Mobility Stroke Care

The “MOBILITY” App (Mobile Medical Application Post Stroke Care Strategy) for stroke survivors and their caregivers is being tested in a multicentric randomised controlled trial (MOBILITY Trial) within the INSTRuCT Network, which comprises various hospitals across India. It is funded by the Indian Council of Medical Research (ICMR), New Delhi.
This clinical trial aims to establish an evidence-based strategy for post-stroke home care using the “MOBILITY App”. It trains the caregivers of stroke survivors in basic nursing care practices such as bedsore prevention, urinary catheter care, feeding, position change, and active and passive exercises. So that caregivers can become capable of providing basic nursing care at home and stroke survivors would face substantially lesser post-stroke morbidity and mortality.
MOBILITY App has the following features:
i. Sign-in page and registration: OTP (one-time password)- based authentication is done. The registration process is mandatory.
ii. Main page/Home page: The application's home page has a Menu option on the upper left side, which contains the Patient Details, Caregiver Details, language, post-stroke complications, about, and contact. Users can select their preferred language for the app (Hindi, English, Punjabi, Assamese, Oriya, Telugu, Marathi, Kannada, Bengali, Malayalam, or Tamil). The home page has five sections that contain the content of the ‘MOBILITY’ intervention.
iii. Sections: There are five main sections which can selected by the user:
a) ‘What is Stroke?’ contains an educational animated video about stroke, its types, risk factors, treatment, and rehabilitation.
b) ‘My patient may suffer from these problems after a stroke’: Contains the list of the post-stroke complications like bedsores, halitosis (bad smell from mouth), shoulder pain, limb weakness, limb spasticity/contractures, difficulty in speech, and any other health problems. This section, which is in the form of a pictorial description, helps the users to understand the complications which a stroke patient can suffer after a stroke. After getting appraised of these problems, the user is expected to select the specific problem being faced by the patient. For example, if the patient has a feeding tube, urinary catheter, and/or tracheostomy tube in-situ, they can select that specific problem. Once selected, the links to the care procedure videos associated with those particular problems get activated in the “Taking care of my patient at home” section. This feature ensures that the user only gets trained in the problems which are faced by the user rather than going through the entire compendium of videos. The data of user selection is captured at the backend through a secured server for analysis.
c) ‘‘Taking care of my patient at home’: This section on the main page redirects the user to a page with the activated links to the care procedural videos for the caregiver. The caregiver can then view and understand the care procedures to provide self-care to the stroke patient at home and prevent post-stroke complications.
d) ‘Feedback’: This section assists the user in posting feedback in the form of a short video (25 sec) or written text regarding any queries or challenges they faced while performing/following any procedure on the patients. The investigator can view these in the admin section of the app and can call the user to answer their query or solve the problem being faced.
iv. Administrator module: This smartphone-enabled intervention is built with an administrator module, where the usage and utilisation patterns of this application by the users can be tracked continuously, and reports can be generated that can be utilised to improve the working of the app. The administrator can modify the video content in the application as and when required, thereby customising or improvising the intervention content according to the needs of the users.