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The importance of physical activity and exercise-based interventions in neuro-orthopaedic rehabilitation is undisputed. Yet, patients and clinicians do not implement minimally required doses of physical activity in standard rehabilitation programs. This is partly due to intrinsic factors such as motivation, or due to physical condition that prevent any kind of exercise. In most cases, however, it is owed to limited time spent with therapists who would be able to supervise and apply the required doses to induce any potential exercise effects. Methods to semi-autonomously exercise with high motivation and continuous feedback would complement existing therapies and allow adherence to minimal dose recommendations.
For this study, a prototype of a new portable training solution for intensive walking exercise with built-in sensor-technology and a smartphone interface will be tested regarding its usability and its efficiency in a clinical setting.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Test group | Experimental |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| TONEFITreha | Device | The newly developed Tonefit Reha is based on the existing fitness device, the TONEFIT belt. Similar to Nordic Walking, the device aims to include upper limb activity in walking exercise to train the shoulder girdle and arm. While Nordic Walking uses poles, the existing TONEFIT belt uses body-worn resistance handles to actively involve the upper body. It is worn around the waist, like a belt. The two independent pull-push elements with non-adjustable resistance on each side allow increased intensity for strengthening and endurance training during walking, particular for upper extremities and trunk stability. |
| Measure | Description | Time Frame |
|---|---|---|
| Usability | Participants will be asked to rate the perceived usability based on the System Usability Scale (SUS). SUS assesses perceived effectiveness (can users successfully achieve their objectives), information quality (how much effort and resource is expended in achieving those objectives) and general satisfaction (was the experience satisfactory). The SUS hast 10 items that can be rated on a 5-point likert scale. The items will be scored as follows:
| 3-4 weeks |
| Measure | Description | Time Frame |
|---|---|---|
| Usability: Assists | Each participant will have a list of tasks to be completed per session. Amount of additional assistance following the introduction (after three supervised sessions), will be counted as outcome. E.g. additional verbal cues or practical assistance. | 3-4 weeks |
| Usability: Completion rate efficiency [%/s] |
| Measure | Description | Time Frame |
|---|---|---|
| Experience with walking exercises | The amount of experience with walking exercise (qualitative, verbal description or as hours/week, if applicable), | At first visit (t+0 days). |
| General attitude towards technology based exercise: |
Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Frank A Behrendt, PhD | Reha Rheinfelden | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Reha Rheinfelden | Rheinfelden | Canton of Aargau | 4310 | Switzerland |
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| ID | Term |
|---|---|
| D009422 | Nervous System Diseases |
| D009140 | Musculoskeletal Diseases |
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Each participant will have a list of tasks to be completed per session. mean completion rate/mean task time = completion rate efficiency [%/s]; e.g. 80% completed all tasks within an average of 360 seconds. Task time: mean time taken before training was started [s]. |
| 3-4 weeks |
| Usability: Goal achievement efficiency [%/s] | Each participant will have a list of tasks to be completed per session. mean goal achievement/mean task time = Goal achievement efficiency [%/s]; e.g. 43% completed in 360 seconds Mean goal achievement: Mean extent to which the tasks were completed [%], e.g. 3 out of 7 tasks completed correctly = 43%. | 3-4 weeks |
| Proof-of-Concept: Measurement of covered walking distance with the built-in sensors. | Standardised clinical assessment often employed as part of routine assessments will be used. The 10 Meter Walk Test (10MWT) is a performance measure used to assess walking speed in meters per second over a short distance. It can be employed to determine functional mobility, gait, and vestibular function. | At first visit (t+0) and prior to first training 2-4 days after first vist (t+2) |
| Proof-of-Concept: Gait speed with the built-in sensors. | A second standardised clinical assessment often employed as part of routine assessments will be used. The 6 Minute Walk Test (6MWT) is a sub-maximal exercise test used to assess aerobic capacity and endurance. | At first visit (t+0) and prior to first training 2-4 days after first vist (t+2) |
| Proof-of-Concept: Increased intensity during walking (VCO2/VO2 relationship) | Cardiopulmonary response will be measured using a breath-by-breath cardiorespiratory monitoring system (MetaMax 3B, Cortex Biophysik, Leipzig, Germany) and a receiver board (HRMI, Sparkfun, Boulder, USA). During 10 meter walk test and a 6-minute walk test, oxygen uptake (VO2) and carbon dioxide output (VCO2) will be recorded and reported and VCO2/VO2 relationship. | At first visit (t+0 days) and prior to first training 2-4 days after first vist (t+2 days) |
| Proof-of-Concept: Increased intensity during walking (heart rate) | During 10 meter walk test and a 6-minute walk test, heart rate (HR) will be recorded in both conditions (with and without belt). HR will be recorded over a rate belt (T31, Polar Electro, Kempele, Finland). | At first visit (t+0 days) and prior to first training 2-4 days after first vist (t+2 days) |
- attitude towards technology and the use of sensors (visual analogue scale, VAS, 0 to 100mm, where 0 stands for 'negative attitude' and 100 for 'positive attitude'),
| At first visit (t+0 days). |
| Demographics: Age | Age in years. | At first visit (t+0 days). |
| Demographics: Weight and height reported as BMI [kg/m^2] | Weight [kg] and height [m] in BMI [kg/m^2] | At first visit (t+0 days). |
| Demographics: Profession | Profession (qualitative description) | At first visit (t+0 days). |
| Attrition | For attrition, the number of participants lost during the intervention was recorded. For adherence, participants' engagement with the intervention will be assessed. | 3 to 4 weeks after first visit. |
| Adherence | Adherence will be calculated as the number of completed training sessions as a percentage of the maximal possible training sessions. | 3 to 4 weeks after first visit. |
| Exercise diary: | Training duration and intensity will be derived from the smartphone interface. | 3-4 weeks |