None listed
Conditions
Brief summary
Background Following stroke around 80% of people are left with reduced function in their arm. Maximising recovery is an ongoing challenge for stroke rehabilitation providers. Research demonstrates that high frequency and intensity of exercise and functional movement has been associated with improved functional outcomes and reduced time in hospital for people with stroke[4]. However, the recommended dose and intensity of rehabilitation in the most effective rehabilitation studies is difficult to implement within the constraints of current models of practice and funding, both in New Zealand and internationally. In fact, the only observational study collecting data on upper limb movement in a rehabilitation setting has demonstrated that very little arm movement occurs over the course of a standard rehabilitation day. Study Aims The purpose of this study is to describe the amount of upper limb activity undertaken during an inpatient rehabilitation day for a group of adults experiencing the effects of sub-acute stroke by observational methods and accelerometry. And to observe the effect introducing a wristband that provides a vibrating nudge reminder to use the arm has on levels of upper limb activity over the day. The following questions will be addressed: 1. Is there an association between data collected by upper limb accelerometers and observational methods of upper limb movement data collection? 2. Does the implementation of the BuzzNudge reminder increase the amount of upper limb activity undertaken by people with stroke in rehabilitation?
Interventions
Participants will undergo unobtrusive observations monitoring their upper limb use over a single 12 hour period. During the observation days some patients will wear devices containing IMU accelerometers.
For the second phase of data collection participants will be assessed using the usual practice on the ward. Participants who consent to the study will be randomised into two groups of 10. Both groups will wear the BuzzNudge haptic reminder bands and up to three other accelerometers. The contro
Participants will undergo unobtrusive observations monitoring their upper limb use over a single 12 hour period. During the observation days some patients will wear devices containing IMU accelerometers. For the second phase of data collection participants will be assessed using the usual practice on the ward. Participants who consent to the study will be randomised into two groups of 10. Both groups will wear the BuzzNudge haptic reminder bands and up to three other accelerometers. The control group will just wear the bands and in the BuzzNudge group the bands will be set to vibrate approximately every 20 minutes during the day. Participants in both groups will be shown the nudge reminder bands which contain accelerometers plus up to three other accelerometers. Accelerometers will be unobtrusively attached to participants wrists, upper arm and torso. They will be attached using either watch like wrist bands or hypoallergenic tape. In the instance of the participant having significant hair they will be given the option of shaving for comfort. The participants arm length will be measured with a soft measuring tape to ensure correct positioning of the accelerometers. Education on use of the nudge reminder and measurement of the arms is estimated to take less than 30 minutes. The groups will be introduced to the nudge reminder band by a fourth year physiotherapy student who will explain how the band is used and give them standardised instructions. Participants will be encouraged to wear the BuzzNudge bands and accelerometers during the day. A 4th year physiotherapy student will explain to participants in both groups the value of moving their hemiplegic arm after stroke. Participants in the BuzzNudge group will be asked to interpret the vibration of the band on their hemiplegic wrist as a cue to remind them to use their arm. The 4th year student will encourage the participant to move their arm or attempt to move their arm when they sense the band vibrating. Any movement or attempted movement will be considered of benefit provided it doesn’t cause any pain in the arm or shoulder. A patient’s decision on whether or not to use or respond to the nudge reminder system will have no impact on other treatment decisions made by the therapist. Data will be collected continuously from the accelerometers and also by observation intermittently over a 12 hour period as per the initial data collection.
Sponsors
Auckland University of Technology
Study design
Allocation
Non-randomised trial
Primary purpose
Treatment
Eligibility
Sex/Gender
All
Age
17 Years to No maximum
Healthy volunteers
No
Inclusion criteria
1. Inpatient on Murawai Ward or Wainamu Ward, Waitakere hospital, Auckland, at the time of study 2. Adult over 17 years 3. Diagnosis of Stroke 4. Determined medically stable and fit for rehabilitation by a Medical Consultant.
Exclusion criteria
1. ndividiuals considered medically unstable for active rehabilitation in the opinion of the Rehabilitation Ward Medical Consultant, Waitakere Hospital. 2. Individuals with cognitive, behavioural and/ or communication impairment that in the opinion of the research team means that participating in the study would add significantly to the persons burden. 3. Individuals who are within 3 days of planned discharge from inpatient rehabilitation. 4. Individuals unable to provide written consent and a relative of other person is unavailable to provide consent
Outcome results
None listed