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The Effect of Activity Feedback Enabled by Smart Watches During In-patient Stroke Rehabilitation

20 avril 2017 mis à jour par: Dr Derick Wade, The Second Affiliated Hospital of Anhui University of Traditional Chinese Medicine

An International Randomized Clinical Trial of Activity Feedback During In-patient Stroke Rehabilitation Enabled by Smart Watches

The amount of activity completed by individuals within rehabilitation programs, even when units are well staffed, is often far below that required for optimal stroke rehabilitation, and is not individually adapted on a day-to-day basis. Daily feedback on their activity levels may motivate stroke survivors to engage in greater skills practice and thus outcome after stroke. To date only a few trials suggests that augmented feedback may be effective. There is a need for a large pragmatic trial to explore the impact of augmented activity feedback on top of their standard care. The purpose of this study is to determine the effect of augmented activity feedback by smart watches to support in-patient stroke rehabilitation.

Aperçu de l'étude

Statut

Inconnue

Les conditions

Intervention / Traitement

Description détaillée

This study had a feasibility and pilot development phase from September 2015 to April 2016, and then moved into the main study with some changes in design and execution occurring in the light of experience. Its execution has also been constrained by external factors beyond control.

It is in essence asking whether wearing a Smart Watch which gives feedback on activity every two hours, with a specific target tailored to the patient's performance 24 hours earlier will be associated with a higher rate of physical activity than seen in people wearing the same watch without and feedback been given.

The intervention only lasts unto 21 days, but earlier discharge will terminate that patient's participation sooner. A telephone interview at 12 weeks after entry collect data on mobility.

Outcome measures will assess mobility, activity, and health status.

Type d'étude

Interventionnel

Inscription (Anticipé)

200

Phase

  • N'est pas applicable

Contacts et emplacements

Cette section fournit les coordonnées de ceux qui mènent l'étude et des informations sur le lieu où cette étude est menée.

Lieux d'étude

  • Chine
    • Anhui
      • Hefei, Anhui, Chine
        • Recrutement
        • The 2nd Affiliated Hospital to Anhui University of Tranditional Chinese Medicine
        • Contact:

Critères de participation

Les chercheurs recherchent des personnes qui correspondent à une certaine description, appelée critères d'éligibilité. Certains exemples de ces critères sont l'état de santé général d'une personne ou des traitements antérieurs.

Critère d'éligibilité

Âges éligibles pour étudier

18 ans à 75 ans (Adulte, Adulte plus âgé)

Accepte les volontaires sains

Non

Sexes éligibles pour l'étude

Tout

La description

Inclusion Criteria:

  • Admission for acute/sub-acute in-patient neurorehabilitation of a first stroke at the 2nd affiliated hospital of Anhui University of Traditional Medicine and Acupuncture, Hefei, China.
  • Time from onset of stroke to admission for rehabilitation <16 weeks.
  • Ability to follow a two stage command; pick up an object, put object on table.
  • Independent in mobility prior to admission. Subjects can use any type of assistive device and brace needed.
  • Able to understand and repeat information related to the Informed Consent.

Exclusion Criteria:

  • Admission for second stroke.
  • Subjects who are unable to provide consent due to a cognitive impairment.

Plan d'étude

Cette section fournit des détails sur le plan d'étude, y compris la façon dont l'étude est conçue et ce que l'étude mesure.

Comment l'étude est-elle conçue ?

Détails de conception

  • Objectif principal: Traitement
  • Répartition: Randomisé
  • Modèle interventionnel: Affectation parallèle
  • Masquage: Double

Armes et Interventions

Groupe de participants / Bras
Intervention / Traitement
Expérimental: Feedback against tailored target
For each two hour epoch, the watch calculate the level of activity for the same epoch the day before, and adds 5% as the new target to be achieved.
Comportemental: Feedback against tailored target
Participants will wear a smart watch every weekday for nine hours during in-patient rehabilitation to monitor activity levels while receiving their usual care. In the active group, the watch will summate activity movement in two hour epochs and the target for the day for that epoch is the activity in the same epoch 24 hours earlier, plus 5%. During an epoch the patient is shown progress towards the target at at the end of an epoch, they will see their final process towards target for that epoch.
Comparateur factice: No Feedback
For participants assigned to the control group, the smart watch will not provide any activity feedback against a target; it simply shows which two hour epoch a person is in.
Comportemental: No feedback
Participants will wear a smart watch every weekday for nine hours during in-patient rehabilitation to monitor activity levels while receiving their usual care. However the watch face will simply show which epoch a person is in. The watch will collect the activity in exactly the same way over the day.

Que mesure l'étude ?

