4. Discussion
stroke
STROKE, RECRUITMENT
This randomised crossover study evaluated the Arm Activity Tracker’s feasibility (adherence, acceptance and usability) and explored the efficacy of stimulating paretic UE activity in stroke patients. Seventeen participants were included; five of them dropped out, and two had insufficient data collection with the AAT caused by technical issues with the devices. In participants who adhered to the study, the AAT showed good acceptance and usability. Moreover, we found promising efficacy and increased UE activity compared to the control and baseline conditions.Although the literature shows that dropout rates largely differ between studies in stroke rehabilitation (from 0–83 per cent) and are related to trial characteristics such as trial size, the continent of recruitment and recruitment strategy [In patients who completed the study, we observed good acceptance and usability of the AAT. Those participants scored above 68 on the SUS, indicating that the system was easy to use. Our results on usability are similar to those found in a study investigating the usability of a similar device, which aimed to improve daily UE activity in stroke patients by stimulating paretic UE activity with vibrotactile triggers [Although our study was not powered to analyse intervention effects, we found promising results regarding the efficacy of the AAT on paretic UE activity and UE activity ratio. We found small to moderate effect sizes for absolute UE activity (ηThe two aforementioned comparable interventions are still under research, and although the results from pilot studies are also promising, their efficacy has yet to be published [This study has some limitations. The intervention period in the study was two weeks, which is short compared to most interventions to change stroke patients’ movement behaviour [Based on the promising results of this study on feasibility and estimates of the effect size of an intervention with the AAT, we recommend proceeding with further research to evaluate the (long-term) efficacy of the AAT. The results of this study can be used to efficiently plan a randomised controlled trial with sufficient power. In addition, we recommend selecting patients who can potentially benefit from this intervention based on upper extremity recovery profiles for stroke patients [