title: Using wireless technology in clinical practice: does feedback of daily walking activity improve walking outcomes of individuals receiving rehabilitation post-stroke? Study protocol for a randomized controlled trial.
abstract: BACKGROUND
  Regaining independent ambulation is the top priority for individuals recovering from stroke. Thus, physical rehabilitation post-stroke should focus on improving walking function and endurance. However, the amount of walking completed by individuals with stroke attending rehabilitation is far below that required for independent community ambulation. There has been increased interest in accelerometer-based monitoring of walking post-stroke. Walking monitoring could be integrated within the goal-setting process for those with ambulation goals in rehabilitation. The feedback from these devices can be downloaded to a computer to produce reports. The purpose of this study is to determine the effect of accelerometer-based feedback of daily walking activity during rehabilitation on the frequency and duration of walking post-stroke.
  
  
  METHODS
  Participants will be randomly assigned to one of two groups: feedback or no feedback. Participants will wear accelerometers daily during in- and out-patient rehabilitation and, for participants in the feedback group, the participants' treating physiotherapist will receive regular reports of walking activity. The primary outcome measures are the amount of daily walking completed, as measured using the accelerometers, and spatio-temporal characteristics of walking (e.g. walking speed). We will also examine goal attainment, satisfaction with progress towards goals, stroke self-efficacy, and community-integration.
  
  
  CONCLUSIONS
  Increased walking activity during rehabilitation is expected to improve walking function and community re-integration following discharge. In addition, a focus on altering walking behaviour within the rehabilitation setting may lead to altered behaviour and increased activity patterns after discharge.
  
  
  BACKGROUND
  ClinicalTrials.gov NCT01521234.
authors.affiliation: Balance Mobility and Falls Clinic and Mobility Research Team, Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada. avril.mansfield@uhn.ca
authors.forename: Avril
authors.initials: A
authors.lastname: Mansfield
authors.forename: Jennifer S
authors.initials: JS
authors.lastname: Wong
authors.forename: Mark
authors.initials: M
authors.lastname: Bayley
authors.forename: Lou
authors.initials: L
authors.lastname: Biasin
authors.forename: Dina
authors.initials: D
authors.lastname: Brooks
authors.forename: Karen
authors.initials: K
authors.lastname: Brunton
authors.forename: Jo-Anne
authors.initials: JA
authors.lastname: Howe
authors.forename: Elizabeth L
authors.initials: EL
authors.lastname: Inness
authors.forename: Simon
authors.initials: S
authors.lastname: Jones
authors.forename: Jackie
authors.initials: J
authors.lastname: Lymburner
authors.forename: Ramona
authors.initials: R
authors.lastname: Mileris
authors.forename: William E
authors.initials: WE
authors.lastname: McIlroy
mesh_terms: D000203:Activities of Daily Living; D015331:Cohort Studies; D005081:Exercise Therapy / Q000379:methods*; D005246:Feedback; D005260:Female; D020233:Gait Disorders, Neurologic / Q000209:etiology / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D009042:Motivation; D020127:Recovery of Function; D016037:Single-Blind Method; D020521:Stroke / Q000150:complications; D013997:Time Factors; D016896:Treatment Outcome; D016138:Walking / Q000502:physiology*; D059015:Wireless Technology