Outcome Measures of Free-Living Activity in Spinal Cord Injury Rehabilitation

Curr Phys Med Rehabil Rep., 2019 · DOI: 10.1007/s40141-019-00228-5 · Published: September 1, 2019

Spinal Cord Injury Assistive Technology Rehabilitation

Simple Explanation

Body-worn activity monitors can help researchers understand barriers to physical activity and identify effective interventions for people with spinal cord injury (SCI). Activity monitors have been validated and proven to be reliable tools for measurement of free-living physical activity for a variety of populations, including able-bodied adults, children, and wheelchair users. Current research utilizing accelerometers or inertial measurement units (IMU) in the SCI population is focused on understanding physical activity for fitness and cardiovascular metabolic changes, movement for seating-related pressure-injury prevention, patterns of activity to quantify wheelchair use, and temporal wheelchair propulsion characteristics

Study Duration

Not specified

Participants

Not specified

Evidence Level

Not specified

Key Findings

1
Distance traveled is ranked as the most important outcome measure to quantify with sensors when working with individuals in manual wheelchairs.
2
Upper limb activity counts were correlated with independence and inversely correlated with the neurological level of injury in SCI patients.
3
Algorithms developed based on bipedal ambulation may not correctly account for the limited or lack of function of the lower limbs encountered in wheelchair users

Research Summary

Body-worn sensors can accurately measure physical activity in free-living environments, potentially enhancing the understanding of barriers to adequate activity and identifying effective interventions for people with SCI. Commonly used sensor-based measures in SCI rehabilitation include stroke number, push frequency, upper limb activity counts, and wheelchair propulsion distance. Challenges in using activity monitors in rehabilitation include participant adherence, data quality, sensor placement, and the need for validated protocols specific to the SCI population.

Practical Implications

Improved Treatment Strategies

Quantifying activity routines following SCI can lead to improved treatment and prevention of secondary complications.

Enhanced Understanding of Mobility

Measuring wheelchair propulsion characteristics can provide insights into the long-term effects on shoulder health and inform wheelchair prescription and design.

Personalized Activity Recommendations

Individually calibrated cut-points for activity levels may be needed to accurately describe the amount of activity performed across functional levels in individuals with SCI.

Study Limitations

1
Participant adherence to wearing sensors and calibration protocols.
2
Variations in sensor placement affecting data accuracy.
3
Lack of validated protocols that translate well across different SCI studies and populations.

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