ApplTree: A single case experimental design study of a smartphone reminding application with community-dwelling adults who have sustained a stroke

Chapter 1. A systematic review was conducted to assess the efficacy of portable electronic personal assistant devices (PEPADs) in the rehabilitation of prospective memory (PM) following stroke. Methodological quality of included studies was also assessed. Seven electronic databases were searched as well as hand searching of references. Quantitative investigational studies of PEPADs for memory impairment following stroke with adults were considered. The Physiotherapy Evidence Database scale (PEDro) and the Risk of Bias in N of 1 Trials (RoBiN-T) were used to assess risk of bias. A narrative synthesis of findings is presented. Two single case evaluation design studies (SCEDs) and three controlled trials met inclusion criteria. The mean PEDro score was 5/10, the mean RoBiN-T score was 14/30. Mobile phones were the most investigated PEPAD. Study design was heterogenous. Small-large effect sizes were evident when PEPADs were introduced and large effect sizes following their removal. Most participants completed more PM tasks using a PEPAD than a paper-based memory aid in one study. One study found continued PEPAD use at long-term follow-up. PEPADs are a promising avenue in the rehabilitation of post-stroke PM impairment. However, the evidence base is limited. More rigorously designed, long-term SCED and group studies are required to inform clinical practice