Neurological Institute Center for Outcomes Research and Evaluation, Cleveland Clinic, Cleveland, OH, United States.
Cerebrovascular Center, Cleveland Clinic, Cleveland, OH, United States.
JMIR Mhealth Uhealth. 2021 Jan 19;9(1):e14494. doi: 10.2196/14494.
Continuous tracking of ambulatory activity in real-world settings using step activity monitors has many potential uses. However, feasibility, accuracy, and correlation with performance measures in stroke patients have not been well-established.
The primary study objective was to determine adherence with wearing a consumer-grade step activity monitor, the Fitbit Charge HR, in home-going ischemic stroke patients during the first 90 days after hospital discharge. Secondary objectives were to (1) determine accuracy of step counts of the Fitbit Charge HR compared with a manual tally; (2) calculate correlations between the Fitbit step counts and the mobility performance scores at discharge and 30 days after stroke; (3) determine variability and change in weekly step counts over 90 days; and (4) evaluate patient experience with using the Fitbit Charge HR poststroke.
A total of 15 participants with recent mild ischemic stroke wore a Fitbit Charge HR for 90 days after discharge and completed 3 mobility performance tests from the National Institutes of Health Toolbox at discharge and Day 30: (1) Standing Balance Test, (2) 2-Minute Walk Endurance Test, and (3) 4-Meter Walk Gait Speed Test. Accuracy of step activity monitors was assessed by calculating differences in steps recorded on the step activity monitor and a manual tally during 2-minute walk tests.
Participants had a mean age of 54 years and a median modified Rankin scale score of 1. Mean daily adherence with step activity monitor use was 83.6%. Mean daily step count in the first week after discharge was 4376. Daily step counts increased slightly during the first 30 days after discharge (average increase of 52.5 steps/day; 95% CI 32.2-71.8) and remained stable during the 30-90 day period after discharge. Mean step count difference between step activity monitor and manual tally was -4.8 steps (-1.8%). Intraclass correlation coefficients for step counts and 2-minute walk, standing balance, and 4-meter gait speed at discharge were 0.41 (95% CI -0.14 to 0.75), -0.12 (95% CI -0.67 to 0.64), and 0.17 (95% CI -0.46 to 0.66), respectively. Values were similarly poor at 30 days.
The use of consumer-grade Fitbit Charge HR in patients with recent mild stroke is feasible with reasonable adherence and accuracy. There was poor correlation between step counts and gait speed, balance, and endurance. Further research is needed to evaluate the association between step counts and other outcomes relevant to patients, including patient-reported outcomes and measures of physical function.
在真实环境中使用计步器连续跟踪日常活动有许多潜在用途。然而，在中风患者中，其可行性、准确性以及与性能测量的相关性尚未得到很好的证实。
主要研究目的是确定在出院后 90 天内，居家缺血性中风患者佩戴消费级计步器 Fitbit Charge HR 的依从性。次要目的是：(1)确定 Fitbit Charge HR 的计步准确性与手动计数的差异；(2)计算 Fitbit 计步与出院时和中风后 30 天的移动性能评分之间的相关性；(3)确定 90 天内每周计步数的变化和差异；(4)评估中风后患者使用 Fitbit Charge HR 的体验。
共 15 名近期轻度缺血性中风患者出院后佩戴 Fitbit Charge HR 90 天，并在出院和第 30 天完成了国家卫生研究院工具包中的 3 项移动性能测试：(1)站立平衡测试；(2)2 分钟步行耐力测试；(3)4 米步行速度测试。通过计算在 2 分钟步行测试期间计步器和手动计数记录的步数之间的差异来评估计步器的准确性。
参与者的平均年龄为 54 岁，中位改良 Rankin 量表评分为 1 分。平均每日的计步器使用率为 83.6%。出院后第一周的平均每日步数为 4376 步。出院后 30 天内，每日步数略有增加(平均每天增加 52.5 步；95%CI 32.2-71.8)，出院后 30-90 天期间保持稳定。计步器与手动计数之间的平均步数差异为-4.8 步(-1.8%)。出院时，计步与 2 分钟步行、站立平衡和 4 米步态速度之间的组内相关系数分别为 0.41(95%CI-0.14 至 0.75)、-0.12(95%CI-0.67 至 0.64)和 0.17(95%CI-0.46 至 0.66)。30 天时的数值也同样较差。
在近期轻度中风患者中使用消费级 Fitbit Charge HR 是可行的，具有合理的依从性和准确性。计步与步态速度、平衡和耐力之间相关性较差。需要进一步研究以评估计步与其他与患者相关的结果之间的关联，包括患者报告的结果和身体功能的测量。
