Research Article
Issue Date: January/February 2021
Published Online: December 11, 2020
Updated: December 14, 2020
Sensorimotor and Cognitive Abilities Associated With Touchscreen Tablet App Performance to Support Self-Management of Type 2 Diabetes
Author Affiliations
  • Neta Kravitz, OT, MSc, is Occupational Therapist, Department of Hand Rehabilitation, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel. At the time of the study, Kravitz was Master’s Student, Department of Occupational Therapy, Stanley Steyer School of Health Professions, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
  • Yafi Levanon, OT, PhD, is Teacher, Department of Occupational Therapy, Stanley Steyer School of Health Professions, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel, and Deputy, Occupational Therapy Services, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel.
  • Tali Cukierman-Yaffe, MSc, MD, is Head Physician, Center for Successful Aging With Diabetes, Division of Endocrinology, Diabetes and Metabolism, Gertner Institute, Sheba Medical Center, Ramat Gan, Israel; Senior Lecturer, Epidemiology Department, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; and Researcher, Herczeg Institute on Aging, Tel Aviv University, Tel Aviv, Israel.
  • Ayala Nota, OT, MSc, is Occupational Therapist and Head of Occupational Therapy Services, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel.
  • Rachel Kizony, OT, PhD, is Senior Lecturer, Department of Occupational Therapy, University of Haifa, Haifa, Israel, and Occupational Therapist, Occupational Therapy Services, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel.
  • Debbie Rand, OT, PhD, is Senior Lecturer, Department of Occupational Therapy, Stanley Steyer School of Health Professions, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; drand@post.tau.ac.il
Article Information
Research Articles
Research Article   |   December 11, 2020
Sensorimotor and Cognitive Abilities Associated With Touchscreen Tablet App Performance to Support Self-Management of Type 2 Diabetes
American Journal of Occupational Therapy, December 2020, Vol. 75, 7501205080. https://doi.org/10.5014/ajot.2021.040600
American Journal of Occupational Therapy, December 2020, Vol. 75, 7501205080. https://doi.org/10.5014/ajot.2021.040600
Abstract

Importance: Self-management programs (facilitated by mobile devices) may improve health and prevent secondary complications for older adults with diabetes. However, older adults may have difficulties using mobile devices because of neuropathy or cognitive dysfunction.

Objective: To identify sensorimotor and cognitive abilities associated with touchscreen tablet app performance to support self-management of diabetes in older adults.

Design: Cross-sectional study.

Setting: Outpatient Center for Successful Aging With Diabetes.

Participants: Forty-five older adults with Type 2 diabetes.

Outcomes and Measures: Dexterity (Purdue Pegboard Test), touch sensation (Semmes–Weinstein monofilaments), pinch strength (pinch gauge), cognition (Montreal Cognitive Assessment), and executive functioning (Trail Making Test) were assessed. Two apps were then used: Dexteria and SuCare. Demographic data, prior mobile device use, and diabetes severity (hemoglobin A1C [HbA1C]) were collected.

Results: Age and HbA1C accounted for 29.8% and 9.7%, respectively, of the total variance of Dexteria performance time (dominant hand). Dexterity (dominant hand) accounted for an additional 5.4% of the total variance of 45.1%, F(4, 40) = 10.021, p < .001. Prior mobile device use, age, and diabetes severity accounted for 6.4%, 11.8%, and 26.4%, respectively, of the total variance of SuCare performance time. Executive functioning and dominant-hand dexterity accounted for an additional 9.5% and 9.4%, respectively, of the total variance of 61.0%, F(5, 39) = 14.75, p < .001.

Conclusions and Relevance: Beyond age and diabetes severity, executive functioning and dominant-hand dexterity contributed to app performance, highlighting the importance of diabetes self-management. These findings may help determine suitable candidates for tablet use for self-management.

What This Article Adds: App performance is explained by the executive functioning and dexterity of older adults with Type 2 diabetes. These factors, in addition to age and diabetes severity, should be taken into consideration by occupational therapy practitioners in future mobile self-management programs.