目的:住院康复是中风治疗的关键条件,提供密集,有针对性的治疗和特定任务的实践,以最大限度地减少患者的功能缺陷,并促进他们重新融入社区。然而,中风后的损伤和恢复差异很大,这使得很难预测患者未来的结果或对治疗的反应。在这项研究中,作者研究了早期可穿戴传感器数据的价值,以预测3种功能结果(步行,独立性,和跌倒的风险)在康复出院时。
方法:55名接受住院卒中康复的患者参与了这项研究。有监督的机器学习分类器进行了回顾性训练,以使用入院时收集的数据预测出院结果。包括病人信息,功能评估分数,以及在步态和/或平衡任务期间来自下肢的惯性传感器数据。比较了不同数据组合的模型性能,并与未经传感器数据训练的传统模型进行了基准测试。
结果:对于入院时门诊的患者,传感器数据改善了步行和跌倒风险的预测(加权F1分数增加了19.6%和23.4%,分别),并在独立性预测方面保持类似的表现,与没有传感器数据的基准模型相比。性能最佳的基于传感器的模型预测了出院步行(社区与household),独立性(高与低),和下降的风险(正常与高)精度为84.4%,68.8%,和65.9%,分别。大多数错误分类发生在分类边界附近的入院或出院分数。对于入院时不住院的患者,在简单的平衡任务中记录的传感器数据没有提供超过基准模型的预测价值。
结论:这些发现支持对可穿戴传感器的持续研究,易于使用的工具来预测中风后的功能恢复。
结论:准确,可穿戴传感器对中风后康复结果的早期预测将提高我们提供个性化的能力,有效的护理和出院计划在住院和超越。
OBJECTIVE: Inpatient rehabilitation represents a critical setting for stroke treatment, providing intensive, targeted therapy and task-specific practice to minimize a patient\'s functional deficits and facilitate their reintegration into the community. However, impairment and recovery vary greatly after stroke, making it difficult to predict a patient\'s future outcomes or response to treatment. In this study, the authors examined the value of early-stage wearable sensor data to predict 3 functional outcomes (ambulation, independence, and risk of falling) at rehabilitation discharge.
METHODS: Fifty-five individuals undergoing inpatient stroke rehabilitation participated in this study. Supervised machine learning classifiers were retrospectively trained to predict discharge outcomes using data collected at hospital admission, including patient information, functional assessment scores, and inertial sensor data from the lower limbs during gait and/or balance tasks. Model performance was compared across different data combinations and was benchmarked against a traditional model trained without sensor data.
RESULTS: For patients who were ambulatory at admission, sensor data improved the predictions of ambulation and risk of falling (with weighted F1 scores increasing by 19.6% and 23.4%, respectively) and maintained similar performance for predictions of independence, compared to a benchmark model without sensor data. The best-performing sensor-based models predicted discharge ambulation (community vs household), independence (high vs low), and risk of falling (normal vs high) with accuracies of 84.4%, 68.8%, and 65.9%, respectively. Most misclassifications occurred with admission or discharge scores near the classification boundary. For patients who were nonambulatory at admission, sensor data recorded during simple balance tasks did not offer predictive value over the benchmark models.
CONCLUSIONS: These findings support the continued investigation of wearable sensors as an accessible, easy-to-use tool to predict the functional recovery after stroke.
CONCLUSIONS: Accurate, early prediction of poststroke rehabilitation outcomes from wearable sensors would improve our ability to deliver personalized, effective care and discharge planning in the inpatient setting and beyond.