Accelerometer and Global Positioning System Measurement of Recovery of Community Ambulation Across the First 6 Months After Stroke: An Exploratory Prospective Study

Mahendran, Niruthikha; Kuys, Suzanne; Brauer, Sandra G.

doi:10.1016/j.apmr.2016.04.013

Cited by 15 publications

(10 citation statements)

References 36 publications

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“…It has several advantages in revealing a series of clinically useful outcome measures, 19 standardizing stroke outcome measures by revealing significant improvement in stroke patients’ performance, 12 and documenting recovery following stroke treatments. More specifically, it reveals considerable residual mobility problems after treatment 13 with rtPA.…”

Section: Discussionmentioning

confidence: 95%

“…The reliability and validity of ambulation as an assessment tool for functional recovery in the mobility of stroke patients is well-documented in the literature. 12 , 13 The study assesses recovery progress in each patient and determines efficacy of rtPA therapy on restoration of functional mobility. Independent ambulation was evaluated and used to develop a model for functional outcome.…”

Section: Methodsmentioning

confidence: 99%

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Functional Outcome Measures of Recombinant Tissue Plasminogen Activator–Treated Stroke Patients in the Telestroke Technology

et al. 2018

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The efficiency of telestroke programs in improving the rates of recombinant tissue plasminogen activator (rtPA) in stroke patients has been reported. Previous studies have reported favorable treatment outcomes with the use of telestroke programs to improve the use of rtPA, but functional outcomes are not fully understood. This study investigated the effect of telestroke technology in the administration of rtPA and related functional outcomes associated with baseline clinical variables. Retrospective data of a telestroke registry were analyzed. Univariate analysis was used to compare demographic and clinical variables in the rtPA group and the no rtPA group and between the improved functional ambulation group and the no improvement group. A stepwise binary logistic regression identified factors associated with improved functional outcome in the total telestroke population and in the subset of the telestroke population who received rtPA. In adjusted analysis and elimination of any multicollinearity for patients who received rtPA in the telestroke setting, obesity (odds ratio [OR] = 2.138, 95% confidence interval [CI], 1.164-3.928, P < .05), higher systolic blood pressure at the time of presentation (OR = 1.015, 95% CI, 1.003-1.027, P < .05), and baseline high-density lipoprotein at the time of admission (OR = 1.032, 95% CI, 1.005-1.059, P < .05) were associated with improved functional outcomes. Increasing age (OR = 0.940, 95% CI, 0.916-0.965, P < .0001) and higher calculated National Institutes of Health Stroke Scale (OR = 0.903, 95% CI, 0.869-0.937) were associated with a poorer outcome in rtPA-treated patients. Telestroke technology improves functional outcomes at spoke stations where neurological expertise is unavailable. Further studies are necessary to determine how telestroke technology can be optimized, especially to improve contraindications and increase eligibility for thrombolysis therapy.

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Section: Discussionmentioning

confidence: 95%

Section: Methodsmentioning

confidence: 99%

Functional Outcome Measures of Recombinant Tissue Plasminogen Activator–Treated Stroke Patients in the Telestroke Technology

et al. 2018

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“…Additionally, with access to the Global Positioning System (GPS), smartphones can allow clinicians and researchers to quantify outdoor community mobility [10-12] for tracking recovery and societal reintegration. Smartphones offer a favorable alternative to current monitoring devices such as pedometers, step activity monitors (SAMs), or other accelerometry-driven products [13], which focus exclusively on step counts and walking bouts.…”

Section: Introductionmentioning

confidence: 99%

Activity Recognition for Persons With Stroke Using Mobile Phone Technology: Toward Improved Performance in a Home Setting

