JMIR Publications

ABSTRACT

Background:

Recovery from a stroke often leads to a decline in physical condition. This deconditioning can be countered by sustaining appropriate activity levels. Activities that occur outside of scheduled programs, often overlooked, are critical in this context. Wearable technology, such as smart clothing, provides a means to monitor these activities.

Objective:

This study aimed to observe activity levels in stroke patients during the subacute phase, focusing on both scheduled training sessions and other non-training times in an inpatient rehabilitation environment. A smart clothing system is used to simultaneously measure heart rate and acceleration, offering insights into both the amount and intensity of the physical activity.

Methods:

In this preliminary cohort study, 11 individuals undergoing subacute stroke rehabilitation were enrolled. The 48-hour continuous measurement system, deployed at admission and reassessed 4 weeks later, monitored accelerometry data for physical activity (quantified with moving standard deviation of acceleration (MSDA)) and heart rate for intensity (quantified with percent heart rate reserve (%HRR)). The study explored factors such as differences in activity during training and non-training periods, correlations with activities of daily living (ADL) and age, and changes observed after 4 weeks.

Results:

Findings revealed a significant increase in the daily total MSDA after the 4-week program, with averaged %HRR remaining consistent. Physical activity during training positively correlated with ADL levels both at admission (ρ=0.86, p<0.001) and 4 weeks post-admission (ρ=0.96, p<0.001), whereas the correlation between age and MSDA was not significant during training periods at admission (ρ=-0.41, p=0.212) or 4 weeks post-admission (ρ=-0.25, p=0.450). Conversely, non-training activity showed a negative correlation with age, with significant negative correlations with age at admission (ρ=-0.82, p=0.002) and 4 weeks post-admission (ρ=-0.73, p=0.011).

Conclusions:

Inpatient rehabilitation activity levels correlated with ADL performance, primarily driven by training sessions. The study also revealed a negative correlation between non-training activities and age, underlining the importance of customized care, especially for older patients.