Real-time tracking of functional performance using accelerometers on the acute-stroke unit: proof-of-concept study

Abstract

Background: Acute stroke care pathways are increasingly implemented to improve integration of best-practices, but evidence for impact on functional outcomes is not strong. Elements missing from care-pathways are those directly targeting improvement in function: sit-to-stand and time spent walking. The Stroke Team uses care-pathways to track functional capacity, what the patient can and cannot do, but performance on these key outcomes is difficult to track as the patient is observed by multiple people throughout the day. The purpose of this study is to demonstrate the feasibility and added-value of real-time tracking of patients’ mobility. Methods: A chart review was carried out to identify the extent to which functional capacity and performance is tracked routinely by the Stroke Team. Ethical approval was gained for routine use of accelerometers to be affixed to the unaffected thigh. Results: Swallowing, bladder control, toileting, and feeding were consistently tracked for ~90% of patients. Bed-mobility and capacity to transfer rarely tracked (<12%). Capacity for walking and sit-to-stand was noted but never frequency (performance). Conclusion: Our proof-of concept study will test 30 patients over the next 2 months and link real time performance on transitions and walking to stroke severity and outcome.