PDF(Pubmed)
Abstract：
BACKGROUND: Understanding the role of adherence to home exercise programs for survivors of stroke is critical to ensure patients perform prescribed exercises and maximize effectiveness of recovery.
METHODS: Survivors of hemiparetic stroke with impaired motor function were recruited into a 7-day study designed to test the utility and usability of a low-cost wearable system and progressive-challenge cued exercise program for encouraging graded-challenge exercise at-home. The wearable system comprised two wrist-worn MetaMotionR+ activity monitors and a custom smartphone app. The progressive-challenge cued exercise program included high-intensity activities (one repetition every 30 s) dosed at 1.5 h per day, embedded within 8 h of passive activity monitoring per day. Utility was assessed using measures of system uptime and cue response rate. Usability and user experience were assessed using well-validated quantitative surveys of system usability and user experience. Self-efficacy was assessed at the end of each day on a visual analog scale that ranged from 0 to 100.
RESULTS: The system and exercise program had objective utility: system uptime was 92 ± 6.9% of intended hours and the rate of successful cue delivery was 99 ± 2.7%. The system and program also were effective in motivating cued exercise: activity was detected within 5-s of the cue 98 ± 3.1% of the time. As shown via two case studies, accelerometry data can accurately reflect graded-challenge exercise instructions and reveal differentiable activity levels across exercise stages. User experience surveys indicated positive overall usability in the home settings, strong levels of personal motivation to use the system, and high degrees of satisfaction with the devices and provided training. Self-efficacy assessments indicated a strong perception of proficiency across participants (95 ± 5.0).
CONCLUSIONS: This study demonstrates that a low-cost wearable system providing frequent haptic cues to encourage graded-challenge exercise after stroke can have utility and can provide an overall positive user experience in home settings. The study also demonstrates how combining a graded exercise program with all-day activity monitoring can provide insight into the potential for wearable systems to assess adherence to-and effectiveness of-home-based exercise programs on an individualized basis.
METHODS: Survivors of hemiparetic stroke with impaired motor function were recruited into a 7-day study designed to test the utility and usability of a low-cost wearable system and progressive-challenge cued exercise program for encouraging graded-challenge exercise at-home. The wearable system comprised two wrist-worn MetaMotionR+ activity monitors and a custom smartphone app. The progressive-challenge cued exercise program included high-intensity activities (one repetition every 30 s) dosed at 1.5 h per day, embedded within 8 h of passive activity monitoring per day. Utility was assessed using measures of system uptime and cue response rate. Usability and user experience were assessed using well-validated quantitative surveys of system usability and user experience. Self-efficacy was assessed at the end of each day on a visual analog scale that ranged from 0 to 100.
RESULTS: The system and exercise program had objective utility: system uptime was 92 ± 6.9% of intended hours and the rate of successful cue delivery was 99 ± 2.7%. The system and program also were effective in motivating cued exercise: activity was detected within 5-s of the cue 98 ± 3.1% of the time. As shown via two case studies, accelerometry data can accurately reflect graded-challenge exercise instructions and reveal differentiable activity levels across exercise stages. User experience surveys indicated positive overall usability in the home settings, strong levels of personal motivation to use the system, and high degrees of satisfaction with the devices and provided training. Self-efficacy assessments indicated a strong perception of proficiency across participants (95 ± 5.0).
CONCLUSIONS: This study demonstrates that a low-cost wearable system providing frequent haptic cues to encourage graded-challenge exercise after stroke can have utility and can provide an overall positive user experience in home settings. The study also demonstrates how combining a graded exercise program with all-day activity monitoring can provide insight into the potential for wearable systems to assess adherence to-and effectiveness of-home-based exercise programs on an individualized basis.
摘要：
背景：了解坚持家庭锻炼计划对中风幸存者的作用对于确保患者进行规定的锻炼并最大程度地提高康复效果至关重要。
方法：招募运动功能受损的偏瘫性中风幸存者参加一项为期7天的研究，旨在测试低成本可穿戴系统和渐进式挑战提示锻炼计划的实用性和可用性，以鼓励在家中进行分级挑战锻炼。可穿戴系统包括两个手腕佩戴的MetaMotionR+活动监视器和一个定制的智能手机应用程序。渐进式挑战提示锻炼计划包括每天1.5h的高强度活动（每30s重复一次），嵌入每天8小时的被动活动监测。使用系统正常运行时间和提示响应率的度量来评估效用。使用经过充分验证的系统可用性和用户体验定量调查来评估可用性和用户体验。每天结束时，以0至100的视觉模拟量表评估自我效能。
结果：系统和锻炼计划具有客观实用性：系统正常运行时间为预期小时数的92±6.9％，提示传递成功率为99±2.7％。该系统和程序在激励提示运动方面也有效：在提示98±3.1％的时间内的5秒内检测到活动。如通过两个案例研究所示，加速度测量数据可以准确地反映分级挑战运动指令，并揭示不同运动阶段的可区分活动水平。用户体验调查表明，在家庭环境中总体可用性是积极的，使用该系统的强烈个人动机，以及对设备的高度满意度，并提供培训。自我效能评估表明参与者对熟练程度的强烈感知(95±5.0)。
结论：这项研究表明，低成本的可穿戴系统提供频繁的触觉提示以鼓励中风后的分级挑战锻炼可以具有实用性，并且可以在家庭环境中提供整体积极的用户体验。该研究还展示了如何将分级锻炼计划与全天活动监测相结合，可以深入了解可穿戴系统在个性化基础上评估家庭锻炼计划的依从性和有效性的潜力。
方法：招募运动功能受损的偏瘫性中风幸存者参加一项为期7天的研究，旨在测试低成本可穿戴系统和渐进式挑战提示锻炼计划的实用性和可用性，以鼓励在家中进行分级挑战锻炼。可穿戴系统包括两个手腕佩戴的MetaMotionR+活动监视器和一个定制的智能手机应用程序。渐进式挑战提示锻炼计划包括每天1.5h的高强度活动（每30s重复一次），嵌入每天8小时的被动活动监测。使用系统正常运行时间和提示响应率的度量来评估效用。使用经过充分验证的系统可用性和用户体验定量调查来评估可用性和用户体验。每天结束时，以0至100的视觉模拟量表评估自我效能。
结果：系统和锻炼计划具有客观实用性：系统正常运行时间为预期小时数的92±6.9％，提示传递成功率为99±2.7％。该系统和程序在激励提示运动方面也有效：在提示98±3.1％的时间内的5秒内检测到活动。如通过两个案例研究所示，加速度测量数据可以准确地反映分级挑战运动指令，并揭示不同运动阶段的可区分活动水平。用户体验调查表明，在家庭环境中总体可用性是积极的，使用该系统的强烈个人动机，以及对设备的高度满意度，并提供培训。自我效能评估表明参与者对熟练程度的强烈感知(95±5.0)。
结论：这项研究表明，低成本的可穿戴系统提供频繁的触觉提示以鼓励中风后的分级挑战锻炼可以具有实用性，并且可以在家庭环境中提供整体积极的用户体验。该研究还展示了如何将分级锻炼计划与全天活动监测相结合，可以深入了解可穿戴系统在个性化基础上评估家庭锻炼计划的依从性和有效性的潜力。
