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

Abstract Background Digital health technologies are increasingly used in stroke rehabilitation, but older adults with stroke may experience barriers related to cognitive, physical, motivational, and usability factors. Structured support during inpatient rehabilitation may provide an opportunity to acquire basic digital device skills before discharge. Objective This study aimed to evaluate the feasibility of a structured digital device instruction program and the perceived usability of the integrated digital device environment among older adults with stroke during convalescent rehabilitation. Methods This single-center prospective feasibility study enrolled older adults (≥65 years) with stroke admitted to a Japanese convalescent rehabilitation ward. Participants received a 14-day program consisting of a 7-day therapist-supported instruction phase followed by a 7-day independent practice phase. Seven predefined tasks involving a tablet computer, chat app, video calling system, and wearable device were assessed daily using a 5-point task performance scale. Perceived usability of the integrated digital device environment was assessed on day 14 using the System Usability Scale (SUS). Results Nineteen participants (mean age 76.3, SD 6.9 years; n=9, 47% women; mean Mini-Mental State Examination score 26.1, SD 3.2) completed the 14-day program. No participant was independent across all 7 predefined digital tasks on day 1, whereas 14 (74%) achieved independence across all predefined digital tasks by day 14. Independence reached 18 (95%) for tablet and wearable device management and basic operation tasks, whereas chat app use (n=15, 79%) and video calling (n=14, 74%) remained comparatively more challenging. The mean SUS score was 57.8 (SD 15.0), indicating moderate perceived usability of the integrated digital device environment. Conclusions This feasibility study suggests that a structured instruction and practice 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. These 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.