Otaka Eri, Oguchi Kazuyo, Yagihashi Kei, Hoshino Takashi, Munakata Sachiko, Hayakawa Atsuko, Otaka Yohei
Department of Rehabilitation Medicine, Kariya Toyota General Hospital, Kariya, Japan.
Assistive Robot Center, National Center for Geriatrics and Gerontology, Obu, Japan.
Front Rehabil Sci. 2023 Mar 22;4:1050638. doi: 10.3389/fresc.2023.1050638. eCollection 2023.
Wearable devices for the quantification of walking have recently been adopted for gait rehabilitation. To apply this method in subacute rehabilitation settings, this approach must be effective in these populations and implemented as a feasible method in terms of adherence and safety, especially the risk of falling. This study aimed to investigate the feasibility and efficacy of an activity monitoring approach in subacute rehabilitation using a commercially available pedometer validated with slow walking. This randomized controlled study with blinded assessors recruited 29 patients admitted to a rehabilitation ward. The participants were randomly assigned to either the feedback (intervention) or the no-feedback (control) group. Participants in both groups received at least 120 min of therapy sessions every day for 6 or 7 days per week while wearing pedometers on their unaffected ankles from the day they were permitted to walk independently till discharge. Only participants in the feedback group received weekly encouragement and the next goals. The primary outcome was the change in the 6-minute walking distance (Δ6MD). Feasibility (percentage of pedometer data acquisition days in the total observational period and the number of falls) and other efficacy outcomes (step counts, gait speed, 30-seconds chair stand test, Berg Balance Scale, and Timed Up and Go Test) were also evaluated. Regarding feasibility outcomes, the data acquisition rate was 94.1% and the number of falls during the observation period was one in the feedback group. Regarding efficacy outcomes, Δ6MD was not significantly greater in the feedback group [mean (standard deviation): 79.1 (51.7) m] than in the no-feedback group [86.1 (65.4) m] (= 0.774) and the other five secondary outcomes showed no between-group difference. Considering the large number of steps per day in both groups [6,912 (4,751) and 5,600 (5,108) steps in the feedback and no-feedback group, respectively], the effect of the intended intervention might have been masked by the effect of simply wearing pedometers in the control group. This study revealed that the activity monitoring approach using an ankle-worn pedometer was practical in terms of adherence and safety. Further clinical trials are required to elucidate ways to effectively use wearable devices in subacute rehabilitation.
用于量化步行的可穿戴设备最近已被应用于步态康复。为了在亚急性康复环境中应用这种方法，这种方法必须在这些人群中有效，并且在依从性和安全性方面，特别是跌倒风险方面，作为一种可行的方法来实施。本研究旨在调查在亚急性康复中使用经慢走验证的市售计步器进行活动监测方法的可行性和有效性。这项由盲法评估者参与的随机对照研究招募了29名入住康复病房的患者。参与者被随机分配到反馈（干预）组或无反馈（对照）组。两组参与者每周6或7天，每天至少接受120分钟的治疗，从被允许独立行走之日起至出院期间，在其未受影响的脚踝上佩戴计步器。只有反馈组的参与者每周会得到鼓励和下一个目标。主要结局是6分钟步行距离的变化（Δ6MD）。还评估了可行性（计步器数据采集天数在总观察期内的百分比和跌倒次数）和其他有效性结局（步数、步态速度、30秒椅子站立测试、伯格平衡量表和定时起立行走测试）。关于可行性结局，反馈组的数据采集率为94.1%，观察期内跌倒次数为1次。关于有效性结局，反馈组的Δ6MD [平均值（标准差）：79.1（51.7）米] 并不显著高于无反馈组 [86.1（65.4）米]（= 0.774），其他五个次要结局在组间无差异。考虑到两组每天的步数都很多 [反馈组和无反馈组分别为6,912（4,751）步和5,600（5,108）步]，对照组中仅佩戴计步器的效果可能掩盖了预期干预的效果。本研究表明，使用脚踝佩戴计步器的活动监测方法在依从性和安全性方面是可行的。需要进一步的临床试验来阐明在亚急性康复中有效使用可穿戴设备的方法。
