Wearable Activity Monitors to Quantify Gait During Stroke Rehabilitation: Data from a Pilot Randomised Controlled Trial Examining Auditory Rhythmical Cueing

Hemiparesis is a disabling consequence of stroke, causing abnormal gait patterns with biomechanical asymmetries. Gait mechanics for stroke survivors appear resistant to conventional rehabilitation. Auditory rhythmical cueing (ARC) represents an emerging intervention option. To determine effective gait interventions, objective measures of gait collected from real-world environments may be required in addition to standard clinical outcomes to aid understanding of gait mechanics. This study reports on the ability of wearable activity monitors to quantify an ARC intervention for fifty-nine stroke survivors randomised into an ARC gait and balance training programme or an equivalent training programme without ARC. Gait assessments were undertaken at baseline and at 6 weeks for 4-metre walks and continuously for 7 days following each home assessment using a wearable activity monitor. The success rates of data collection using the wearable activity monitors ranged from 64 to 95%. Forty-eight Digital Mobility Outcomes representing a broad range of gait mechanics were calculated. Visualisation of all DMOs using radar plots indicated changes from baseline in both groups, with individual data indicating large variability in response to the intervention and control programme. Including wearable activity monitors to evaluate gait interventions for stroke survivors provides additional value to traditional methods and aids understanding of individual responses; as such, they should be used for future intervention-based research.