This project has been generously funded, by a grant from the Ontario Ministry of Health and Long-Term Care, administered and supported by the Ontario Stroke Network. The views expressed do not necessarily reflect those of the Ministry or the Ontario Stroke Network.

Authors: Mansfield A, Wong JS, Bryce J, Brunton K, Inness EL, Knorr S, Jones S, Taati B, McIlroy WE.
Research: Use of accelerometer-based feedback of walking activity for appraising progress with walking-related goals in inpatient stroke rehabilitation: a randomized controlled trial
Info: Neurorehabil Neural Repair 2015;doi: 10.1177/1545968314567968

1. What are your main findings?

We monitored daily walking activity in a group of individuals with stroke who were in in-patient rehabilitation. Some patients received feedback about their daily walking activity, through their physiotherapists, who used the information to determine if patients were making progress with their walking goals. While people who received feedback did not walk more often that those who did not get feedback, they did walk faster during the day and had greater improvements in walking speed at discharge from rehabilitation.

2. What is new about your research?

Previous research has found that people with stroke walk very little during in-patient rehabilitation. However, walking more outside of scheduled therapies could help to increase walking endurance and improve the quality of walking. Physiotherapists can suggest that their patients walk frequently during the day but they don’t know for sure if their patients are doing their ‘homework’. This study used accelerometers – small devices that measure movement of the legs – to measure walking activity throughout the day. Physiotherapists could then use this information to determine if their patients were doing enough walking during the day, and suggest strategies to increase walking activity.

3. Can you explain your methodology?

This was a randomized controlled trial, which means that participants were randomly allocated to either receive feedback or not receive feedback. The group that didn’t receive feedback was the ‘control’ group – this group received the usual care for patients in in-patient rehabilitation. We used the accelerometers to measure walking activity throughout the day for participants in both groups. We then compared change in walking activity from the start of the study until discharge from in-patient rehabilitation between the two groups.

4. What policy recommendations do your findings suggest?

These findings suggest that feedback obtained from devices that can measure daily walking activity could be useful for improving walking outcomes in in-patient stroke rehabilitation. In this study, we used commercially-available accelerometers with custom-written software that might not be very easy for others to use. There are many newer devices (pedometers) on the market that measure walking activity; physiotherapists and patients might find these devices easier to use. However, many commercial pedometers have not been validated for use with people who walk slowly or with an ‘atypical’ walking pattern, as is common after stroke.

5. Do your findings contradict any views or sources? If so, which ones?

To our knowledge, these findings to not contradict others.

6. How is your research meaningful for the ordinary person?

Remaining physically active is important for everyone. Many people are now monitoring their own daily walking activities using new pedometer devices. This work suggests devices like this may actually be helpful for changing behaviour and improving the quality or quantity of physical activity.