Poster The Joint Annual Meeting of the Stroke Society of Australasia (SSA) and Smartstrokes 2023

A Nudge in the Right Direction? Haptic Nudging using Wearable Devices for Upper Limb Stroke Rehabilitation (#151)

Nada Signal 1 , Sharon Olsen 1 , Usman Rashid 1 , Ruth McLaren 1 , Alain Vandal 2 , Marcus King 3 , Denise Taylor 1
  1. Auckland University of Technology, Auckland, NORTH ISLAND, New Zealand
  2. Department of Statistics, University of Auckland, Auckland, North Island, New Zealand
  3. Calllaghan Innovation, Christchurch, South Island, New Zealand

Background: Wearable devices that deliver haptic nudges have shown potential for increasing physical activity in stroke rehabilitation. Haptic nudges provide vibratory stimuli via a wearable device. These devices have the potential to improve outcomes from rehabilitation for people with stroke by promoting upper limb activity.

Aims: The aim of this study was to determine the optimal method for delivering haptic nudges to promote upper limb activity in stroke rehabilitation by investigating diurnal variation in the effect of haptic nudges, the duration of the effect, and the impact of repeated nudges on upper limb activity.

Methods: The study analysed data from a multiple-period randomized crossover study involving 20 participants with stroke undergoing inpatient rehabilitation. The participants received haptic nudges via the BuzzNudge wrist worn wearable device over a single 12-hour day. Observations were conducted in 72 one-minute periods, during which participants received either a ‘nudge’ or ‘no nudge’ at the start of each period, based on a randomization schedule. The upper limb movement of each participant was observed and classified, and statistically analysed using longitudinal mixed models.

Results: The findings showed that the odds of affected upper limb activity immediately following nudging varied significantly across the day. Increasing repetitions of nudges did not have a cumulative effect. However, longer breaks without haptic nudging resulted in a diminished effect. The effect of the haptic nudge was no longer statistically significant at 50-60 secs post-nudge.

Conclusion: The research has implications for the development of wearable devices that deliver haptic nudges in stroke rehabilitation and provides valuable insights into how these devices can be used most effectively. The findings suggest that the scheduling of nudging across the rehabilitation day should be carefully planned, and long periods without nudging avoided. Further research is needed to determine the effects of different haptic nudge schedules over longer periods of time.