Understanding preferences of stroke survivors for feedback provision about functional movement behavior from wearable sensors: a mixed-methods study.

Autor:	Demers M; University of Montreal., Cain A; University of California, Los Angeles., Bishop L; University of California, Los Angeles., Gunby T; University of California, Los Angeles., Rowe JB; Flint Rehabilitation Devices (United States)., Zondervan D; Flint Rehabilitation Devices (United States)., Winstein CJ; University of California, Los Angeles.
Jazyk:	angličtina
Zdroj:	Research square [Res Sq] 2023 Apr 13. Date of Electronic Publication: 2023 Apr 13.
DOI:	10.21203/rs.3.rs-2789807/v1
Abstrakt:	Background: In stroke rehabilitation, wearable technology can be used as an intervention modality by providing timely, meaningful feedback on motor performance. Stroke survivors' preferences may offer a unique perspective on what metrics are intuitive, actionable, and meaningful to change behavior. However, few studies have identified feedback preferences from stroke survivors. This project aims to determine stroke survivors' satisfaction with feedback from wearable sensors (both mobility and arm/hand use) and to identify preferences for feedback type and delivery schedule. Methods: A sample of 30 chronic stroke survivors wore a multi-sensor system in the natural environment over a 1-week monitoring period. The sensor system captured time in active movement of each arm, arm use ratio, step counts and stance time symmetry. Using the data from the monitoring period, participants were presented with a movement report with visual displays of quantitative and qualitative feedback. A survey and qualitative interview were used to assess ease of understanding, actionability and components of feedback that users found most meaningful to drive lasting behavior change. Results: Arm/hand use and mobility sensor-derived feedback metrics were easy to understand and actionable. The preferred metric to encourage arm/hand use was the hourly arm use bar plot, and similarly the preferred metric to encourage mobility was the hourly steps bar plot, which were each ranked as top choice by 40% of participants. Participants perceived that quantitative (i.e., step counts) and qualitative (i.e., stance time symmetry) mobility metrics provided complementary information. Three main themes emerged from the qualitative analysis: 1) Motivation for behavior change, 2) Real-time feedback based on individual goals, and 3) Value of experienced clinicians for prescription and accountability. Participants stressed the importance of having feedback tailored to their own personalized goals and receiving guidance from clinicians on strategies to progress and increase functional movement behavior in the unsupervised home and community setting. Conclusion: The resulting technology has the potential to integrate engineering and personalized rehabilitation to maximize participation in meaningful life activities outside clinical settings in a less structured environment-one where stroke survivors live their lives. Competing Interests: Competing interests: CJW is a member of the data safety and monitoring board for Enspire DBS Therapy, Inc (DBS is Deep Brain Stimulation) and receives an honorarium for her services. She is a member of the external advisory board for MicroTransponder, Inc. and receives payment for her consulting. She is Editor of the 6th edition of Motor Control and Learning, published by Human Kinetics, Inc and receives royalty payments. She is an Editor for the 2nd Edition of Stroke Recovery and Rehabilitation, published by DemosMedical Publishers and receives royalty payments. JBR is a full-time employee of Flint Rehabilitation Devices, LLC. DZ is a full-time employee and co-owner of Flint Rehabilitation Devices, LLC.
Databáze:	MEDLINE
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