Wearable Technology to Increase Activity During Idle-Time Post-Stroke: Feasibility in an Inpatient and At-Home Settings

Research Objectives: Investigate the feasibility of a wearable device system, Souvenir, that cues exercise during patient inactive time in an inpatient rehabilitation (IPR) setting and monitors patient upper extremity (UE) motion within IPR and home settings.

Design: Feasibility study

Setting: IPR and at-home

Participants: First-time stroke survivors were recruited in the acute phase of recovery and followed up with at home between two and six months post-IPR discharge.

Interventions: Participants wore wearable sensors on both wrists; these paired with a smartphone that scheduled delivery of haptic cues intended to inspire idle time exercise. Exercise sessions lasted 30 minutes in length and were scheduled 3 times per day outside inpatient therapy sessions. UE activity was monitored for a total of 8 hours (including the 1.5 hours of cued exercise time). During follow-up at home, participants wore the devices for 8 hours of UE activity monitoring on two days.

Main Outcome Measures: Feasibility was assessed by evaluating 1) study recruitment and study retention, 2) intervention technological implementation and safety.

Results: 45 participants were deemed eligible through electronic health records. 29 individuals provided written, informed consent. To date, 19 patients have completed the inpatient study with 10 individuals having withdrawn (34.5% attrition rate). The at home portion of the study currently stands at an enrollment retention of 100%. We additionally assessed technological feasibility via cueing accuracy. A total of 366 cued exercise sessions were scheduled across participants, with 327 sessions providing cues as expected, for a total accuracy of 89.3% for scheduled cues. After implementing a system improvement, accuracy rate increased to 100% for the last 99 scheduled sessions. No serious adverse events have been noted.

Conclusions: The implementation of Souvenir to increase patient activity through exercises during early phases of recovery from stroke is feasible and relevant in an IPR setting. In addition, monitoring UE activity in a home setting with this technology is feasible.

Author(s) Disclosures: None