探讨临床步行测试与脑卒中和脊髓损伤幸存者8个月的基于惯性测量单元(IMU)的真实世界活动追踪的关系。

Q2 Medicine
Andreas Hug, Tamara Spingler, Viola Pleines, Laura Heutehaus, Mircea Ariel Schoenfeld, Björn Hauptmann, Jürgen Moosburger, Roland Thietje, Oliver Pade, Wolfgang Rössy, Klaus Stecker, Jochen Klucken, Tiziana Daniel, Michel Wensing, Cornelia Hensel, Rüdiger Rupp, Norbert Weidner
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引用次数: 0

摘要

背景:活动能力对感觉运动障碍患者的参与和生活质量至关重要,但在现实世界中,关于其过程的科学证据有限。所谓的测量身体活动的可穿戴设备可能有助于克服这种知识差距,允许日常测量活动。本研究的目的是研究临床步行测试和基于惯性测量单元的社区卒中和脊髓损伤(SCI)幸存者活动追踪之间的关系。方法:在单个观察时间点,在健康受试者和脑卒中或脊髓损伤幸存者(n=57)中,以标准化的方式评估活动追踪器的精度。随后进行了一项多中心观察性队列研究(n=116名参与者),在该研究中,在急性住院康复出院后立即评估中风和脊髓损伤幸存者的活动能力超过8个月。使用活动跟踪器记录社区环境中每天覆盖的距离。既定的步行测试-包括10米步行测试(10MWT)和计时行走测试(TUG)-在基线进行,并在4个月和8个月的随访中进行。使用回归模型分析离散研究访问(基线、出院后4个月(中期)和8个月(最终))时门诊每日距离与10MWT或TUG表现之间的关系。结果:运动追踪器在测量标准化跑道覆盖距离时的精度随运动类型的不同而不同。在手动轮椅使用者中获得了最高的精度(与零的偏差:-1.5±1.03% (p=0.15)),而在SCI和显著步行障碍的参与者中观察到的精度最低(-14.6±2%)。结论:对于SCI和中风幸存者,特别是中速步行者,在现实世界环境中的活动跟踪提供了比临床步行测试更有价值的见解。改善活动能力的康复干预的临床研究应考虑现实生活中的日常距离作为关键终点。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Exploring the relationship of clinical walking tests with 8-months inertial measurement unit (IMU)-based real world mobility tracking in stroke and spinal cord injury survivors.

Background: Mobility is crucial for participation and quality of life in individuals with sensorimotor impairments, yet scientific evidence on its course in real-world settings is limited. So-called wearables for measuring physical activity might help to overcome this knowledge gap allowing daily measurements of mobility. The aim of the present study is to examine the relationship between clinical walking tests and inertial measurement unit-based mobility tracking in the community setting of stroke and spinal cord injury (SCI) survivors.

Methods: At a single observational time point, the precision of the activity tracker was evaluated in a standardized parcours in healthy subjects and stroke or SCI survivors (n=57). This was followed by a multicenter observational cohort study (n=116 participants), in which the mobility of stroke and SCI survivors was assessed over 8 months immediately after discharge from acute inpatient rehabilitation. Daily distances covered in the community setting were recorded using the activity tracker. Established walking tests-including the 10-meter walk test (10MWT) and the timed up and go test (TUG)-were conducted at baseline, as well as at 4- and 8-month follow up visits. The relationship between daily distances in the ambulatory setting and 10MWT or TUG performance at discrete study visits (baseline, 4 months (midterm), and 8 months (final) after hospital discharge) was analyzed using regression models.

Results: The precision of the activity tracker in measuring covered distance in a standardized parcours varied by mobility type. The highest precision was achieved in manual wheelchair users (deviation from zero: -1.5±1.03% (p=0.15) while the least favorable precision was observed in participants with SCI and significant walking impairment (-14.6±2% (p<0.001). The widely used 10MWT speed showed a relationship with the ambulatory daily distance. The regression coefficients [m/(1m/s)] were: 874 (95% CI: 578-1171) at baseline (p<0.001), 895 (95% CI: 614-1176) at midterm (p<0.001), and 824 (95% CI: 537-1112) at the final visit (p<0.001). Interestingly, in the category of good walkers with the most favorable walking speeds the daily covered distance unmasked distinct subgroups with shorter and longer daily distances.

Conclusions: For SCI and stroke survivors, especially medium to fast walkers, activity tracking in real-world settings adds valuable insight beyond clinical walking tests. Clinical studies on rehabilitative interventions for mobility improvement should consider real-life daily distance as a key endpoint.

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