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How Active Are People With Stroke?: Use of Accelerometers to Assess Physical Activity
Abstract
Background and Purpose— Accelerometers are a unique tool used to objectively measure free-living physical activity, but their reliability for people with stroke has not been established. The primary aim was to assess the day-to-day reliability of these instruments for the paretic and nonparetic hips. The secondary aims were to measure the amount of physical activity with accelerometers that people with stroke undertake in the community and its relationship with walking capacity (6-minute walk test distance). Methods— Forty people with stroke wore one Actical accelerometer on each hip for 3 consecutive days at home and during the 6-minute walk test in the laboratory. The accelerometer measured physical activity using total activity counts per day and energy expenditure (kcal/d). Results— Excellent intraclass correlation coefficients (ICCs) for the activity counts (paretic hip ICC [1,3] =0.95, nonparetic hip ICC [1,3] =0.94) and for the energy expenditure (paretic hip ICC [1,3] =0.95, nonparetic hip ICC [1,3] =0.95) were found across the 3 consecutive days at home. Excellent ICCs were also found between the paretic versus the nonparetic hips for the activity counts (ICC [1,3] =0.98) and for the energy expenditure (ICC [1,3] =0.96). Free-living physical activity was very low and 58% of the participants did not meet recommended physical activity levels. Only moderate correlations ( r =0.6 to 0.73, P <0.001) were found between the 6-minute walk test distance in the laboratory and 3-day physical activity recording at home. Conclusions— The accelerometer was found to be a reliable objective instrument. The use of accelerometers quantified the low level of free-living physical activity of people with stroke.
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“In stroke, the step counts and measures of upper extremity and physical activity were shown to be reliable [48, 49, 52, 56–59]”
From Wearable sensors for clinical applications in epilepsy, Parkinson’s disease, and stroke: A mixed-methods systematic review (2018) · cites this paper as [57]
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“Nevertheless, 17%, respectively 58% of the participants did not achieve the recommended 142 kcal/day [5,11].”
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“Few meet activity guidelines, and time spent sedentary is greater than 80% of the day [7], which is significantly greater than sedentary time of their peers [8, 9].”
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The Use of Pedometers in Stroke Survivors: Are They Feasible and How Well Do They Detect Steps?
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“Les patients ont les capacités nécessaires pour pratiquer une activité physique régulière mais celle-ci n’est pas poursuivie en dehors des séances réalisées en présence d’un masseurkinésithérapeute : les limites à l’activité semblent essentiellement comportementales [36].”
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BackgroundA Review on Human Healthcare Internet of Things: A Technical Perspective
Karthick, G. S., & Pankajavalli, P. B. (2020) · SN Computer Science · doi:10.1007/s42979-020-00205-z · Cited by 53
Vahlberg, B. M., Cederholm, T., Lindmark, B., Zetterberg, L., & Hellström, K. (2013) · Journal of Stroke and Cerebrovascular Diseases · doi:10.1016/j.jstrokecerebrovasdis.2013.04.028 · Cited by 52
Identifying Activity Levels and Steps of People With Stroke Using a Novel Shoe-Based Sensor
Fulk, G. D., Edgar, S., Bierwirth, R., Hart, P., Lopez‐Meyer, P., & Sazonov, E. E. (2012) · Neurology Report · doi:10.1097/npt.0b013e318256370c · Cited by 51
Marzolini, S., Tang, A., McIlroy, W. E., OH, P. I., & Brooks, D. (2014) · Journal of Stroke and Cerebrovascular Diseases · doi:10.1016/j.jstrokecerebrovasdis.2014.01.008 · Cited by 50
“Despite this, few stroke survivors exercise regularly.(4,7,8) This may be because structured exercise programs that are aimed at reducing risk of recurrent stroke are not widely available or accessible.”
Is walking endurance associated with activity and participation late after stroke??
Danielsson, A., Willén, C., & Sunnerhagen, K. S. (2011) · Disability and Rehabilitation · doi:10.3109/09638288.2011.560329 · Cited by 50
“The participants showed a large variation in walking endurance on the 6MWT, with a mean distance of just above half of published reference values [5], similar to other reports on communitydwelling stroke subjects [13,21].”
