A Novel Approach to Ambulatory Monitoring: Investigation Into the Quantity and Control of Everyday Walking in Patients With Subacute Stroke
Open accessAbstract
Background. Promoting whole body activities, such as walking, can help improve recovery after stroke. However, little information exists regarding the characteristics of daily walking in patients enrolled in rehabilitation poststroke. The objectives of this study were to: (1) examine the quantity of walking and duration of individual bouts of walking during an inpatient day, (2) compare standard laboratory symmetry measures with measures of symmetry captured throughout the day, and (3) investigate the association between quantity of walking and indices of stroke severity. Methods. The study examined ambulatory activity among 16 inpatients with subacute stroke who were bilaterally instrumented with a wireless accelerometer above the ankle for approximately 8 continuous hours. Results. On average, patients demonstrated 47.5 minutes (standard deviation [SD] = 26.6 minutes) of total walking activity and walking bout durations of 54.4 s (SD = 21.5 s). A statistically significant association was found between the number of walking bouts to total walking time ( r = .76; P = .006) and laboratory gait speed ( r = .51; P = .045) and between laboratory gait speed and balance impairment ( r = .60; P = .013). Also, a significant increase in gait asymmetry was observed during day-long measurement compared with the standard laboratory-based assessment ( P = .006). Conclusions. Rather modest amounts of daily walking were found for these ambulatory inpatients, consistent with previous reports about patients after stroke. Bouts of walking were short in duration, and the gait was more asymmetrical, compared with a standard gait assessment. Unobtrusive monitoring of daily walking exposes the characteristics and temporal qualities of poststroke ambulation.
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In one study, walking activity measured with ankle accelerometers in hospital showed low correlation with stroke severity.
“In one study, the walking activity measured with ankle accelerometers in hospital showed low correlation with stroke severity, but interestingly, a greater level of asymmetry was detected for individuals with stroke during their daily walking at hospital compared to laboratory gait analysis [61].”
From Wearable sensors for clinical applications in epilepsy, Parkinson’s disease, and stroke: A mixed-methods systematic review (2018) · cites this paper as [61]
A greater level of asymmetry was detected for individuals with stroke during daily walking at hospital compared to laboratory gait analysis.
“In one study, the walking activity measured with ankle accelerometers in hospital showed low correlation with stroke severity, but interestingly, a greater level of asymmetry was detected for individuals with stroke during their daily walking at hospital compared to laboratory gait analysis [61].”
From Wearable sensors for clinical applications in epilepsy, Parkinson’s disease, and stroke: A mixed-methods systematic review (2018) · cites this paper as [61]
Prajapati et al showed that a system using two wireless accelerometers placed on each leg was able to monitor the quantity, symmetry and major biomechanical characteristics of walking in stroke survivors.
“Results showed that the system was able to monitor the quantity, symmetry and major biomechanical characteristics of walking.”
From A review of wearable sensors and systems with application in rehabilitation (2012) · cites this paper as [108]
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- Authors
- Prajapati, S. K., Gage, W. H., Brooks, D., Black, S. E., & McIlroy, W. E.
- Affiliations
- University of Toronto (CA)
- York University (CA)
- Sunnybrook Health Science Centre (CA)
- Corresponding author
- McIlroy, William E.
- Venue
- Neurorehabilitation and Neural Repair
- Publisher
- SAGE Publications
- Published
- 2010-09-09
- Volume
- 25
- Issue
- 1
- Pages
- 6-14
- ISSN
- 0888-4390 (ISSN-L)
- 1545-9683
- 1552-6844
- OpenAlex
- W2100242142
- Cited by
- 86
- References
- 21
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 3 · 2023: 2 · 2022: 6 · 2021: 7 · 2020: 6 · 2019: 6 · 2018: 12 · 2017: 4 · 2016: 6 · 2015: 6 · 2014: 10 · 2013: 5 · 2012: 7
- FWCI
- 5.32
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Neurorehabilitation and neural repair (publishedVersion)
- PubMed (publishedVersion)
- Funders
- McMaster University
- Toronto Rehabilitation Institute
- Canadian Institutes of Health Research (323492-06)
- Topics
- Health Sciences › Medicine › Rehabilitation › Stroke Rehabilitation and Recovery
- Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Balance, Gait, and Falls Prevention
- Health Sciences › Medicine › Physiology › Physical Activity and Health
- Keywords
- stroke rehabilitation, gait asymmetry, walking speed, balance disorders, stroke severity, ambulatory activity monitoring, wireless accelerometers, non-intrusive monitoring
- MeSH terms
- Stroke Rehabilitation, Activities of Daily Living, Adult, Aged, Female, Gait, Humans, Kinetocardiography, Functional Laterality, Male, Middle Aged, Severity of Illness Index, Reproducibility of Results, Walking, Monitoring, Ambulatory, Stroke, Computers, Handheld
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