Journal
FRONTIERS IN NEUROLOGY
Volume 9, Issue -, Pages -Publisher
FRONTIERS MEDIA SA
DOI: 10.3389/fneur.2018.01039
Keywords
spinal cord injury; rehabilitation; physical activity; intervention studies; wearable sensors; reliability
Categories
Funding
- International Foundation for Research in Paraplegia (IRP) [P 157]
- Clinical Research Priority Program (CRPP) Neuro-Rehab of the University of Zurich
- Swiss Paraplegic Foundation (SPS)
- Wings for Life [143]
- ETH Zurich Foundation
- Hocoma AG
- HMZ seed project (project title: ZurichMOVE: Wearable sensors tomonitor movement quality and mobility in health care) - University of Zurich
- Swiss State Secretariat for Education, Research and Innovation (SERI) [15.0255, 681094]
- NATIONAL INSTITUTE OF GENERAL MEDICAL SCIENCES [P20GM121312] Funding Source: NIH RePORTER
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Physical activity (PA) has been shown to have a positive influence on functional recovery in patients after a spinal cord injury (SCI). Hence, it can act as a confounder in clinical intervention studies. Wearable sensors are used to quantify PA in various neurological conditions. However, there is a lack of knowledge about the inter-day reliability of PA measures. The objective of this study was to investigate the single-day reliability of various PA measures in patients with a SCI and to propose recommendations on how many days of PA measurements are required to obtain reliable results. For this, PA of 63 wheelchair-dependent patients with a SCI were measured using wearable sensors. Patients of all age ranges (49.3 +/- 16.6 years) and levels of injury (from C1 to L2, ASIA A-D) were included for this study and assessed at three to four different time periods during inpatient rehabilitation (2 weeks, 1 month, 3 months, and if applicable 6 months after injury) and after in-patient rehabilitation in their home-environment (at least 6 months after injury). The metrics of interest were total activity counts, PA intensity levels, metrics of wheeling quantity and metrics of movement quality. Activity counts showed consistently high single-day reliabilities, while measures of PA intensity levels considerably varied depending on the rehabilitation progress. Single-day reliabilities of metrics of movement quantity decreased with rehabilitation progress, while metrics of movement quality increased. To achieve a mean reliability of 0.8, we found that three continuous recording days are required for out-patients, and 2 days for in-patients. Furthermore, the results show similar weekday and weekend wheeling activity for in- and out-patients. To our knowledge, this is the first study to investigate the reliability of an extended set of sensor-based measures of PA in both acute and chronic wheelchair-dependent SCI patients. The results provide recommendations for sensor-based assessments of PA in clinical SCI studies.
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