Using Wireless-technology for Feedback of Daily Walking Activity Post-stroke

NCT01521234 | Completed

• 1 other identifier: OSN-Mansfield-2011
• Study Type: interventional
• Target: 63
• Locations: 1 country
• Sites: 1

Brief Summary

Regaining independent walking is the top priority for individuals recovering from stroke. Thus, physical rehabilitation post-stroke should focus on improving walking function and endurance. However, the amount of walking completed by individuals with stroke attending rehabilitation is far below that required for independent community ambulation. There has been increased interest in accelerometer-based monitoring of walking post-stroke. Walking monitoring could be integrated within the goal-setting process for those with ambulation goals in rehabilitation. The purpose of this study is to determine the effect of accelerometer-based feedback of daily walking activity during rehabilitation on the frequency and duration of walking post-stroke.

Conditions

Stroke

Outcome Measures

Primary Outcomes (2)

• Change in walking activity from admission to discharge from rehabilitation

  Total daily walking acitivty, measured by number of steps per day, total duration of walking activity, total distance walked, and frequency of 'long' walking bouts (\>5 minutes in duration).

  Admission and discharge from in-patient rehabilitation (approx. 4-6 weeks)

• Change in control of walking

  Self-selected walking speed and symmetry of spatio-temporal characteristics of walking

  Admission and discharge from in-patient rehabilitation (approx. 4-6 weeks)

Secondary Outcomes (6)

• Change in self-efficacy

  Admission and discharge from in-patient rehabilitation (approx. 4-6 weeks)

• Goal attainment

  Discharge from in-patient rehabilitation (4-6 weeks), discharge from out-patient rehabilitation (10-16 weeks)

• Community integration

  Discharge from out-patient rehabilitation (10-16 weeks) and 3-month follow-up

• Satisfaction with progress towards rehabilitation goals

  Discharge from in-patient rehabilitation (4-6 weeks) and discharge from out-patient rehabilitation (10-16 weeks)

• Barriers to walking

  Monitored throughout participants' enrolment (0-28 weeks)

Study Arms (2)

Feedback group

EXPERIMENTAL

For participants assigned to the feedback group, physiotherapists will receive a summary of patients' walking activity for the previous week as a tool to guide goal planning. Physiotherapists will use the information as a 'homework checker' to determine if patients are complying with an assigned walking program. In the case of non-compliance, the physiotherapist will discuss a coping strategy for better integrating walking activity into the patients' day. In the event that the patient is meeting their specific sub-goals for walking activity, the physiotherapist will re-evaluate these sub-goals and suggest more challenging goals.

Behavioral: Feedback of daily walking activity

No-feedback group

NO INTERVENTION

For participants assigned to the control group, physiotherapists will not receive accelerometer-based feedback of daily walking activity. However, physiotherapists will still discuss the achievement of walking goals with their patients. This is usual care around goal planning.

Interventions

Feedback of daily walking activity BEHAVIORAL

Participants will wear accelerometers every weekday during in-patient rehabilitation to monitor walking activity. Feedback of daily walking activity will be provided to the patients' treating physiotherapists to assist with goal-planning around walking.

Feedback group

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• individuals with sub-acute stroke attending in-patient rehabilitation at Toronto Rehab
• patients who have identified improving walking function as a rehabilitation goal
• patients who can walk without supervision at the time of recruitment into the study

Sponsors & Collaborators

• Toronto Rehabilitation Institute: lead

Study Sites (1)

Toronto Rehabilitation Institute

Toronto, Ontario, M5G 2A2, Canada

Location

Related Publications (3)

• Prajapati SK, Gage WH, Brooks D, Black SE, McIlroy WE. A novel approach to ambulatory monitoring: investigation into the quantity and control of everyday walking in patients with subacute stroke. Neurorehabil Neural Repair. 2011 Jan;25(1):6-14. doi: 10.1177/1545968310374189. Epub 2010 Sep 9.

  PMID: 20829413 BACKGROUND

• Mansfield A, Wong JS, Bayley M, Biasin L, Brooks D, Brunton K, Howe JA, Inness EL, Jones S, Lymburner J, Mileris R, McIlroy WE. Using wireless technology in clinical practice: does feedback of daily walking activity improve walking outcomes of individuals receiving rehabilitation post-stroke? Study protocol for a randomized controlled trial. BMC Neurol. 2013 Jul 18;13:93. doi: 10.1186/1471-2377-13-93.

  PMID: 23865593 BACKGROUND

• Mansfield A, Wong JS, Bryce J, Brunton K, Inness EL, Knorr S, Jones S, Taati B, McIlroy WE. Use of Accelerometer-Based Feedback of Walking Activity for Appraising Progress With Walking-Related Goals in Inpatient Stroke Rehabilitation: A Randomized Controlled Trial. Neurorehabil Neural Repair. 2015 Oct;29(9):847-57. doi: 10.1177/1545968314567968. Epub 2015 Jan 20.

  PMID: 25605632 RESULT

MeSH Terms

Conditions

Stroke

Condition Hierarchy (Ancestors)

Cerebrovascular Disorders; Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Vascular Diseases; Cardiovascular Diseases

Study Officials

• Avril Mansfield, PhD

  Toronto Rehabilitation Institute

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Post-doctoral fellow

Study Record Dates

• First Submitted: January 23, 2012
• First Posted: January 30, 2012
• Study Start: October 1, 2012
• Primary Completion: January 1, 2014
• Study Completion: June 1, 2014
• Last Updated: May 13, 2015

Record last verified: 2015-05

Locations

CA (1)