title: Best practice for arm recovery post stroke: an international application.
abstract: OBJECTIVE
  To develop an evidence-based application ('app') for post-stroke upper extremity rehabilitation that can be used globally by therapists.
  
  
  METHODS
  Twenty-three experienced neurorehabilitation therapists, applied scientists and physicians, and 10 consultants dedicated to the provision of best practice to stroke survivors.
  
  
  METHODS
  This team evaluated the evidence to support the timely and appropriate provision of interventions and the most defensible outcome measures during a 4-year voluntary information gathering and assimilation effort, as a basis for the sequencing of an algorithm informed by the data and directed by changes in impairment and chronicity.
  
  
  METHODS
  The primary outcome was the formulation of a testable app that will be available for minimal user cost. The app is for a smartphone, and the comments of a focus group (audience at a World Confederation for Physical Therapy 2015 presentation, approximate n=175) during a 30-minute 'Questions and Answers' session were assessed.
  
  
  RESULTS
  Analysis of documented, extensive input offered by the audience indicated a highly favourable disposition towards this novel tool, with provision of concrete suggestions prior to launching the final version. Suggestions centred on: inclusion of instructions; visuals and demonstrations; monitoring of adverse responses; availability of updates; autonomous use by patients; and potential to characterise practice.
  
  
  CONCLUSIONS
  A simple, user-friendly app for decision making in the treatment of upper extremity impairments following stroke is feasible and welcomed.
authors.affiliation: Department of Rehabilitation Medicine, Division of Physical Therapy Education, Emory University School of Medicine, Atlanta, GA, USA; Veterans Affairs Center of Excellence in Visual and Neurocognitive Rehabilitation, Atlanta, GA, USA. Electronic address: swolf@emory.edu.
authors.forename: S L
authors.initials: SL
authors.lastname: Wolf
authors.affiliation: Department of Rehabilitation Medicine, VU University Medical Centre, Amsterdam, The Netherlands.
authors.forename: G
authors.initials: G
authors.lastname: Kwakkel
authors.affiliation: Brain and Spinal Cord Rehabilitation Program, Toronto Rehabilitation Institute, University of Toronto, Ontario, Canada.
authors.forename: M
authors.initials: M
authors.lastname: Bayley
authors.affiliation: International Centre for Allied Health Evidence, Sansom Institute for Health Research, School of Health Sciences, University of South Australia, Adelaide, Australia.
authors.forename: M N
authors.initials: MN
authors.lastname: McDonnell
mesh_terms: D000465:Algorithms; D001132:Arm; D019317:Evidence-Based Medicine; D006801:Humans; D063731:Mobile Applications; D026741:Physical Therapy Modalities; D020127:Recovery of Function; D000071939:Stroke Rehabilitation / Q000379:methods*
keywords: Cerebrovascular accident; Motor activity; Portable electronic apps; Upper extremity; e-Health