Abstract
Objective
To examine the feasibility, acceptability, and validity of multimodal ambulatory monitoring,
which combines accelerometry with ecological momentary assessment (EMA), to assess
daily activity and health-related symptoms among survivors of stroke.
Design
Prospective cohort study involving 7 days of ambulatory monitoring; participants completed
8 daily EMA surveys about daily activity and symptoms (mood, cognitive complaints,
fatigue, pain) while wearing an accelerometer. Participants also completed retrospective
assessments and an acceptability questionnaire.
Setting
Community.
Participants
Forty survivors of stroke (N=40).
Interventions
Not applicable.
Main Outcome Measures
Feasibility was determined using attrition rate and compliance. Acceptability was
reported using the acceptability questionnaire. Convergent and discriminant validity
were determined by the correlations between ambulatory monitoring and retrospective
self-reports. Criterion validity was determined by the concordance between accelerometer-measured
and EMA-reported daily activity.
Results
All participants completed the study (attrition rate=0%). EMA and accelerometer compliance
were 93.6 % and 99.7%, respectively. Participants rated their experience with multimodal
ambulatory monitoring positively. They were highly satisfied (mean, 4.8/5) and confident
(mean, 4.7/5) in using ambulatory monitoring and preferred it over traditional retrospective
assessments (mean, 4.7/5). Multimodal ambulatory monitoring estimates correlated with
retrospective self-reports of the same and opposing constructs in the predicted directions
(r=−0.66 to 0.72, P<.05). More intense accelerometer-measured physical activity was observed when participants
reported doing more physically demanding activities and vice versa.
Conclusions
Findings support the feasibility, acceptability, and validity of multimodal ambulatory
monitoring in survivors of mild stroke. Multimodal ambulatory monitoring has potential
to provide a more complete understanding of survivors’ daily activity in the context
of everyday life.
Keywords
List of abbreviations:
EMA (ecological momentary assessment), MET (metabolic equivalent), Neuro-QoL (Quality of Life in Neurological Disorders), PHQ-9 (Patient Health Questionnaire-9), PIEL (Participation in Everyday Life), PSQI (Pittsburgh Sleep Quality Index)To read this article in full you will need to make a payment
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Article Info
Publication History
Published online: June 30, 2022
Accepted:
June 1,
2022
Received in revised form:
May 6,
2022
Received:
February 2,
2022
Publication stage
In Press Journal Pre-ProofFootnotes
Supported by the Program in Occupational Therapy Dissertation Fund, Washington University in St. Louis.
Disclosures: Allison A. King received consulting payment from Global Blood Therapeutics planning a clinical trial unrelated to this project. Other authors declare no conflict of interest.
Identification
Copyright
© 2022 by the American Congress of Rehabilitation Medicine.
