Thesis

Co-design and development of a Dosage and Intensity Monitor (DAIM) for stroke rehabilitation

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Awarding institution
  • University of Strathclyde
Date of award
  • 2026
Thesis identifier
  • T17658
Person Identifier (Local)
  • 202150407
Qualification Level
Qualification Name
Department, School or Faculty
Abstract
  • Rehabilitation is essential for regaining motor, cognitive, and functional abilities following stroke. Recent updates to the National Clinical Guidelines for Stroke in the UK and Ireland now recommend a minimum of three hours of daily multidisciplinary therapy, a fourfold increase from the previous 45-minutes. Accurately measuring the true delivery of rehabilitation dosage and intensity, however, remains a critical challenge. Commonly, clinical trials describe their control groups as "standard physiotherapy," but fail to detail accurately what this entails. Without accurate measurement techniques, it is impossible to ensure guideline adherence, correctly interpret research outcomes, or meaningfully compare new interventions against existing practices. This thesis presents the co-design, development, and evaluation of a Dosage and Intensity Monitor (DAIM), a digital system specifically created to objectively quantify rehabilitation dosage and intensity in stroke survivors across home, research, and clinical environments. Built through a user-centred design framework aligned with Medical Research Council (MRC) guidance for complex interventions, the thesis employed focus groups, iterative prototyping, stakeholder feedback, and survey-based validation to ensure the system was relevant, usable, and grounded in real-world rehabilitation needs. The final DAIM system integrates a wearable movement sensor and NFC tagging with a user-friendly mobile application, accurately capturing rehabilitation activities such as walking, cycling and sit-to-stand. Real-time feedback, gamified goal setting, and group-based progress tracking were embedded to promote motivation, engagement, and adherence to rehabilitation. Software prototypes, developed through collaborative design methods and Android Studio prototyping, ensured optimal accessibility and usability, particularly for users with stroke-related cognitive or motor impairments. Validation testing in both clinical and research settings demonstrated that the DAIM provided highly accurate (96% agreement with optical tracking) data with a user friendly system (100% user success) that agreed (1.23 min difference, on average) with clinician-recorded data. This system, therefore, addresses the critical gap in objectively measuring rehabilitation dosage and intensity, offering a robust solution for both clinical practice and research applications. Future work should focus on optimising hardware ergonomics, producing a market ready system and scaling up usability testing.
Advisor / supervisor
  • Kerr, Andrew, Ph. D.
  • Dunlop, Mark
Resource Type
DOI
Date Created
  • 2025

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