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Open Access Study protocol

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

Avril Mansfield1234*, Jennifer S Wong1, Mark Bayley12, Lou Biasin13, Dina Brooks134, Karen Brunton13, Jo-Anne Howe13, Elizabeth L Inness134, Simon Jones1, Jackie Lymburner1, Ramona Mileris1 and William E McIlroy12345

Author Affiliations

1 Balance Mobility and Falls Clinic and Mobility Research Team, Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada

2 Heart and Stroke Foundation Centre for Stroke Recovery, Toronto Rehabilitation Institute and Sunnybrook Health Sciences Centre sites, Toronto, ON, Canada

3 Department of Physical Therapy, University of Toronto, Toronto, ON, Canada

4 Graduate Department of Rehabilitation Science, University of Toronto, Toronto, ON, Canada

5 Department of Kinesiology, University of Waterloo, Waterloo, ON, Canada

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BMC Neurology 2013, 13:93  doi:10.1186/1471-2377-13-93

Published: 18 July 2013

Abstract

Background

Regaining independent ambulation 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 feedback from these devices can be downloaded to a computer to produce reports. 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.

Methods

Participants will be randomly assigned to one of two groups: feedback or no feedback. Participants will wear accelerometers daily during in- and out-patient rehabilitation and, for participants in the feedback group, the participants’ treating physiotherapist will receive regular reports of walking activity. The primary outcome measures are the amount of daily walking completed, as measured using the accelerometers, and spatio-temporal characteristics of walking (e.g. walking speed). We will also examine goal attainment, satisfaction with progress towards goals, stroke self-efficacy, and community-integration.

Discussion

Increased walking activity during rehabilitation is expected to improve walking function and community re-integration following discharge. In addition, a focus on altering walking behaviour within the rehabilitation setting may lead to altered behaviour and increased activity patterns after discharge.

Trial registration

ClinicalTrials.gov NCT01521234

Keywords:
Stroke; Rehabilitation; Walking; Physical activity; Goal setting; Technology