gms | German Medical Science

Background: Cognitive, emotional and behavioural problems resulting from acquired brain injury (ABI) limit independence, restrict participation and pose a challenge for rehabilitation. Smart technologies to support independence are limited [1]. Brain-in-Hand (BiH) is a smartphone app designed to support self-management of these symptoms.

Aim: To determine if BiH had an effect on outcomes (independence, mood, cognition, fatigue, participation) in people with ABI after six and 12 months use.

Method: ABI participants were given BiH to use for 12 months, providing a structured diary, reminders and traffic light system to monitor anxiety or fatigue. An n-of-1 case study design was used to determine if BiH had an effect on anxiety, depression, fatigue, participation, cognition and activities of daily living (ADL), assessed at baseline, six and 12 months, using self-report questionnaires. Data were analysed individually and combined across cases.

Results/findings: Ten ABI participants used BiH (mean age 43.5, men (n=8), traumatic brain injury (n=7), stroke (n=1), other ABI (n=3)) and monitored anxiety (n=4) or fatigue (n=6). BiH had no effect on mood. No statistical significant differences were found at six months for other outcomes. There were non-significant improvements in cognitive function and participation, decreased ADL, and increased fatigue levels at 12 months. All participants could see a use for BiH.

Discussion and conclusions: Although BiH had no significant effect on outcomes, it appeared to facilitate self-monitoring of anxiety/fatigue and increase awareness of symptoms. BiH has the potential to be a valuable tool in community rehabilitation to support independent living.

Further research is needed to determine the effect of BiH on outcomes compared to usual care (e.g. paper diary). More sensitive measures should be used in the future.