to target mobility and physical activity problems for 6 months. Technology included video and computer games/exercises, tablet applications and activity monitors. The control group received no additional intervention and both groups received usual rehabilitation care. The co‐primary outcomes were objectively assessed physical activity (average minutes per day spent upright using activPAL) and mobility (Short Physical Performance Battery, SPPB, 0‐3 continuous score) at 6 months after randomisation. Linear models assessed the effect of group allocation with baseline scores entered as covariates. Results: Participants (mean age 74 (SD14); 50% female; 54% with neurological conditions limiting mobility) received on average 11 (SD11) inpatient sessions using 4 (SD1) different technologies and 15 physiotherapy contacts to support technology use in the post‐hospital phase. At 6‐months physical activity was similar between groups (mean between group difference (95% CI) uptime in minutes: ‐3.1 (‐39.4 to 33.2; P = 0.87)) and mobility was significantly better in the intervention group compared to the control group (mean SPPB between group change score 6‐month to baseline 0.2 points (95% CI 0.1 to 0.3, P <0.01)). Secondary outcomes of mobility also favoured the intervention group as did other aspects of physical activity (e.g. self‐reported physical activity), particularly for younger participants. Conclusion: A tailored intervention using technology, targeting specific mobility limitations and promoting physical activity in addition to usual rehabilitation, improved mobility and some aspects of physical activity and appears to have greater impact in younger people. Copyright © 2018
Original languageEnglish
Pages (from-to)e86
JournalAnnals of Physical and Rehabilitation Medicine
Publication statusPublished - 15 Jul 2018

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