Abstract
BackgroundRehabilitative treatment plans after stroke are based on clinical examinations of functional capacity and patient-reported outcomes. Objective information about daily life performance is usually not available, but it may improve therapy personalization.ObjectiveTo show that sensor-derived information about daily life performance is clinically valuable for counseling and the planning of rehabilitation programs for individual stroke patients who live at home. Performance information is clinically valuable if it can be used as a decision aid for the therapeutic management or counseling of individual patients.MethodsThis was an observational, cross-sectional case series including 15 ambulatory stroke patients. Motor performance in daily life was assessed with body-worn inertial sensors attached to the wrists, shanks and trunk that estimated basic physical activity and various measures of walking and arm activity in daily life. Stroke severity, motor function and activity, and degree of independence were quantified clinically by standard assessments and patient-reported outcomes. Motor performance was recorded for an average of 5.03 ± 1.1 h on the same day as the clinical assessment. The clinical value of performance information is explored in a narrative style by considering individual patient performance and capacity information.ResultsThe patients were aged 59.9 ± 9.8 years (mean ± SD), were 6.5 ± 7.2 years post stroke, and had a National Institutes of Health Stroke Score of 4.0 ± 2.6. Capacity and performance measures showed high variability. There were substantial discrepancies between performance and capacity measures in some patients.ConclusionsThis case series shows that information about motor performance in daily life can be valuable for tailoring rehabilitative therapy plans and counseling according to the needs of individual stroke patients. Although the short recording time (average of 5.03 h) limited the scope of the conclusions, this study highlights the usefulness of objective measures of daily life performance for the planning of rehabilitative therapies. Further research is required to investigate whether information about performance in daily life leads to improved rehabilitative therapy results.
Highlights
When a rehabilitation physician meets with a postacute stroke patient for counseling and rehabilitation program planning, decisions are usually based on two types ofFlury et al J NeuroEngineering Rehabil (2021) 18:102 but with the development of wearable sensors, it is increasingly used in rehabilitation
There were substantial discrepancies between performance and capacity measures in some patients. This case series shows that information about motor performance in daily life can be valuable for tailor‐ ing rehabilitative therapy plans and counseling according to the needs of individual stroke patients
Further research is required to investigate whether information about performance in daily life leads to improved rehabilitative therapy results
Summary
When a rehabilitation physician meets with a postacute stroke patient for counseling and rehabilitation program planning, decisions are usually based on two types ofFlury et al J NeuroEngineering Rehabil (2021) 18:102 but with the development of wearable sensors, it is increasingly used in rehabilitation. Information about performance would be available for the planning and monitoring of a rehabilitation program and would include several aspects, such as overall physical activity, walking behavior and upper-limb use. Studies involving wearable sensors generally report low physical activity levels, low walking performance and little use of the affected arm in daily life in stroke patients at the population level [3, 4]. The variability of daily life performance measures among patients was considerable in most studies [5, 6]. Rehabilitative treatment plans after stroke are based on clinical examinations of functional capacity and patient-reported outcomes. Objective information about daily life performance is usually not available, but it may improve therapy personalization
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