ABSTRACT Background: Wearable activity monitors offer clinicians and researchers accessible, scalable, and cost-effective tools for continuous remote monitoring of functional status. These technologies complement traditional clinical outcome measures by providing detailed, minute-by-minute remote monitoring data on a wide array of biometrics that include, as examples, physical activity and heart rate. There is significant potential for the use of these devices in rehabilitation after stroke; however, the perceptions of persons with stroke regarding the acceptance of these devices are not well understood. Objective: In this study, we investigated the participant-reported acceptance of a wrist-worn wearable activity monitor (the Fitbit Inspire 2) for remote monitoring of daily activity and heart rate in persons with stroke. We also assessed potential relationships between reported acceptance and real-world device wear. Methods: Sixty-five participants with stroke wore a Fitbit Inspire 2 for three months. We assessed the perceived acceptance of the devices using the Technology Acceptance Questionnaire (TAQ) and calculated metrics of adherence to device wear in the three weeks preceding TAQ administration. We then also performed Spearmans correlations to assess relationships between responses on the TAQ and adherence metrics. Results: In their responses to statements on the TAQ, most participants reported the device to be generally beneficial for their health, efficient for monitoring their health, easy to use and don/doff, and unintrusive to daily life; participants reported generally agreeable responses across all seven dimensions of the TAQ, indicating general acceptance of the device. Participants wore the Fitbit for an average of 80.0% of daily minutes (median: 91%, IQR: 22%) and had 78.0% valid wear days (median: 90%, IQR: 33%). Contrary to our hypothesis, TAQ responses showed no significant positive correlations with adherence metrics. Conclusions: Our study highlights the perceived acceptance of the Fitbit Inspire 2 among persons with stroke, with participants reporting agreement across all seven TAQ dimensions and no significant concerns interpreted as being directly relatable to post-stroke motor impairment (e.g., minimal concerns about donning and doffing devices, using the device independently). These findings align with previous studies on wearable technology acceptance in other populations and support the potential for scalable implementation of these devices in stroke rehabilitation. However, monitoring of wearable device adherence is required despite the high reported acceptance, as perceived acceptance was not positively related with adherence to wearing the device. Accordingly, technologies capable of automated monitoring and management of device wear will be important for scalability of these technologies in larger clinical and research use cases. In summary, this study provides new insights into the perceived acceptance of wearable activity monitors among persons with stroke and their association with real-world adherence to device use.

The authors have declared no competing interest.

This study was funded by the American Heart Association (grants 23IPA1054140 and 935556 to RTR, grant 24POST1187285 to GCB) and the Sheikh Khalifa Stroke Institute at Johns Hopkins Medicine.

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The Johns Hopkins Medicine Institutional Review Boards approved.

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All data produced in the present study are available upon reasonable request to the authors