Does feedback on daily activity level from a Smart watch during inpatient stroke rehabilitation increase physical activity levels?

There already is this out there on Fitbit; I disagree.

Wearing a Fitbit Won't Help You Lose Weight, Experts Say | Inc.com

https://trialsjournal.biomedcentral.com/articles/10.1186/s13063-018-2476-z

• Yun Dong,
• Dax Steins,
• Shanbin Sun,
• Fei Li,
• James D. Amor,
• Christopher J. James,
• Zhidao Xia,
• Helen Dawes,
• Hooshang Izadi,
• Yi CaoEmail author,
• Derick T. WadeEmail author and
• Smart watch activity feedback trial committee (SWAFT)

Trials201819:177

https://doi.org/10.1186/s13063-018-2476-z

©  The Author(s). 2018

Received: 13 March 2017

Accepted: 10 January 2018

Published: 9 March 2018

Open Peer Review reports

Abstract

Background

Practicing activities improves recovery after stroke, but many people in hospital do little activity. Feedback on activity using an accelerometer is a potential method to increase activity in hospital inpatients. This study’s goal is to investigate the effect of feedback, enabled by a Smart watch, on daily physical activity levels during inpatient stroke rehabilitation and the short-term effects on simple functional activities, primarily mobility.

Methods/design

A randomized controlled trial will be undertaken within the stroke rehabilitation wards of the Second Affiliated hospital of Anhui University of Traditional Chinese Medicine, Hefei, China. The study participants will be stroke survivors who meet inclusion criteria for the study, primarily: able to participate, no more than 4 months after stroke and walking independently before stroke. Participants will all receive standard local rehabilitation and will be randomly assigned either to receive regular feedback about activity levels, relative to a daily goal tailored by the smart watch over five time periods throughout a working day, or to no feedback, but still wearing the Smart watch. The intervention will last up to 3 weeks, ending sooner if discharged. The data to be collected in all participants include measures of daily activity (Smart watch measure); mobility (Rivermead Mobility Index and 10-metre walking time); independence in personal care (Barthel Activities of Daily Living (ADL) Index); overall activities (the World Health Organization (WHO) Disability Assessment Scale, 12-item version); and quality of life (the Euro-Qol 5L5D). Data will be collected by assessors blinded to allocation of the intervention at baseline, 3 weeks or at discharge (whichever is the sooner); and a reduced data set will be collected at 12 weeks by telephone interview. The primary outcome will be change in daily accelerometer activity scores. Secondary outcomes are compliance and adherence to wearing the watch, and changes in mobility, independence in personal care activities, and health-related quality of life.

Discussion

This project is being implemented in a large city hospital with limited resources and limited research experience. There has been a pilot feasibility study using the Smart watch, which highlighted some areas needing change and these are incorporated in this protocol.

Trial registration

ClinicalTrials.gov, NCT02587585. Registered on 30 September 2015. Chinese Clinical Trial Registry, ChiCTR-IOR-15007179. Registered on 8 August 2015.

Keywords

StrokePhysical activityTechnologyGoal settingFeedback

Background

After stroke, practicing an activity and being active helps increase the speed and/or extent of recovery [1] but it is well-established that most inpatients in stroke rehabilitation settings have low levels of activity [2, 3, 4]. Increasing patients’ self-generated activity is possible through reorganizing care [5, 6] and could potentially play an important role in increasing independence.

Another way to increase activity and therefore to improve recovery of independence is to provide tailored feedback on activity and on progress towards goals. This could increase motivation, self-efficacy, and self-generated activity. Accelerometers can be used to record activity [2], and they can also be used to provide feedback; use of daily data by therapists can increase time spent walking [7]. There are several studies investigating the effect of feedback about physical activity from accelerometers to individuals. Some show no effect [8, 9] but some show beneficial effects [7, 10]. Benefits seem more likely if feedback is supported by other motivational support [11]. Most of these studies were published after the design of this project; there are many other study protocols published but not yet completed.

The primary objective of this study is to determine whether patient feedback about the amount of activity undertaken compared to their activity the previous day, provided at fixed time points during the day, will increase patient activity. We hypothesise that, compared to a control group who do not receive feedback from a Smart watch, those who receive feedback on daily activity will have increased physical activity levels, as measured by the activity scores, with no harms. We also hypothesize that this increased activity during inpatient stroke rehabilitation will result in improved mobility, and possibly cognition, arm function, independence in daily activities, and health-related quality of life. A third objective is to investigate the feasibility of setting up large-scale trials in a research-naïve setting. This protocol follows an initial pilot and feasibility study. (Lawrie S, Gong Y, Steins D, Xia Z, Esser P, Sun S, Li F, Amor J, James C, Izadi H, Chao Y, Wade DT, Dawes H: Augmented Feedback of Daily Activity on Physical Activity Levels after Acute Stroke: a pilot randomised controlled feasibility study, in preparation).

Methods

This study was originally registered with ClinicalTrials.gov on 30 September 2015 (NCT02587585). 

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