title: Use of Accelerometer-Based Feedback of Walking Activity for Appraising Progress With Walking-Related Goals in Inpatient Stroke Rehabilitation: A Randomized Controlled Trial.
abstract: BACKGROUND
  Regaining independent ambulation is important to those with stroke. Increased walking practice during "down time" in rehabilitation could improve walking function for individuals with stroke.
  
  
  OBJECTIVE
  To determine the effect of providing physiotherapists with accelerometer-based feedback on patient activity and walking-related goals during inpatient stroke rehabilitation.
  
  
  METHODS
  Participants with stroke wore accelerometers around both ankles every weekday during inpatient rehabilitation. Participants were randomly assigned to receive daily feedback about walking activity via their physiotherapists (n = 29) or to receive no feedback (n = 28). Changes in measures of daily walking (walking time, number of steps, average cadence, longest bout duration, and number of "long" walking bouts) and changes in gait control and function assessed in-laboratory were compared between groups.
  
  
  RESULTS
  There was no significant increase in walking time, number of steps, longest bout duration, or number of long walking bouts for the feedback group compared with the control group (P values > .20). However, individuals who received feedback significantly increased cadence of daily walking more than the control group (P = .013). From the in-laboratory gait assessment, individuals who received feedback had a greater increase in walking speed and decrease in step time variability than the control group (P values < .030).
  
  
  CONCLUSIONS
  Feedback did not increase the amount of walking completed by individuals with stroke. However, there was a significant increase in cadence, indicating that intensity of daily walking was greater for those who received feedback than the control group. Additionally, more intense daily walking activity appeared to translate to greater improvements in walking speed.
authors.affiliation: Toronto Rehabilitation Institute-University Health Network, Toronto, Ontario, Canada Heart and Stroke Foundation Canadian Partnership for Stroke Recovery, Toronto, Ontario, Canada University of Toronto, Toronto, Ontario, Canada Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada Avril.Mansfield@uhn.ca.
authors.forename: Avril
authors.initials: A
authors.lastname: Mansfield
authors.affiliation: Toronto Rehabilitation Institute-University Health Network, Toronto, Ontario, Canada University of Toronto, Toronto, Ontario, Canada.
authors.forename: Jennifer S
authors.initials: JS
authors.lastname: Wong
authors.affiliation: Toronto Rehabilitation Institute-University Health Network, Toronto, Ontario, Canada.
authors.forename: Jessica
authors.initials: J
authors.lastname: Bryce
authors.affiliation: Toronto Rehabilitation Institute-University Health Network, Toronto, Ontario, Canada University of Toronto, Toronto, Ontario, Canada.
authors.forename: Karen
authors.initials: K
authors.lastname: Brunton
authors.affiliation: Toronto Rehabilitation Institute-University Health Network, Toronto, Ontario, Canada University of Toronto, Toronto, Ontario, Canada.
authors.forename: Elizabeth L
authors.initials: EL
authors.lastname: Inness
authors.affiliation: Toronto Rehabilitation Institute-University Health Network, Toronto, Ontario, Canada.
authors.forename: Svetlana
authors.initials: S
authors.lastname: Knorr
authors.affiliation: Toronto Rehabilitation Institute-University Health Network, Toronto, Ontario, Canada.
authors.forename: Simon
authors.initials: S
authors.lastname: Jones
authors.affiliation: Toronto Rehabilitation Institute-University Health Network, Toronto, Ontario, Canada Heart and Stroke Foundation Canadian Partnership for Stroke Recovery, Toronto, Ontario, Canada University of Toronto, Toronto, Ontario, Canada.
authors.forename: Babak
authors.initials: B
authors.lastname: Taati
authors.affiliation: Toronto Rehabilitation Institute-University Health Network, Toronto, Ontario, Canada Heart and Stroke Foundation Canadian Partnership for Stroke Recovery, Toronto, Ontario, Canada University of Toronto, Toronto, Ontario, Canada Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada University of Waterloo, Waterloo, Ontario, Canada.
authors.forename: William E
authors.initials: WE
authors.lastname: McIlroy
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D030141:Feedback, Psychological; D005260:Female; D005684:Gait; D006040:Goals; D006801:Humans; D007297:Inpatients; D008297:Male; D008875:Middle Aged; D018670:Monitoring, Ambulatory; D026741:Physical Therapy Modalities; D016037:Single-Blind Method; D000071939:Stroke Rehabilitation; D016896:Treatment Outcome; D016138:Walking; D055815:Young Adult
keywords: goal setting; physical activity; rehabilitation; stroke; technology; walking