Measuring Community Mobility in Survivors of Stroke Using Global Positioning System Technology: A Prospective Observational Study
Measuring Community Mobility in Survivors of Stroke Using Global Positioning System Technology: A Prospective Observational Study
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DOI：
10.1097/npt.0000000000000279
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发表时间：
2019-07-01
影响因子：
3.8
通讯作者：
Evans, Christian C.
中科院分区：
文献类型：
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作者：
Hanke, Timothy A.;Hwang, Sungsoon;Evans, Christian C.
背景和目的：返回社区活动对于中风患者的康复非常重要，但很少有研究直接测量住院康复后的这种结构。使用全球定位系统（GPS）技术，我们研究了中风（SS）幸存者出院后第一年的社区活动能力，并将其与年龄匹配的无神经功能障碍的对照组进行比较。方法：我们进行了一项前瞻性观察性研究，包括SS（n = 14）和年龄和位置匹配的对照受试者（CS; n = 6）。所有参与者都确定了对他们的社区流动目标很重要的目标位置，并在出院后的第一周、第五周和第九周，或从CS基线，以及在26周和52周的随访中佩戴GPS装置。收集6分钟步行试验（SMWT）、贝格平衡试验（BBT）、重返正常生活（RNLI）和简明生活质量调查表-36身体功能领域（SF-36-PF）。从GPS数据中提取了旅行次数和访问目标的百分比。结果：14例SS中有12例完成了9周，7例完成了全年，无CS退出。与CS相比，SS在第1周和第9周的旅行次数更少，达到的目标更少，但在第5周，第26周和第52周则没有。所有4项临床结局指标均与trips显著相关（SMWT的斯皮尔曼r = 0.5067，BBT = 0.3841，RNLI = 0.4119，SF-36-PF = 0.4192）。讨论和结论：从住院康复出院后9周内，直接测量的SS社区流动性下降。临床指标和出行次数之间的双变量相关性的有限强度支持了社区流动性结构的独特性。视频摘要可从作者获得更多见解（参见补充数字内容1，可在http：//links.lww.com/JNPT/A277上获得）。
Background and Purpose: Returning to community mobility is important for people recovering from a stroke, yet few studies have directly measured this construct following inpatient rehabilitation. Using global positioning system (GPS) technology, we examined community mobility of survivors of stroke (SS) over the first year after discharge and compared them to an age-matched comparison group without neurological impairment. Methods: We conducted a prospective observational study that included SS (n = 14) and age- and location-matched comparison subjects (CS; n = 6). All participants identified target locations important to their community mobility goals and wore a GPS unit during the first, fifth and ninth weeks after discharge, or from baseline for CS, and at 26 and 52 weeks' follow up. The 6-minute walk test (SMWT), Berg balance test (BBT), Reintegration to Normal Living (RNLI), and Short Form-36 Quality of Life Survey Physical Functioning domain (SF-36-PF) were collected. Number of trips and percentage of targets visited were extracted from GPS data. Results: Twelve of 14 SS completed 9 weeks, 7 completed the full year, and no CS withdrew. The SS took fewer trips and attained fewer targets compared with CS at weeks 1 and 9, but not at weeks 5, 26, and 52. All 4 clinical outcome measures were significantly correlated to trips (Spearman r for SMWT = 0.5067, BBT = 0.3841, RNLI = 0.4119, and SF-36-PF = 0.4192). Discussion and Conclusions: Directly measured community mobility in SS was decreased through 9 weeks following discharge from inpatient rehabilitation. The limited strength of bivariate correlations between clinical measures and number of trips supported the uniqueness of the community mobility construct. Video Abstract available for more insights from the authors (see Supplemental Digital Content 1, available at: http://links.lww.com/JNPT/A277).