Principaux critères de jugement

Mesure des résultats
Délai
Change in activity counts as measured by a triaxial accelerometer from a smart watch from admission to 3 weeks or discharge from rehabilitation
Délai: Baseline, Three weeks or at discharge from in-patient rehabilitation if sooner
Baseline, Three weeks or at discharge from in-patient rehabilitation if sooner

Mesures de résultats secondaires

Mesure des résultats
Description de la mesure
Délai
Activity goal attainment as measured and provided by the smart watch
Délai: At three weeks, or discharge if sooner
Participants in feedback group receive a preset activity goal based on their previous activity levels at baseline. The smart watch will then provide graduated encouragement by increasing their activity goal by about 5%. Every 10-15 minutes the screen lights up and participants can see their activity progress expressed by activity bars (representing 0-100%). Participants reaching their activity goal is used to measure goal attainment.
At three weeks, or discharge if sooner
Change in walking mobility
Délai: Baseline, Three weeks or discharge from in-patient rehabilitation if sooner
Change in walking speed and spatio-temporal characteristics of walking as measured by an inertial sensor on the lower trunk during a 10m walk test.
Baseline, Three weeks or discharge from in-patient rehabilitation if sooner
Fatigue
Délai: Baseline, Three weeks or discharge from in-patient rehabilitation if sooner
Fatigue Severity Index
Baseline, Three weeks or discharge from in-patient rehabilitation if sooner
Health status on EQ-5D-5L
Délai: Baseline, Three weeks or discharge from in-patient rehabilitation if sooner, and 12 weeks (by telephone)
This scale is used a measure for health status and compromises 5 dimensions: mobility, self-care, usual activities, pain/discomfort, and anxiety/depression
Baseline, Three weeks or discharge from in-patient rehabilitation if sooner, and 12 weeks (by telephone)
Change in functional mobility as measured by Rivermead Mobility Index (RMI)
Délai: Baseline, Three weeks or discharge from in-patient rehabilitation if sooner, and 12 weeks (by telephone)
This scale assesses functional mobility in gait, balance and transfers after stroke
Baseline, Three weeks or discharge from in-patient rehabilitation if sooner, and 12 weeks (by telephone)
Change in cognitive function as measured by The Montreal Cognitive Assessment (MoCA)
Délai: Baseline, Three weeks or discharge from in-patient rehabilitation if sooner
This is a screening instrument for to measure mild cognitive dysfunction. It assesses different cognitive domains: attention and concentration, executive functions, memory, language, visuoconstructional skills, conceptual thinking, calculations, and orientation.
Baseline, Three weeks or discharge from in-patient rehabilitation if sooner
Change in arm function recovery
Délai: Baseline, Three weeks or discharge from in-patient rehabilitation if sooner
Grip dynamometer
Baseline, Three weeks or discharge from in-patient rehabilitation if sooner
Change in performance of activities of daily living as measured by Barthel ADL Index
Délai: Baseline, Three weeks or discharge from in-patient rehabilitation if sooner
This scale is used to record what the participant undertakes in personal activities, to establish a degree of independence from any help, physical or verbal.
Baseline, Three weeks or discharge from in-patient rehabilitation if sooner
Change in disability as measured by WHO Disability Assessment Scale (12 item version)
Délai: Baseline, Three weeks or discharge from in-patient rehabilitation if sooner, and 12 weeks
This scale provides a global measure of disability covering 6 domains: cognition, mobility, self-care, getting along, life activities, and participation
Baseline, Three weeks or discharge from in-patient rehabilitation if sooner, and 12 weeks
Adverse events
Délai: At three weeks, or discharge if sooner and at 12 weeks
Self-reported adverse events
At three weeks, or discharge if sooner and at 12 weeks

Collaborateurs et enquêteurs

C'est ici que vous trouverez les personnes et les organisations impliquées dans cette étude.

Parrainer

The Second Affiliated Hospital of Anhui University of Traditional Chinese Medicine

Collaborateurs

Oxford Brookes University
University of Warwick
Oxford International Rehabilitation Foundation and Innovation

Les enquêteurs

  • Chercheur principal: Derick T Wade, MD, Oxford Brookes University

Publications et liens utiles

La personne responsable de la saisie des informations sur l'étude fournit volontairement ces publications. Il peut s'agir de tout ce qui concerne l'étude.

Publications générales

Dates d'enregistrement des études

Ces dates suivent la progression des dossiers d'étude et des soumissions de résultats sommaires à ClinicalTrials.gov. Les dossiers d'étude et les résultats rapportés sont examinés par la Bibliothèque nationale de médecine (NLM) pour s'assurer qu'ils répondent à des normes de contrôle de qualité spécifiques avant d'être publiés sur le site Web public.

Dates principales de l'étude

Début de l'étude

1 septembre 2015

Achèvement primaire (Anticipé)

1 janvier 2018

Achèvement de l'étude (Anticipé)

1 août 2018

Dates d'inscription aux études

Première soumission

30 septembre 2015

Première soumission répondant aux critères de contrôle qualité

23 octobre 2015

Première publication (Estimation)

27 octobre 2015

Mises à jour des dossiers d'étude

Dernière mise à jour publiée (Réel)

21 avril 2017

Dernière mise à jour soumise répondant aux critères de contrôle qualité

20 avril 2017

Dernière vérification

1 mars 2017

Plus d'information

Termes liés à cette étude

Termes MeSH pertinents supplémentaires

Autres numéros d'identification d'étude

  • ChiECRCT-20150034

Plan pour les données individuelles des participants (IPD)

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INDÉCIS

Description du régime IPD

In the unlikely event that someone asks, it will probably be shared but so far (March 2017) there is no plan

Informations sur les médicaments et les dispositifs, documents d'étude

Étudie un produit pharmaceutique réglementé par la FDA américaine

Non

Étudie un produit d'appareil réglementé par la FDA américaine

Non

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