Optimizing Home Hand Rehabilitation Technology: User Adherence and Response to Delayed Success

Home-based rehabilitation programs can complement in-clinic sessions by encouraging more practice but conventional approaches suffer from low adherence while newer technological approaches have seen slow adoption. Previous studies have suggested that early success in completing exercises is a key predictor of adherence. Despite this, some individuals persist with home rehabilitation even with low initial success. To understand what may influence this behavior we analyzed an anonymous dataset of 1,597 users of a wearable grip sensor categorizing them into low users (<2 days), medium users (2–9 days), and power users (>9 days). We further identified a subset of power users with an initial game success <60% as delayed power users. Compared to low users, delayed power users explored game parameters more, engaged in more sessions, and had a higher daily habit score (defined as exercise frequency multiplied by exercise duration). It took these users a minimum of two days – more time than low users allotted for – to achieve success levels above 60%. These findings emphasize the need for managing expectations and establishing strong habits from the onset, aligning with principles from exercise literature on perseverance and habit formation.