BackgroundResultRenke, M. B., Marcinkowska, A. B., Kujach, S., & Winklewski, P. J. (2022) · Frontiers in Aging Neuroscience · doi:10.3389/fnagi.2022.803332 · Cited by 50
“…et al., 2020; Lehmann et al., 2020) conducted well-controlled exercise programs that lasted 12–19 weeks for 10–40 participants and two studies (Rosano et al., 2010; Espeland et al., 2018) were conducted in much larger groups of subjects for more than 5 years; however, the amount of exercise…”
BackgroundMethodInfluentialPromoting physical activity after stroke via self-management: a feasibility study
Preston, E., Dean, C. M., Ada, L., Stanton, R., Brauer, S., Kuys, S. S., & Waddington, G. S. (2017) · Topics in Stroke Rehabilitation · doi:10.1080/10749357.2017.1304876 · Cited by 49
McDonald, A. D., Sasangohar, F., Jatav, A., & Rao, A. H. (2019) · IISE Transactions on Healthcare Systems Engineering · doi:10.1080/24725579.2019.1583703 · Cited by 55
Zhou, B., Wang, H., Hu, F., Feng, N., Xi, H., Zhang, Z., & Tang, H. (2020) · Computer Methods and Programs in Biomedicine · doi:10.1016/j.cmpb.2020.105486 · Cited by 50
Circuit class therapy for improving mobility after stroke
English, C., & Hillier, S. (2010) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd007513.pub2 · Cited by 50
Alzahrani, M. A., Dean, C. M., & Ada, L. (2011) · Brazilian Journal of Physical Therapy · doi:10.1590/s1413-35552011005000002 · Cited by 48
Fini, N. A., Burge, A. T., Bernhardt, J. A., & Holland, A. E. (2018) · Archives of Physical Medicine and Rehabilitation · doi:10.1016/j.apmr.2018.10.006 · Cited by 48
Marzolini, S., Balitsky, A. K., Jagroop, D., Corbett, D., Brooks, D., Grace, S. L., Lawrence, D., & OH, P. I. (2015) · Journal of Stroke and Cerebrovascular Diseases · doi:10.1016/j.jstrokecerebrovasdis.2015.08.039 · Cited by 47
“97 (1-5) 2 1 I prefer to take care of my health alone 1.”
BackgroundInfluentialPhysical Activity Level Among Stroke Patients Hospitalized in a Rehabilitation Unit
Lacroix, J., Daviet, J., Borel, B., Kammoun, B., Salle, J., & Mandigout, S. (2015) · PM&R · doi:10.1016/j.pmrj.2015.06.011 · Cited by 46
“Our subjects had a mean active energy expenditure of 91 122 kcal versus 142 kcal per day as reported by Rand et al [8].”
BackgroundMethodResultInfluentialGunnes, M., Langhammer, B., Aamot, I., Lydersen, S., Ihle‐Hansen, H., Indredavik, B., Reneflot, K. H., Schroeter, W., & Askim, T. (2018) · Physical Therapy · doi:10.1093/ptj/pzy126 · Cited by 51
Validating Accelerometry as a Measure of Physical Activity and Energy Expenditure in Chronic Stroke
Serra, M. C., Balraj, E., DiSanzo, B. L., Ivey, F. M., Hafer-Macko, C. E., Treuth, M. S., & Ryan, A. S. (2017) · Topics in Stroke Rehabilitation · doi:10.1080/10749357.2016.1183866 · Cited by 46
Tinlin, L., Fini, N. A., Bernhardt, J. A., Lewis, L. K., Olds, T., & English, C. (2017) · International Journal of Rehabilitation Research · doi:10.1097/mrr.0000000000000253 · Cited by 45
Ngueleu, A.-M., Blanchette, A. K., Maltais, D. B., Moffet, H., McFadyen, B. J., Bouyer, L. J., & Batcho, C. S. (2019) · Sensors · doi:10.3390/s19112438 · Cited by 44
Totty, M. S., & Wade, E. (2017) · IEEE Transactions on Biomedical Engineering · doi:10.1109/tbme.2017.2738440 · Cited by 44
Facilitating Stroke Management using Modern Information Technology
Nam, H. S., Park, E., & Heo, J. H. (2013) · Journal of Stroke · doi:10.5853/jos.2013.15.3.135 · Cited by 44
