The added value of monitoring physical behaviour for an assessment protocol for stroke rehabilitation in a rehabilitation centre: a cross-sectional, observational study

Abstract

Aim

Physical behaviour (PB) of patients after stroke often changes as a result from physical impairments. Changes in PB may lead to lower levels of independence and participation, which are related to quality of life. Activity monitors can measure PB. The relationship between PB and usual care assessments of capacity such as walking ability (WA), balance, and motor impairment (MI) is unclear. Also, physical and mental burdening of monitoring PB, and the experienced added value for the health professional is unknown. This study aims to determine the added value of monitoring PB for an assessment protocol for stroke rehabilitation at a rehabilitation centre.

Methods

For 15 patients with stroke, a single assessment of percentage of time of being physically active (PB), the 10m walking test (WA), Berg Balance Scale (Balance), and Motricity Index (MI) was done. PB was measured for 7 days, 24 hours per day with an Activ8 activity monitor. Pearson’s correlation coefficient assessed the relationship between PB and WA, balance, and MI. Questionnaires assessed the experienced added value of monitoring PB for physical therapists, and physical and mental burdening for patients and nurses. Questions were scaled ordinally with 5 points per question, and averaged per group.

Results

The correlation between PB and WA (r=-0,255, p=0,360), balance (r=0,234, p=0,402), and MI (r=0,356, p = 0,192) is absent. Mean scores for questions regarding burdening for nurses (1,0 and 1,0 points) and patients (1,13 and 1,32 points) are little . The experienced added value for physical therapists (3 and 2,5 points) is neutral.

Conclusion

Monitoring PB may be an added value for an assessment protocol for stroke rehabilitation.

Clinical relevance

Monitoring PB is of little burdening and hindering for patients and caregivers. Monitoring PB provides an outcome measure that may be unrelated to frequently used outcome measures for capacity.