Ecological Momentary Assessment of Real-World Functional Behaviors in Individuals With Stroke: A Longitudinal Observational Study.

Autor:	Bui Q; Division of Biostatistics, Washington University School of Medicine, St Louis, Missouri., Kaufman KJ; Center for Rehabilitation Outcomes Research, Shirley Ryan AbilityLab, Chicago, Illinois., Pham V; Department of Psychiatry, Washington University School of Medicine, St Louis, Missouri., Lenze EJ; Department of Psychiatry, Washington University School of Medicine, St Louis, Missouri., Lee JM; Department of Neurology, Washington University School of Medicine, St Louis, Missouri., Mohr DC; Center for Behavioral Intervention Technologies, Northwestern University Feinberg School of Medicine, Chicago, Illinois; Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois., Fong MWM; Department of Neurology, Washington University School of Medicine, St Louis, Missouri; Department of Physical Medicine and Rehabilitation, Northwestern University Feinberg School of Medicine, Chicago, Illinois; Psychology and Patient Family Counseling, Shirley Ryan AbilityLab, Chicago, Illinois., Metts CL; Department of Pathology and Laboratory Medicine, Medical University of South Carolina, Charleston, South Carolina., Tomazin SE; Center for Rehabilitation Outcomes Research, Shirley Ryan AbilityLab, Chicago, Illinois., Wong AWK; Center for Rehabilitation Outcomes Research, Shirley Ryan AbilityLab, Chicago, Illinois; Department of Physical Medicine and Rehabilitation, Northwestern University Feinberg School of Medicine, Chicago, Illinois; Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States. Electronic address: wwong@sralab.org.
Jazyk:	angličtina
Zdroj:	Archives of physical medicine and rehabilitation [Arch Phys Med Rehabil] 2022 Jul; Vol. 103 (7), pp. 1327-1337. Date of Electronic Publication: 2022 Mar 09.
DOI:	10.1016/j.apmr.2022.02.011
Abstrakt:	Objective: To validate and characterize real-world functional behaviors in individuals after stroke. Design: Longitudinal observational study using ecological momentary assessment (EMA) as a real-time assessment of functional behaviors in natural contexts. Wilcoxon rank-sum tests, Fisher exact tests, and Spearman correlations were used to analyze data. Setting: Community. Participants: Individuals with mild to moderate stroke (N=212). Interventions: Not applicable. Main Outcome Measures: Individuals were assessed 5 times daily for 14 days with EMA surveys to determine what, with whom, and where individuals were doing activities and appraise mental, somatic, and cognitive symptoms. Individuals also completed standardized assessments during laboratory visits, including Lawton Instrumental Activities of Daily Living Scale, Activity Card Sort, Patient-Reported Outcome Measurement Information System, and Quality of Life in Neurological Disorders. Results: Most individuals (median age, 60 years; 55% male) were ischemic stroke (90%) and had mild stroke severity (median National Institutes of Health Stroke Scale, 2). A total of 14,140 EMA surveys were analyzed. Individuals were home 78% of the time; primarily participated in passive, unproductive activities (27%), especially watching television and resting; and participated least in physical activities (4%). EMA was sensitive to indicators of poststroke disability; unemployed individuals reported fewer vocational activities but more activities of daily living (ADL) and passive activities than employed counterparts. Users of mobility devices and individuals with cognitive problems spent significantly less time on vocational activities and more on ADL than nonusers and those without cognitive problems. Our data supported the validity of EMA methods in stroke, with small to moderate correlations of EMA with in-laboratory measures of daily functioning (r=-0.30 to 0.35, P<.05) and very large correlations between EMA and in-laboratory measures of symptoms, especially those measuring same constructs (r=-0.64 to 0.79, P<.0001). Conclusions: Our findings reveal that EMA tracked poststroke functioning precisely. EMA may be beneficial in examining poststroke functional recovery, in monitoring patients for home-based interventions, and for longitudinal research. (Copyright © 2022 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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