A team of Canadian researchers recently presented an innovative health app designed to support patients recovering from spinal cord injuries.
We’ve seen some exciting applications of digital health tools to support rehabilitation. These include apps for patients recovering from injuries or surgery as well as for patients managing chronic medical conditions like heart failure.
Designed as a self-management tool, the SCI Health Storylines app was tested in an inpatient rehabilitation setting. I spoke with one of creators of the app, Ben Mortenson (University of British Columbia, Department of Occupational Science & Occupational Therapy) at AAP 2017 and learned more about this interesting feasibility study.
20 patients with spinal cord injuries (ranging from 40% ASIA A to 5% ASIA D, ages 21-80) took part in the study. All patients were hospitalized on an inpatient rehabilitation unit. Users completed assessments at admission to establish a baseline and then again at discharge. They were provided with a custom health app that included 7 core tools, and 18 novel spinal cord injury tools.
These tools consisted of bowel, bladder management, education on skin assessment, encouragement for physical activity, and even topics such as autonomic dysreflexia. Additionally, a “My Storylines” feature was built into the app, allowing users to track their mood, symptoms, vitals and more, as well as journaling about their experiences.
Frequency of various in-app tool usage and engagement with the app were assessed throughout the study. 85% of users continued to use the app during their stay, with an average of 1.7 entries per day. Some required caregiver assistance to utilize the app (7 participants had limited to no hand function). Significant improvements in self-management confidence of bowel issues was noted at time of discharge, with other areas also noting non-statistically significant improvements. Patients stayed on average 67 days from admission to discharge, reflecting the complex nature of spinal cord injury rehabilitation.
Health apps to help self-manage serious rehabilitation diagnoses aren’t just limited to spinal cord injury. We’ve previously looked at the VA’s Concussion Coach app, with an array of self-management features for symptoms. The pediatric Spina Bifida ImHere app, also featured at AAP 2017, is another great example of such an app. Giving patients the right tools to help them increase their independence is a key part of rehabilitation medicine, and these apps may play a large role. A particularly interesting aspect here is the use of a health app on the inpatient side to prepare patients for the transition to home. Ultimately, moving from feasibility studies to efficacy studies may help move them forward and into wider adoption.
