Attitudes towards a sensor-feedback technology in gait rehabilitation of patients after stroke

Abstract

Introduction

Intensive gait training is important for effective rehabilitation of people after stroke. “Stappy” is a sensor-feedback system that provides real-time feedback on the persons gait pattern/performance during training. The main aim of this study was to assess attitudes towards “Stappy” in people after stroke to practise walking performance independently at home.

Methods

Demographics were collected. Frequency of practice with “Stappy” was monitored through the system. Participants used “Stappy” at home for two weeks. Semi-structured interviews were conducted to explore patient experiences with “Stappy” afterwards. Interviews were analysed using thematic analysis.

Results

Seventeen people after stroke (13 males, mean age 65, 17 to 172 months after stroke) were interviewed. There was a large variability (ranging from 0 to 14 days) in frequency of use over the two-week period. Although, thirty-eight percent were non-users, participants seemed satisfied about the option of feedback of the system on people’s gait pattern. Moderate to frequent users reported the ability to integrate “Stappy” into daily walking and the presence of support by the social environment as important factors for use.

Conclusion

In a sub sample of stroke patients the ability to receive real-time feedback during practice about walking performance at home was viewed positively. Six participants did not or hardly used the sensor-feedback technology, even though they were positive about potential benefits. This implies that mHealth is not eligible for all individuals. To improve adherence various considerations were derived from this study, that may further optimise the frequency and personalise the use of the technology.

IMPLICATIONS FOR REHABILITATION

• The frequency of use of a sensor-feedback technology in gait rehabilitation varied a lot in a cross-sectional sample of people after stroke.

• Patients after stroke seemed to have a positive attitude towards a sensor-feedback technology to support unsupervised practice of walking. However, this was unrelated to whether they had used or had not used the technology.

• Moderate and frequent users of the sensor-feedback technology reported the ability to integrate sensor-feedback technology in daily life and social support as important factors for use.

• For clinical practice in gait rehabilitation it is important to screen which patients are capable to use and may benefit from a technology as the one used in this study.

Keywords:

• Gait
• sensor-feedback
• attitudes
• stroke
• rehabilitation

Acknowledgements

The authors would like to thank the participants that took part in the study. We thank Elisabetta Farella and Bojan Milosevic for their technical support regarding the technology. We thank Ritch te Kampe for his support and expertise during the planning, and data collection of this study.

We thank Drs. Donna Frost for her support as a native speaker on English language in this article

Disclosure statement

The authors report no conflict of interest.

Additional information

Funding

This study is financially supported by Nationaal Regieorgaan Praktijkgericht Onderzoek SIA [RAAKPRO; grant number 2014-01-49PRO].