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J.M. Legasto1, F. Sander Pereira Clark2, R. Haldar2, N.M. Salbach1,3,4
1University of Toronto, Rehabilitation Sciences Institute, Toronto, Canada, 2University of Toronto, Electrical & Computer Engineering, Toronto, Canada, 3University of Toronto, Department of Physical Therapy, Toronto, Canada, 4KITE-Toronto Rehabilitation Institute, Toronto, Canada
Background: Over 70% of individuals with stroke develop poor cardiovascular (CV) fitness that increases the risk of future CV events, including recurrent stroke. Aerobic exercise (AE) training has been shown to safely and effectively improve CV fitness post-stroke and is a recommended practice in stroke rehabilitation. Once individuals with stroke return home, however, they have a difficult time engaging in effective AE training.
Purpose: With the current widespread availability of mobile phones and fitness trackers with heart rate (HR) monitors, there is an opportunity to use technology to ensure individuals post-stroke exercise at the right intensity and duration to improve their CV fitness in the community. Our objective was to develop a mobile app prototype, designed for individuals post-stroke, that provides personalized, HR-based feedback during AE.
Methods: Following the Agile methodology for software development, a physiotherapist (PT) completing their PhD and two Masters of Engineering of Computer Engineering students collaborated to develop the Maximizing Aerobic eXercise (MAX) app. The team iteratively developed the key functionalities of the MAX app guided by the PT’s clinical experience and Canadian Stroke Best Practice Recommendations. Android Studio was used to code and test the app, GitHub was used for code version control and a Wahoo TICKR HR monitor was paired to the app.
Results: The MAX app allows users to input their therapist-recommended HR range for AE and uses HR data from the fitness tracker to provide personalized feedback during AE training. When a user starts an exercise session, the app provides visual or auditory feedback regarding whether the user is exercising at, below or above their target HR range and provides guidance (slow down/speed up) to keep their HR in that target range. The app also provides guidance for progressing AE duration and intensity, reminders to meet stroke-specific weekly AE recommendations and gamifies the AE experience by providing achievement badges based on their AE frequency and duration.
Conclusion(s): Interdisciplinary collaboration between rehabilitation and engineering professionals yielded an app prototype to help individuals post-stroke engage in AE. Future steps include validity and usability testing.
Implications: The MAX app can help individuals with stroke engage in and sustain meaningful aerobic exercise in the community to maximize their cardiovascular fitness post-stroke and minimize their risk for further cardiovascular events.
Funding, acknowledgements: We acknowledge the support of the Integrated Knowledge Translation Research Network (CIHR Foundation Grant; FDN #143237).
Keywords: Stroke Rehabilitation, Aerobic Exercise, Technology
Topic: Neurology: stroke
Did this work require ethics approval? No
Institution: University of Toronto
Committee: Health Sciences Research Ethics Board
Reason: Ethics approval was not required as the app was developed using information that was publicly available.
All authors, affiliations and abstracts have been published as submitted.