O’Brien¹,

Shawen²,

Mummidisetty³

et al. 2017

J Med Internet Res

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BackgroundSmartphones contain sensors that measure movement-related data, making them promising tools for monitoring physical activity after a stroke. Activity recognition (AR) systems are typically trained on movement data from healthy individuals collected in a laboratory setting. However, movement patterns change after a stroke (eg, gait impairment), and activities may be performed differently at home than in a lab. Thus, it is important to validate AR for gait-impaired stroke patients in a home setting for accurate clinical predictions.ObjectiveIn this study, we sought to evaluate AR performance in a home setting for individuals who had suffered a stroke, by using different sets of training activities. Specifically, we compared AR performance for persons with stroke while varying the origin of training data, based on either population (healthy persons or persons with stoke) or environment (laboratory or home setting).MethodsThirty individuals with stroke and fifteen healthy subjects performed a series of mobility-related activities, either in a laboratory or at home, while wearing a smartphone. A custom-built app collected signals from the phone’s accelerometer, gyroscope, and barometer sensors, and subjects self-labeled the mobility activities. We trained a random forest AR model using either healthy or stroke activity data. Primary measures of AR performance were (1) the mean recall of activities and (2) the misclassification of stationary and ambulatory activities.ResultsA classifier trained on stroke activity data performed better than one trained on healthy activity data, improving average recall from 53% to 75%. The healthy-trained classifier performance declined with gait impairment severity, more often misclassifying ambulatory activities as stationary ones. The classifier trained on in-lab activities had a lower average recall for at-home activities (56%) than for in-lab activities collected on a different day (77%).ConclusionsStroke-based training data is needed for high quality AR among gait-impaired individuals with stroke. Additionally, AR systems for home and community monitoring would likely benefit from including at-home activities in the training data.

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“…This could cause anger and a feeling of vulnerability towards the future [34]; (b) Motivation. Studies identified that "having a positive attitude" [25] and the willingness to engage in "doing things" [2,17,18] helped individuals have an emotional shift from negativity to positivity. This facilitated hope, leading to the factor of; (c) Hope in possibility.…”

Section: Factors That Can Influence Social Identity Evolutionmentioning

confidence: 99%

“…Only studies with participants over the age of 18 years were included and perinatal stroke studies were excluded. This was because perinatal patients would have always had their condition and <6 months diagnosis of stroke is too soon to assess change over time [18]. Where multiple conditions were identified within a study, only results from stroke patients were included.…”

mentioning

confidence: 99%

Factors which Influence Risk Taking and the Evolution of Social-Identity in Stroke Narratives: A Thematic Synthesis

Higgs

Soundy

2020

Behavioral Sciences

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Background: The disruption of a stroke can impact an individual’s sense of social identity. A comprehensive review is required to understand the factors and processes that influence changes in social identity following a stroke. Aims: To undertake a review of literature to discover a process of social identity evolution for people with stroke and identify the factors which influence it. Methods: A meta-ethnographic approach to review was undertaken and a subtle realist viewpoint was assumed. Studies were included if they documented experiences and perceptions relating to stroke. Eight electronic databases were searched from January 2009 until January 2019. Quality assessment and synthesis techniques were applied. Findings: Out of the 18 papers included, a total of 251 (141/251, 56% male, 109/251, 43% female, 1/251, 0.4% undisclosed) individuals were included within the synthesis. The evolution of social-identity model was developed and identified with five key stages to represent a process that individuals with stroke can experience. Factors which influence the process were identified and direct implications for clinical practice are given. Conclusion: This review has highlighted the major themes within the evolution of social identity and management strategies for risk taking to achieve a desired future. Further research is required to consider how these findings may be tested in clinical practice.

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Accelerometer and Global Positioning System Measurement of Recovery of Community Ambulation Across the First 6 Months After Stroke: An Exploratory Prospective Study

Cited by 15 publications

References 36 publications

Functional Outcome Measures of Recombinant Tissue Plasminogen Activator–Treated Stroke Patients in the Telestroke Technology

Functional Outcome Measures of Recombinant Tissue Plasminogen Activator–Treated Stroke Patients in the Telestroke Technology

Activity Recognition for Persons With Stroke Using Mobile Phone Technology: Toward Improved Performance in a Home Setting

Factors which Influence Risk Taking and the Evolution of Social-Identity in Stroke Narratives: A Thematic Synthesis

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