http://www.neurology.org/content/84/14_Supplement/P5.176.short
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Neurology April 6, 2015 vol. 84 no. 14 Supplement P5.176
- Abstract
Abstract
OBJECTIVE: Demonstrate that the quality of
gait, in addition to walking speed and distance, can be derived from
inertial sensors
worn at both ankles. (better yet would be at the knees, toes and hips)
BACKGROUND: The international
Stroke Inpatient Rehabilitation Reinforcement of ACTivity (SIRRACT)
trial
deployed wireless sensors and activity-recognition
algorithms to monitor and provide feedback about the quantity of stroke
patients’ daily walking activity (epub,
Neurorehabil Neural Repair, 2014). This follow-up study aimed to
characterize the
quality of walking by calculating spatiotemporal
gait metrics.
DESIGN/METHODS: In SIRRACT, 135 trial participants wore
sensors
throughout the average 3-week inpatient
rehabilitation admission. Stopwatch-timed 10-meter walks (performed
weekly for system
calibration) were selected for the current
analysis. Individual steps were delimited by identifying heel strike and
toe-off
times. Metrics including gait cycle duration,
symmetry of stance and swing times, and double-limb support time were
calculated
for both the paretic and non-paretic limbs. The
magnitude of peak lower leg acceleration during the swing phase of gait
was
also calculated.
RESULTS: Data from five trial
participants are presented as exemplars. Walking speeds averaged 0.24 ±
0.14m/s
on study entry and 0.81 ± 0.35m/s at the time of
discharge. Gait cycle duration decreased during rehabilitation
(median:334ms
[211,853]), as did double-limb support time
(median:188ms [72,681]). Stance and swing time asymmetries were present
throughout
rehabilitation. Peak swing-time acceleration of the
paretic leg was greater at discharge (median:0.20g-units [0.15,0.31]).
CONCLUSIONS: The laboratory-quality gait metrics
calculated by our wireless sensor system were sensitive to functional
improvements
during a period of known clinical recovery.
Commercial sensor systems, for which steps counts are inaccurate at the
slow speeds
typical of hemi-paretic walking, have difficulty
producing outcomes related to motor control in persons disabled by
neurologic
disease. Measurement of the quantity and quality of
movements performed during daily activities enables clinicians and
researchers
to supervise gait training and skills practice
during rehabilitation.
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