Division of Biokinesiology and Physical Therapy, Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, CA, USA.
School of Rehabilitation, University of Montreal, 7077 Ave. du Parc, Montreal, QC, H3N 1X7, Canada.
J Neuroeng Rehabil. 2023 Nov 1;20(1):146. doi: 10.1186/s12984-023-01271-z.
In stroke rehabilitation, wearable technology can be used as an intervention modality by providing timely, meaningful feedback on motor performance. Stroke survivors' preferences may offer a unique perspective on what metrics are intuitive, actionable, and meaningful to change behavior. However, few studies have identified feedback preferences from stroke survivors. This project aims to determine the ease of understanding and movement encouragement of feedback based on wearable sensor data (both arm/hand use and mobility) for stroke survivors and to identify preferences for feedback metrics (mode, content, frequency, and timing).
A sample of 30 chronic stroke survivors wore a multi-sensor system in the natural environment over a 1-week monitoring period. The sensor system captured time in active movement of each arm, arm use ratio, step counts and stance time symmetry. Using the data from the monitoring period, participants were presented with a movement report with visual displays of feedback about arm/hand use, step counts and gait symmetry. A survey and qualitative interview were used to assess ease of understanding, actionability and components of feedback that users found most meaningful to drive lasting behavior change.
Arm/hand use and mobility sensor-derived feedback metrics were easy to understand and actionable. The preferred metric to encourage arm/hand use was the hourly arm use bar plot, and similarly the preferred metric to encourage mobility was the hourly steps bar plot, which were each ranked as top choice by 40% of participants. Participants perceived that quantitative (i.e., step counts) and qualitative (i.e., stance time symmetry) mobility metrics provided complementary information. Three main themes emerged from the qualitative analysis: (1) Motivation for behavior change, (2) Real-time feedback based on individual goals, and (3) Value of experienced clinicians for prescription and accountability. Participants stressed the importance of having feedback tailored to their own personalized goals and receiving guidance from clinicians on strategies to progress and increase functional movement behavior in the unsupervised home and community setting.
The resulting technology has the potential to integrate engineering and personalized rehabilitation to maximize participation in meaningful life activities outside clinical settings in a less structured environment.
在中风康复中，可穿戴技术可以作为一种干预方式，通过提供关于运动表现的及时、有意义的反馈。中风幸存者的偏好可能为确定哪些指标直观、可操作且对改变行为有意义提供独特的视角。然而，很少有研究确定中风幸存者的反馈偏好。本项目旨在确定基于可穿戴传感器数据（手臂/手部运动和移动性）的反馈对中风幸存者的易理解性和运动激励程度，并确定反馈指标（模式、内容、频率和时间）的偏好。
在为期一周的监测期间，30 名慢性中风幸存者佩戴多传感器系统在自然环境中。传感器系统记录每个手臂的主动运动时间、手臂使用率、步数和站立时间对称性。使用监测期间的数据，参与者可以查看带有手臂/手部使用、步数和步态对称性的反馈的可视化显示的运动报告。使用调查和定性访谈评估易理解性、可操作性以及用户认为对驱动持久行为改变最有意义的反馈组成部分。
手臂/手部使用和移动性传感器衍生的反馈指标易于理解和操作。鼓励手臂/手部使用的首选指标是每小时手臂使用条形图，同样鼓励移动性的首选指标是每小时步数条形图，这两个指标均被 40%的参与者评为首选。参与者认为定量（即步数）和定性（即站立时间对称性）移动性指标提供了互补信息。定性分析中出现了三个主要主题：（1）行为改变的动机，（2）基于个人目标的实时反馈，（3）经验丰富的临床医生在处方和问责方面的价值。参与者强调了根据自己的个性化目标定制反馈以及从临床医生那里获得在非监督家庭和社区环境中进步和增加功能性运动行为的策略的重要性。
这项技术有可能整合工程和个性化康复，以最大限度地参与临床环境之外有意义的生活活动，在结构较少的环境中。
