mHealth technologies used to capture walking and arm use behavior in adult stroke survivors: a scoping review beyond measurement properties

Purpose We aimed to provide a critical review of measurement properties of mHealth technologies used for stroke survivors to measure the amount and intensity of functional skills, and to identify facilitators and barriers toward adoption in research and clinical practice. Materials and methods Using Arksey and O'Malley's framework, two independent reviewers determined eligibility and performed data extraction. We conducted an online consultation survey exercise with 37 experts. Results Sixty-four out of 1380 studies were included. A majority reported on lower limb behavior (n = 32), primarily step count (n = 21). Seventeen studies reported on arm-hand behaviors. Twenty-two studies reported metrics of intensity, 10 reported on energy expenditure. Reliability and validity were the most frequently reported properties, both for commercial and non-commercial devices. Facilitators and barriers included: resource costs, technical aspects, perceived usability, and ecological legitimacy. Two additional categories emerged from the survey: safety and knowledge, attitude, and clinical skill. Conclusions This provides an initial foundation for a field experiencing rapid growth, new opportunities and the promise that mHealth technologies affords for envisioning a better future for stroke survivors. We synthesized findings into a set of recommendations for clinicians and clinician-scientists about how best to choose mHealth technologies for one's individual objective. (AU)