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The Effect of Activity Feedback Enabled by Smart Watches During In-patient Stroke Rehabilitation

Not Applicable
Conditions
Stroke
Interventions
Behavioral: Feedback against tailored target
Behavioral: No feedback
Registration Number
NCT02587585
Lead Sponsor
The Second Affiliated Hospital of Anhui University of Traditional Chinese Medicine
Brief Summary

The amount of activity completed by individuals within rehabilitation programs, even when units are well staffed, is often far below that required for optimal stroke rehabilitation, and is not individually adapted on a day-to-day basis. Daily feedback on their activity levels may motivate stroke survivors to engage in greater skills practice and thus outcome after stroke. To date only a few trials suggests that augmented feedback may be effective. There is a need for a large pragmatic trial to explore the impact of augmented activity feedback on top of their standard care. The purpose of this study is to determine the effect of augmented activity feedback by smart watches to support in-patient stroke rehabilitation.

Detailed Description

This study had a feasibility and pilot development phase from September 2015 to April 2016, and then moved into the main study with some changes in design and execution occurring in the light of experience. Its execution has also been constrained by external factors beyond control.

It is in essence asking whether wearing a Smart Watch which gives feedback on activity every two hours, with a specific target tailored to the patient's performance 24 hours earlier will be associated with a higher rate of physical activity than seen in people wearing the same watch without and feedback been given.

The intervention only lasts unto 21 days, but earlier discharge will terminate that patient's participation sooner. A telephone interview at 12 weeks after entry collect data on mobility.

Outcome measures will assess mobility, activity, and health status.

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
200
Inclusion Criteria
  • Admission for acute/sub-acute in-patient neurorehabilitation of a first stroke at the 2nd affiliated hospital of Anhui University of Traditional Medicine and Acupuncture, Hefei, China.
  • Time from onset of stroke to admission for rehabilitation <16 weeks.
  • Ability to follow a two stage command; pick up an object, put object on table.
  • Independent in mobility prior to admission. Subjects can use any type of assistive device and brace needed.
  • Able to understand and repeat information related to the Informed Consent.
Exclusion Criteria
  • Admission for second stroke.
  • Subjects who are unable to provide consent due to a cognitive impairment.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Feedback against tailored targetFeedback against tailored targetFor each two hour epoch, the watch calculate the level of activity for the same epoch the day before, and adds 5% as the new target to be achieved.
No FeedbackNo feedbackFor participants assigned to the control group, the smart watch will not provide any activity feedback against a target; it simply shows which two hour epoch a person is in.
Primary Outcome Measures
NameTimeMethod
Change in activity counts as measured by a triaxial accelerometer from a smart watch from admission to 3 weeks or discharge from rehabilitationBaseline, Three weeks or at discharge from in-patient rehabilitation if sooner
Secondary Outcome Measures
NameTimeMethod
Change in disability as measured by WHO Disability Assessment Scale (12 item version)Baseline, Three weeks or discharge from in-patient rehabilitation if sooner, and 12 weeks

This scale provides a global measure of disability covering 6 domains: cognition, mobility, self-care, getting along, life activities, and participation

Change in walking mobilityBaseline, Three weeks or discharge from in-patient rehabilitation if sooner

Change in walking speed and spatio-temporal characteristics of walking as measured by an inertial sensor on the lower trunk during a 10m walk test.

Change in arm function recoveryBaseline, Three weeks or discharge from in-patient rehabilitation if sooner

Grip dynamometer

Change in functional mobility as measured by Rivermead Mobility Index (RMI)Baseline, Three weeks or discharge from in-patient rehabilitation if sooner, and 12 weeks (by telephone)

This scale assesses functional mobility in gait, balance and transfers after stroke

Adverse eventsAt three weeks, or discharge if sooner and at 12 weeks

Self-reported adverse events

Change in cognitive function as measured by The Montreal Cognitive Assessment (MoCA)Baseline, Three weeks or discharge from in-patient rehabilitation if sooner

This is a screening instrument for to measure mild cognitive dysfunction. It assesses different cognitive domains: attention and concentration, executive functions, memory, language, visuoconstructional skills, conceptual thinking, calculations, and orientation.

Activity goal attainment as measured and provided by the smart watchAt three weeks, or discharge if sooner

Participants in feedback group receive a preset activity goal based on their previous activity levels at baseline. The smart watch will then provide graduated encouragement by increasing their activity goal by about 5%. Every 10-15 minutes the screen lights up and participants can see their activity progress expressed by activity bars (representing 0-100%). Participants reaching their activity goal is used to measure goal attainment.

FatigueBaseline, Three weeks or discharge from in-patient rehabilitation if sooner

Fatigue Severity Index

Health status on EQ-5D-5LBaseline, Three weeks or discharge from in-patient rehabilitation if sooner, and 12 weeks (by telephone)

This scale is used a measure for health status and compromises 5 dimensions: mobility, self-care, usual activities, pain/discomfort, and anxiety/depression

Change in performance of activities of daily living as measured by Barthel ADL IndexBaseline, Three weeks or discharge from in-patient rehabilitation if sooner

This scale is used to record what the participant undertakes in personal activities, to establish a degree of independence from any help, physical or verbal.

Trial Locations

Locations (1)

The 2nd Affiliated Hospital to Anhui University of Tranditional Chinese Medicine

🇨🇳

Hefei, Anhui, China

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