Sirract

Dorsch, Andrew; Thomas, Seth; Xu, Xiaoyu; Kaiser, William J.; Dobkin, Bruce H.

doi:10.1177/1545968314550369

Cited by 73 publications

(64 citation statements)

References 23 publications

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“…Two trials to increase walking activity through monitoring and feedback in rehabilitation of stroke patients have recently been published [29, 30]. In contrast to our study, no significant increase in walking time in the intervention group was reported.…”

Section: Discussioncontrasting

confidence: 99%

Promoting Activity in Geriatric Rehabilitation: A Randomized Controlled Trial of Accelerometry

et al. 2016

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BackgroundLow activity levels in inpatient rehabilitation are associated with adverse outcomes. The study aimed to test whether activity levels can be increased by the provision of monitored activity data to patients and clinicians in the context of explicit goal setting.MethodsA randomized controlled trial in three sites in Australia included 255 inpatients aged 60 and older who had a rehabilitation goal to become ambulant. The primary outcome was patients’ walking time measured by accelerometers during the rehabilitation admission. Walking times from accelerometry were made available daily to treating therapists and intervention participants to motivate patients to improve incidental activity levels and reach set goals. For the control group, ‘usual care’ was followed, including the setting of mobility goals; however, for this group, neither staff nor patients received data on walking times to aid the setting of daily walking time targets.ResultsThe median daily walking time in the intervention group increased from 10.3 minutes at baseline to 32.1 minutes at day 28, compared with an increase from 9.5 to 26.5 minutes per day in the control group. Subjects in the intervention group had significantly higher non-therapy walking time by about 7 minutes [mean (95% CI): 24.6 (21.7, 27.4)] compared to those in the control group [mean(95% CI): 17.3 (14.4, 20.3)] (p = 0.001).ConclusionsDaily feedback to patients and therapists using an accelerometer increased walking times during rehabilitation admissions. The results of this study suggest objective monitoring of activity levels could provide clinicians with information on clinically important, mobility-related activities to assist goal setting.Trial RegistrationAustralian New Zealand Clinical Trials Registry ACTRN12611000034932 http://www.ANZCTR.org.au/

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Section: Discussioncontrasting

confidence: 99%

Promoting Activity in Geriatric Rehabilitation: A Randomized Controlled Trial of Accelerometry

et al. 2016

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“…43,44 Internet-connected mHealth tools include mobile telecommunications between medical professionals and their patients. Smartphones, for example, enable text messaging, conference calls with video, instructional video recordings, and visual and spoken feedback between patients and investigators, therapists or a social support group.…”

Section: Solutionsmentioning

confidence: 99%

“…In addition, wearable sensors with algorithms that recognize activity patterns can identify the type, quantity and aspects of quality of movements during skills practice and daily activities. 43,44 To date, body sensors have been underutilized for health care purposes, but they are likely to become ubiquitous. 45 …”

Section: Solutionsmentioning

confidence: 99%

“…We successfully tested a key component of a RIoT, a remote motion sensor system for walking and cycling that includes a triaxial accelerometer and gyroscope worn on each ankle (see Figure). 44 In this randomized clinical trial called SIRRACT, 140 inpatient stroke rehabilitation subjects from 16 sites on four continents were given feedback about 10-m walking speed twice a week or enhanced feedback about daily walking speeds, distance, and duration of bouts from sensor-derived data. 72 For our goal of increasing self-managed practice and fitness after stroke, we are also testing the user friendliness of a bundle of potential mHealth devices, including a heart rate monitor, an instrumented resistance exercise band (see Figure), a pedaling ergometer for bed and floor, and a small box with sensor that makes a virtual reality transformation of reach-to-pinch or grasp practice tasks.…”

Section: Solutionsmentioning

confidence: 99%

“…In the SIRRACT trial, this method enabled daily data collections that revealed that the average amount of daily walking practice during inpatient rehabilitation for stroke across 16 facilities was only 17 minutes and decreased as patients achieved walking speeds of only 0.8 m/s. 44 …”

Section: Solutionsmentioning

confidence: 99%

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A Rehabilitation-Internet-of-Things in the Home to Augment Motor Skills and Exercise Training

Dobkin

2016

Neurorehabil Neural Repair

Self Cite

111

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Although motor learning theory has led to evidence-based practices, few trials have revealed the superiority of one theory-based therapy over another after stroke. Nor have improvements in skills been as clinically robust as one might hope. We review some possible explanations, then potential technology-enabled solutions. Over the Internet, the type, quantity, and quality of practice and exercise in the home and community can be monitored remotely and feedback provided to optimize training frequency, intensity, and progression at home. A theory-driven foundation of synergistic interventions for walking, reaching and grasping, strengthening, and fitness could be provided by a bundle of home-based Rehabilitation Internet-of-Things (RIoT) devices. A RIoT might include wearable, activity-recognition sensors and instrumented rehabilitation devices with radio transmission to a smartphone or tablet to continuously measure repetitions, speed, accuracy, forces, and temporal spatial features of movement. Using telerehabilitation resources, a therapist would interpret the data and provide behavioral training for self-management via goal setting and instruction to increase compliance and long-term carryover. On top of this user-friendly, safe, and conceptually sound foundation to support more opportunity for practice, experimental interventions could be tested or additions and replacements made, perhaps drawing from virtual reality and gaming programs or robots. RIoT devices continuously measure the actual amount of quality practice; improvements and plateaus over time in strength, fitness, and skills; and activity and participation in home and community settings. Investigators may gain more control over some of the confounders of their trials and patients will have access to inexpensive therapies.

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Activity monitors for increasing physical activity in adult stroke survivors

Lynch

Jones

Simpson

et al. 2018

Cochrane Database of Systematic Reviews

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Only four small RCTs with 274 participants (three in inpatient rehabilitation and one in the community) have examined the efficacy of activity monitors for increasing physical activity after stroke. Although these studies showed activity monitors could be incorporated into practice, there is currently not enough evidence to support the use of activity monitors to increase physical activity after stroke.

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Sirract

Cited by 73 publications

References 23 publications

Promoting Activity in Geriatric Rehabilitation: A Randomized Controlled Trial of Accelerometry

Promoting Activity in Geriatric Rehabilitation: A Randomized Controlled Trial of Accelerometry

A Rehabilitation-Internet-of-Things in the Home to Augment Motor Skills and Exercise Training

Activity monitors for increasing physical activity in adult stroke survivors

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