Division of Biokinesiology and Physical Therapy, Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, CA, USA.
Department of Neurology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
Top Stroke Rehabil. 2021 Dec;28(8):594-605. doi: 10.1080/10749357.2020.1856557. Epub 2020 Dec 3.
Motivated by recent advances in technologies, ecological momentary assessment (EMA), and ecological momentary intervention (EMI) have seen a rise in behavioral medicine research that in real-time, informs the context for the behavior and prompts interventions to change that behavior in the natural setting when necessary. However, EMA and EMI have yet to be fully embraced in the field of stroke rehabilitation. Our objective is to provide a theoretically based perspective for the combined and synergistic use of EMA and EMI to promote person-centered, recovery-based durable changes in functional movement behaviors of stroke survivors. Research abounds for non-stroke populations with emerging evidence for the benefits of using real-time data capture techniques (i.e. EMA) coupled with EMI to better customize the content and timing of interventions to the inherent fluctuations in state and context that encompass the target behavior. We review existing EMA and EMI literature broadly in behavioral medicine and psychological science to identify how real-time repeated sampling technology has been used in the context of stroke rehabilitation and to delineate the pros and cons of this approach in general with non-stroke populations. We propose a coupled EMA and EMI strategy be used in conjunction with existing stroke recovery and rehabilitation practices. There is tremendous potential to effectively personalize recovery-promoting interventions to achieve durable behavior change, and importantly, shift the focus of rehabilitation practice from the health-care provider and clinical environment to the individual and their lived experience in the home and community.
受近期技术、生态瞬时评估(EMA)和生态瞬时干预(EMI)发展的推动,行为医学研究中实时提供行为背景信息并在必要时提示干预措施以改变自然环境中行为的方法越来越多。然而,EMA 和 EMI 尚未在中风康复领域得到充分应用。我们的目标是为 EMA 和 EMI 的联合和协同使用提供理论基础,以促进中风幸存者的功能性运动行为的以患者为中心、基于康复的持久变化。针对非中风人群的研究层出不穷,越来越多的证据表明,使用实时数据采集技术(即 EMA)结合 EMI 来更好地根据状态和环境的固有波动定制干预内容和时间,从而更好地定制干预内容和时间,这对目标行为有好处。我们广泛回顾了行为医学和心理科学领域中的现有 EMA 和 EMI 文献,以确定实时重复采样技术在中风康复背景下的使用情况,并概括地阐述了这种方法在非中风人群中的优缺点。我们提出了一种结合 EMA 和 EMI 的策略,与现有的中风康复和康复实践相结合。将促进康复的干预措施有效地个性化,以实现持久的行为改变,这具有巨大的潜力,重要的是,将康复实践的重点从医疗保健提供者和临床环境转移到个体及其在家庭和社区中的生活体验。
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