App-based supplemental exercise in rehabilitation

This thesis explores current activity levels in rehabilitation and investigates the use of mHealth as a novel means to encourage physical activity in this setting.

It is known that achieving a sufficient level of physical activity is beneficial for health. In more recent times, it has also been proven that a lack of physical activity is associated with higher morbidity and mortality. In rehabilitation, physical activity is encouraged and plays a large role in the restoration of an individual’s function after injury or disease. However, research indicates that individuals participating in inpatient rehabilitation complete only a small amount of activity each day and are largely sedentary. This is despite a relationship between increased therapy time and improved outcomes, particularly in certain populations common to the rehabilitation setting, including stroke and orthopaedics.

Methods of increasing physical activity in the rehabilitation setting must be explored. This is to foster an improvement in function as well as maintain general health. Physical activity may be achieved through purposeful formal exercise as well as incidental activity. Current methods by which this is achieved include increasing the amount of time spent in supervised or semi-supervised therapy sessions, or increasing independent practice. Traditional approaches by which to deliver independent practice include setting up programs via verbal or paper-based instructions. However, this does not reflect the current state of technological advancement.

Technology is now a major part of everyday life in our society. Although there is increasing evidence into the use of mHealth to promote physical activity in the community setting, there is little research to investigate the use of technology in the area of rehabilitation. Therefore, a randomised controlled trial was completed to investigate the use of an app-based exercise program to promote supplemental exercise in rehabilitation. Those using the chosen app achieved a small supplementary exercise dose but this did not translate to any improvements in length of stay or functional outcomes.

The study findings suggest that there is potential for the use of mHealth for physical activity promotion in the rehabilitation setting but benefits are unclear. Technologies are complex and the use of technology in the rehabilitation setting requires careful consideration. More research is required to assess the role of mHealth in different settings and with various health conditions.