Improving patients experience in neuro-rehabilitation unit using tablet computers

Rationale, aims and objectives: Patients in stroke rehabilitation units spend considerable time unengaged in therapeutic or meaningful activity, feeling bored with suboptimal engagement in rehabilitation. Systematic reviews have shown that novel interventions such as interactive video gaming result in improved motor function and cognitive performance. The objective of this study was to evaluate the feasibility of introducing “tablet computers - iPads” in hospital rehabilitation programmes and their impact on patients’ boredom and overall satisfaction. In addition, acceptance and familiarity of the multidisciplinary members of the neuro-rehabilitation team with iPads were explored. Methods: A £10,000 fund was secured from Health Education England, UK to buy 10 iPads. A loan scheme was implemented to regulate iPad use. Information technology and governance issues were agreed with the hospital trust to ensure safety, accountability and confidentiality. Members of the multidisciplinary team offered training and education to patients on iPad use. Questionnaires were used before iPad use to assess patients and staff views on iPads. After iPad use patients and staff completed another questionnaire and were interviewed about which specific applications were used, boredom levels before and after use, and overall satisfaction. Results: Nine patients (7 males) used the iPads (8 strokes and 1 traumatic brain injury), with an average age of 59 (19-79) years. Staff used several applications in physiotherapy and speech therapy and found some applications such as memory games and puzzles particularly helpful. In addition to therapeutic uses, patients used iPads for internet searches, e-mail, Facebook, Skype and games. Eighty-nine percent of patients were satisfied with the iPad experience and 100% reported less boredom or between better and the same boredom compared to baseline. Conclusions: iPad use is feasible and beneficial to patients and welcomed by staff in neuro-rehabilitation units.