Feasibility and Validity of a Wearable GPS Device for Measuring Outings after Stroke

Abstract

Aim. Self-report diaries are a low-cost method of measuring community participation but may be inaccurate, while the "gold standard," observation is time consuming and costly. This study aimed to investigate the feasibility and validity of a global positioning system (GPS) for measuring outings after stroke. Design. Cross-sectional cohort study. Methods. Twenty ambulant people with stroke wore a GPS device and kept a diary for 7 days, and 18 were observed for half a day. We recorded recruitment rate, user perceptions, and data extraction time. GPS data were analysed against Google maps. Percent exact agreement (PEA) with observation was calculated for GPS and diary. Results. Of 23 eligible participants, 20 consented (mean 3.6 years after stroke). GPS data recovery was high (87%). Some participants had difficulty operating the on/off switch and reading the small screen. Data extraction took an average of 5 hours per participant. PEA with observation was high for number of outings (GPS 94%; diary 89%) but lower for purpose of outings (GPS 71%; diary 82%). Conclusions. The GPS device and diary were both feasible and valid for measuring outings after stroke. Simultaneous use of GPS and diaries is recommended for comprehensive analysis of outings.

Ambulation recovery after stroke

“…Only two studies have used device-based measures of community ambulation after stroke (Evans et al, 2012;McCluskey et al, 2012). These studies include a case study of one stroke survivor (Evans et al, 2012) and a study investigating the feasibility and validity of GPS for measurement of outings after stroke .…”

“…Two studies have used global positioning systems (GPS) to investigate community ambulation after stroke (Evans et al, 2012;McCluskey et al 2012). These provided information regarding community locations visited, trip frequency and purpose, and distances walked within community locations (Evans et al, 2012;McCluskey et al 2012). However, investigation of the validity and reliability of GPS for location and measures of ambulation such as step counts, distance walked and time spent walking is required for use in stroke.…”

“…Self-reported frequency of trips into the 43 community is reduced in individuals with chronic stroke when compared to healthy controls (Robinson et al, 2011b). However, this measure of frequency needs accurate measurement, with GPS devices after stroke (Evans et al, 2012;McCluskey et al, 2012). Purpose of community trips is a useful measure to understand the context of community ambulation and capture any changes in participation behaviours (e.g.…”

“…GPS have been reported to be accurate for distance and speed during outdoor walking when compared against direct observation in both healthy adults (Le Faucheur et al, 2007) and individuals with reduced walking ability (Le Faucheur et al, 2008). It also demonstrates potential for use after stroke for community ambulation measurement (Evans et al, 2012;McCluskey et al, 2012). GPS have demonstrated excellent agreement with direct observation for number of community trips in people with chronic stroke, and good agreement with both direct observation and activity diaries for trip purpose .…”

“…GPS devices provide real-time information on speed, time, location and distance travelled during community trips (Evans et al, 2012;McCluskey et al, 2012;Maddison and Ni Mhurchu, 2009;Le Faucheur et al, 2008;Le Faucheur et al, 2007). However, they are yet to be validated for measures of time, location and distance for use after stroke.…”