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The wearable system comprised two wrist-worn MetaMotionR+ activity monitors and a custom smartphone app. The progressive-challenge cued exercise program included high-intensity activities (one repetition every 30\u00a0s) dosed at 1.5\u00a0h per day, embedded within 8\u00a0h of passive activity monitoring per day. Utility was assessed using measures of system uptime and cue response rate. Usability and user experience were assessed using well-validated quantitative surveys of system usability and user experience. Self-efficacy was assessed at the end of each day on a visual analog scale that ranged from 0 to 100.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>The system and exercise program had objective utility: system uptime was 92\u2009\u00b1\u20096.9% of intended hours and the rate of successful cue delivery was 99\u2009\u00b1\u20092.7%. The system and program also were effective in motivating cued exercise: activity was detected within 5-s of the cue 98\u2009\u00b1\u20093.1% of the time. As shown via two case studies, accelerometry data can accurately reflect graded-challenge exercise instructions and reveal differentiable activity levels across exercise stages. User experience surveys indicated positive overall usability in the home settings, strong levels of personal motivation to use the system, and high degrees of satisfaction with the devices and provided training. Self-efficacy assessments indicated a strong perception of proficiency across participants (95\u2009\u00b1\u20095.0).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>This study demonstrates that a low-cost wearable system providing frequent haptic cues to encourage graded-challenge exercise after stroke can have utility and can provide an overall positive user experience in home settings. The study also demonstrates how combining a graded exercise program with all-day activity monitoring can provide insight into the potential for wearable systems to assess adherence to\u2014and effectiveness of\u2014home-based exercise programs on an individualized basis.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12984-024-01359-0","type":"journal-article","created":{"date-parts":[[2024,4,30]],"date-time":"2024-04-30T02:01:19Z","timestamp":1714442479000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Utility and usability of a wearable system and progressive-challenge cued exercise program for encouraging use of the more involved arm at-home after stroke\u2014a feasibility study with case reports"],"prefix":"10.1186","volume":"21","author":[{"given":"Jake","family":"Horder","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leigh A.","family":"Mrotek","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maura","family":"Casadio","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kimberly D.","family":"Bassindale","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"McGuire","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert A.","family":"Scheidt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,4,30]]},"reference":[{"issue":"8","key":"1359_CR1","doi-asserted-by":"publisher","first-page":"E93","DOI":"10.1161\/CIR.0000000000001123","volume":"147","author":"CW Tsao","year":"2023","unstructured":"Tsao CW, et al. 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