Jackson, S., Mercer, C. B., & Singer, B. (2016) · Disability and Rehabilitation · doi:10.1080/09638288.2016.1258437 · Cited by 42
“tribute to a cycle of increasing activity limitation and deconditioning.[45,51] People experiencing fatigue post-stroke would benefit”
BackgroundDean, S. G., Poltawski, L., Förster, A., Taylor, R. S., Spencer, A. E., James, M. A., Allison, R., Stevens, S., Norris, M., Shepherd, A. I., et al. (2018) · BMJ Open · doi:10.1136/bmjopen-2017-018409 · Cited by 42
“Our objectives were to (1) assess feasibility and acceptability of recruitment (target n=48), randomisation, allocation concealment and outcome assessment blinding; (2) determine retention rates (target of <20% attrition); (3) check ReTrain’s acceptability and feasibility for participants, and refine the trainer manua…”
BackgroundMethodKäll, L. B., Pekna, M., Pekny, M., Blomstrand, C., & Nilsson, M. (2019) · Neurorehabilitation · doi:10.3233/nre-192905 · Cited by 42
“Such mobility impairments commonly also affect patients’ ability to maintain social engagement (Alzahrani et al., 2011; Michael, 2002; Rand et al., 2009).”
BackgroundSullivan, J. E., Espe, L., Kelly, A., Veilbig, L. E., & Kwasny, M. (2014) · Topics in Stroke Rehabilitation · doi:10.1310/tsr2102-101 · Cited by 41
Miklitsch, C., Krewer, C., Freivogel, S., & Steube, D. (2013) · Clinical Rehabilitation · doi:10.1177/0269215513485591 · Cited by 41
Measuring Energy Expenditure After Stroke
Moore, S. A., Hallsworth, K., Bluck, L. J. C., Ford, G. A., Rochester, L., & Trenell, M. I. (2012) · Stroke · doi:10.1161/strokeaha.111.646257 · Cited by 43
Metadata
- Authors
- Rand, D., Eng, J. J., Tang, P.-F., Jeng, J.-S., & Hung, C.
- Affiliations
- University of British Columbia (CA)
- Venue
- Stroke
- Published
- 2009-01
- Volume
- 40
- Issue
- 1
- Pages
- 163-168
- ISSN
- 0039-2499 (ISSN-L)
- 1524-4628
- OpenAlex
- W1966287347
- Cited by
- 325
- References
- 42
- Citations by year
- 2026: 3 · 2025: 5 · 2024: 9 · 2023: 6 · 2022: 18 · 2021: 23 · 2020: 12 · 2019: 23 · 2018: 25 · 2017: 27 · 2016: 22 · 2015: 26 · 2014: 30 · 2013: 26 · 2012: 23
- FWCI
- 16.69
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Stroke (publishedVersion)
- PubMed (publishedVersion)
- Funders
- AstraZeneca
- Heart and Stroke Foundation of Canada
- AstraZeneca Canada
- Canadian Stroke Network
- Michael Smith Health Research BC
- National Science Council
- National Health Research Institutes
- International Collaboration on Repair Discoveries
- Canadian Institutes of Health Research
- Topics
- Health Sciences › Medicine › Rehabilitation › Stroke Rehabilitation and Recovery
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Physical Activity and Health
- Physical Sciences › Computer Science › Computer Vision and Pattern Recognition › Context-Aware Activity Recognition Systems
- Keywords
- physical activity, accelerometer, Actical, reliability statistics, paretic limb, energy expenditure, 6-minute walk test, walking capacity, free-living physical activity, accelerometer validity
- MeSH terms
- Acceleration, Stroke Rehabilitation, Activities of Daily Living, Aged, Aged, 80 and over, Disability Evaluation, Female, Humans, Leg, Male, Middle Aged, Paresis, Physical Fitness, Predictive Value of Tests, Walking, Exercise Tolerance, Recovery of Function, Gait Disorders, Neurologic, Stroke
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