Cardiovascular

Structured Digital Device Instruction for Older Adults With Stroke During Convalescent Rehabilitation: Prospective Feasibility Study.

TL;DR

A structured 14-day digital device instruction program can be successfully implemented in a convalescent rehabilitation ward and may facilitate the acquisition of basic digital device skills among selected older adults with stroke.

Key Findings

No participant was independent across all 7 predefined digital tasks on day 1, but 74% achieved independence across all tasks by day 14.

  • 19 participants completed the full 14-day program
  • 0 of 19 participants were independent across all 7 predefined digital tasks at baseline (day 1)
  • 14 of 19 participants (74%) achieved independence across all predefined digital tasks by day 14
  • The program consisted of a 7-day therapist-supported instruction phase followed by a 7-day independent practice phase

Independence rates varied by task type, with tablet and wearable device management reaching 95% but chat app use and video calling remaining more challenging.

  • 18 of 19 participants (95%) achieved independence for tablet and wearable device management and basic operation tasks
  • 15 of 19 participants (79%) achieved independence for chat app use
  • 14 of 19 participants (74%) achieved independence for video calling
  • Seven predefined tasks involved a tablet computer, chat app, video calling system, and wearable device, assessed daily using a 5-point task performance scale

The perceived usability of the integrated digital device environment was moderate, with a mean System Usability Scale score of 57.8.

  • Mean SUS score was 57.8 (SD 15.0) on day 14
  • The SUS score of 57.8 was interpreted as indicating 'moderate perceived usability' of the integrated digital device environment
  • SUS was assessed on day 14 using the System Usability Scale
  • The SUS score suggests room for improvement in the usability of the digital environment as configured

The study enrolled relatively high-functioning older adults with stroke, which limits generalizability of findings.

  • Mean participant age was 76.3 years (SD 6.9); 47% were women (n=9)
  • Mean Mini-Mental State Examination (MMSE) score was 26.1 (SD 3.2), indicating relatively preserved cognition
  • The study was conducted at a single center in a Japanese convalescent rehabilitation ward
  • Sample size was 19 participants with no comparator group and a short follow-up period
  • Authors note findings 'should be interpreted cautiously because of the single-center design, small sample size, absence of a comparator group, short follow-up period, and inclusion of relatively high-functioning participants'

The structured digital instruction program was feasibility-confirmed as implementable within a convalescent rehabilitation ward setting.

  • All 19 enrolled participants completed the full 14-day program, suggesting acceptable program retention
  • The program integrated instruction on multiple device types: tablet computer, chat app, video calling system, and wearable device
  • The two-phase design (7-day supported instruction followed by 7-day independent practice) was operationally implemented without reported major disruptions
  • Digital health technologies are described as increasingly used in stroke rehabilitation, but older adults may face cognitive, physical, motivational, and usability barriers

What This Means

This research suggests that older adults recovering from stroke in a rehabilitation hospital can learn to use digital devices like tablets, chat apps, video calling, and wearable fitness trackers through a structured two-week training program. The study enrolled 19 adults aged 65 and older (average age 76) in Japan. None of them could independently use all seven digital tasks at the start, but by the end of the 14-day program, about three-quarters of participants had mastered all tasks. Simpler tasks like basic tablet and wearable device operation were easier to learn (95% success rate), while more complex tasks like video calling and chat apps were harder, with about 74–79% of participants reaching independence. Despite these skill gains, participants rated the overall digital system as only moderately easy to use, with an average usability score of 57.8 out of 100 on a standard scale. This suggests that while people can learn to operate the devices, the experience is not yet highly intuitive or comfortable for this age group, and there may be room to improve how these digital tools are designed or introduced. This research matters because digital health tools—like remote monitoring and telehealth—are increasingly important for managing health after a stroke, but older adults often struggle to use them. The findings suggest that providing dedicated, structured training during inpatient rehabilitation (before patients go home) could help bridge that gap. However, the study had important limitations: it was small, took place at only one hospital, included no comparison group, only followed participants for two weeks, and enrolled people with relatively good cognitive function. Larger studies are needed to confirm whether this approach works broadly.

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Citation

Ito D, Dogan M, Nambu M, Nishiyama T, Sakazaki J, Sato T, et al.. (2026). Structured Digital Device Instruction for Older Adults With Stroke During Convalescent Rehabilitation: Prospective Feasibility Study.. JMIR formative research. https://doi.org/10.2196/95768