Mobile Application-Based Interventions to Improve Attention in Stroke Survivors: A Scoping Review.

Abstract

<h4>Background</h4>Stroke is a major global cause of disability, and attention deficits are among the most common cognitive impairments in survivors. These deficits limit independence and hinder rehabilitation outcomes. Conventional post-stroke rehabilitation focuses primarily on motor recovery, while targeted cognitive rehabilitation, particularly attention training, remains underrepresented.<h4>Purpose</h4>This scoping review aimed to identify mobile application-based interventions developed to improve attention in stroke survivors. The secondary aim was to describe the implementation settings of these interventions.<h4>Methods</h4>This review followed the PRISMA-ScR Arksey and O'Malley frameworks. Systematic searches were conducted in PubMed, Scopus, EBSCO-host, and Google Scholar up to January 2025. Eligible studies included randomized controlled trials (RCTs), pilot RCTs, and quasi-experimental designs involving post-stroke patients with attentional deficits using mobile applications via smartphones or tablets. Methodological quality was appraised using the Joanna Briggs Institute (JBI) checklist for RCTs and the National Institutes of Health (NIH) tool for pre-post studies without a control group.<h4>Results</h4>Eleven studies were included from 5840 identified records. Two types of mobile applications were identified: cognitive training applications (n = 4) incorporating structured exercises and telehealth support, and game-based rehabilitation applications (n = 7), emphasizing gamification and training tasks. The interventions were implemented in hospital-based and hybrid settings.<h4>Conclusion</h4>Mobile applications show promise in post-stroke attentional rehabilitation, with evidence supporting cognitive training and game-based programs via tablets in hospital or hybrid settings and these interventions improve attention. However, methodological variability and heterogeneous protocols limit study comparability. Future research needs standardized frameworks and large clinical trials, supported by digital literacy among healthcare professionals, to strengthen clinical integration within stroke rehabilitation.