Abstract

Mobilization, verticalization and position change are mandatory for severely affected neurological patients in early neurorehabilitation in order to improve neurological status and prevent complications. However, with the exception of hospitals and rehabilitation facilities, this activity is not usually monitored and so far the automated monitoring of position changes in immobile patients has not been investigated. Therefore, we investigated whether accelerometers on the upper trunk could reliably detect body position changes in immobile patients. Thirty immobile patients in early neurorehabilitation (Barthel Index ≤ 30) were enrolled. Two tri-axial accelerometers were placed on the upper trunk and on the thigh. Information on the position and position changes of the subject were derived from accelerometer data and compared to standard written documentation in the hospital over 24 h. Frequency and duration of different body positions (supine, sidelying, sitting) were measured. Data are presented as mean ± SEM. Groups were compared using one-way ANOVA or Kruskal-Wallis-test. Differences were considered significant if p < 0.05. Trunk sensors detected 100% and thigh sensors 66% of position changes (p = 0.0004) compared to standard care documentation. Furthermore, trunk recording also detected additional spontaneous body position changes that were not documented in standard care (81.8 ± 4.4% of all position changes were documented in standard care documentation) (p < 0.0001). We found that accelerometric trunk sensors are suitable for recording position changes and mobilization of severely affected patients. Our findings suggest that using accelerometers for care documentation is useful for monitoring position changes and mobilization frequencies in and outside of hospital for severely affected neurological patients. Accelerometric sensors may be valuable in monitoring continuation of care plans after intensive neurorehabilitation.

Highlights

  • IntroductionSensors 2018, 18, 3272 usually measured with a Barthel Index ≤ 30, representing major activity limitations in the patient’s daily life

  • Neurorehabilitation in severe neurological disorders, e.g., following stroke, traumatic brain injury or critical illness polyneuropathy, is characterized by loss of functional independence and is Sensors 2018, 18, 3272; doi:10.3390/s18103272 www.mdpi.com/journal/sensorsSensors 2018, 18, 3272 usually measured with a Barthel Index ≤ 30, representing major activity limitations in the patient’s daily life

  • This study provides evidence for the feasibility of using accelerometric trunk sensors to assess assess body position and position changes of immobile patients during early neurorehabilitation

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Summary

Introduction

Sensors 2018, 18, 3272 usually measured with a Barthel Index ≤ 30, representing major activity limitations in the patient’s daily life. These patients suffer from severe motor deficits and are not able to move independently. Patients are dependent on positioning on a regular basis from their caregivers. It is well-known that regular positioning and passive physical activity improve function and general health, decrease complications, contribute to regaining patients’ independence, and reduce mortality [1,2,3,4,5].

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