Can objective stability assessment of walking aid use outside the clinic facilitate stroke rehabilitation?

Project Description

Considering the rising numbers of stroke survivors and the costs associated with their falls, there is an urgent need to improve stroke rehabilitation. Walking aids may be prescribed to stroke survivors to reduce falls, however, unstable use as well as non-use and abandonment can limit their usefulness. At this time, clinicians have no means to monitor frequency and stability of walking aid use in stroke survivors outside the clinic. Walking aids are, almost without exception, passive devices without technology to identify undesirable usage behaviours to trigger prescription review and/or collection of unwanted/unfit devices. To be able to effectively (and appropriately) intervene when unstable use, non-use or abandonment occurs, this project seeks to design a system which recognises these behaviours in the real world. This project takes a first step to develop an appropriate sensor set and algorithms with which to quantify everyday usage and (natural) variability in usage, stability during use, and changes in usage behaviour. Activity monitors, pressure sensors and threshold algorithms will be used to identify periods of unstable use and non-use, and the longer-term behaviour of device abandonment. The project will also seek clinicians’ views on these usage behaviours, in relation to device review and device retraction, and will investigate users’ and their carers’ reasons that led to changes in behaviour and potential solutions. We have already established proof-of-concept data from walking aid-mounted sensors and insights gained from this work will support a larger project to further develop the monitoring technology, with the potential for service development to facilitate stroke rehabilitation.