Effect of affordable technology on physical activity levels and mobility outcomes in rehabilitation

The intervention group will receive tailored technology use in addition to usual care. The research physiotherapist will determine the most appropriate intervention based on discussion with the clinical physiotherapist, baseline assessment, participant goals, and the technology suitable in accordance with the intervention protocol. In addition to usual therapy each participant will be asked to use the intervention technologies between 30 and 60 minutes daily for five or more days per week. The total duration of the intervention will be six months after randomisation and will incorporate both inpatient rehabilitation and post-discharge settings. The prescription of technology to target mobility and physical activity problems will include, but will not be limited to, the use of video, computer and tablet programs and applications to encourage structured exercise and other forms of physical activity as well as pedometers to monitor activity levels. The chosen technologies are all relatively low cost and will provide feedback on mobility task or physical activity performance or dose. Some of the technologies involve games. The research physiotherapist will choose the most appropriate technology/ies for an individual patient by following a protocol refined through pilot testing. The exercise protocol guide will be reviewed quarterly and any new technologies will be added throughout the trial. Each technology used 1) provides feedback about task performance; 2) facilitates individualised tailoring and progression of exercise or physical activity; 3) enables progress towards a functionally relevant goal(s) to be recorded and graphed; and 4) is relatively inexpensive. The research physiotherapist will teach participants to use the technology and will develop individualised exercise procedures to enable participants to use the technology safely outside of therapy times. If judged by staff to be safe to do so, participants will exercise unsupervised or with the supervision of family members/friends, nursing staff and hospital volunteers. After discharge from the inpatient stay, participants will be encouraged to continue using the technologies at home. Participants will be loaned necessary equipment (stand-alone devices or games consoles, installed by study staff) and trained in the safe use and progression of the games/exercises during a home visit by the research physiotherapist. Weekly support via telephone, email or videoconference will be provided during this phase of the study. This support will aim to assist study participants to maintain motivation and will identify and address any barriers to technology use at home. Up to five home visits will be provided to manage technology issues and/or progression. Goals will be set collaboratively with each participant and recorded and reviewed throughout the intervention phase. Practice sheets and information from some of the devices (e.g. game play time, number of steps walked) will be used to monitor the dose of the intervention.