Enhancing safety monitoring in post-stroke rehabilitation through wearable technologies

Objective Current clinical practice guidelines support structured, progressive protocols for improving walking after stroke. Technology enables monitoring of exercise and therapy intensity, but safety concerns could also be addressed. This study explores functional mobility in post-stroke individuals using wearable technology to quantify movement smoothness-an indicator of safe mobility. Design Observational cohort study. Setting A movement analysis and rehabilitation laboratory. Participants A total of 56 chronic post-stroke individuals and 51 healthy controls. Intervention Participants performed the mobility test while wearing an inertial measurement unit attached to their waist. Thirty-two healthy participants also engaged in a steady-state walking task. Main measures Functional mobility smoothness by examining angular velocities in the yaw, pitch, and roll axes, employing the spectral arc length metrics. Results Our findings reveal that post-stroke individuals extend the duration of the timed-up-and-go test (approximate to 9 s and 23 s longer compared to the controls) to ensure safe mobility-greater mobility smoothness (p < 0.001). Notably, for mild and severe impairments, post-stroke mobility demonstrated approximate to 8% and approximate to 11% greater smoothness in pitch movements, respectively (p = 0.025 and p = 0.002). In the roll direction, mobility was approximate to 12% smoother in cases of severe strokes (p = 0.006). Conclusion This study addresses a crucial gap in the understanding of mobility smoothness in chronic stroke survivors using wearable technology. Our study suggests the potential utility of spectral arc length to predict challenging mobility situations in real-world situations. We highlight the potential for automated monitoring of safety offering promising avenues for real-time, real-life monitoring.