Evidence map›Paper›PMID 25261154›Full record

Trial reportNeurorehabilitation and neural repair2015

SIRRACT: An International Randomized Clinical Trial of Activity Feedback During Inpatient Stroke Rehabilitation Enabled by Wireless Sensing.

Andrew K Dorsch, Seth Thomas, Xiaoyu Xu, William Kaiser, Bruce H Dobkin, SIRRACT investigators

Registry-linked trialAbstract readClinical Trial, Phase IIIMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Neurorehabilitation and neural repair, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01246882 (Stroke Inpatient Rehabilitation Reinforcement of ACTivty), which is not on this map. Cited by 45 papers, 11 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
45citing papers in PubMed, 11 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT01246882 phase3completednot on this map

Stroke Inpatient Rehabilitation Reinforcement of ACTivty: An International Multisite Clinical Trial

TypeinterventionalSponsorUniversity of California, Los AngelesRan2011 to 2012Enrolled140ConditionsStrokeArmsAugmented activity feedback, Speed-only feedback
3 · Its place in the literature

Who cites it

45 citing papers in PubMed, 11 syntheses or guidelines pooled it.

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  10. Remote Patient Monitoring via Non-Invasive Digital Technologies: A Systematic Review.Telemedicine journal and e-health : the official journal of the American Telemedicine Association · 2017
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

6 authors.

Andrew K DorschUniversity of California, Los Angeles, CA, USA.
Seth ThomasUniversity of California, Los Angeles, CA, USA.
Xiaoyu XuUniversity of California, Los Angeles, CA, USA.
William KaiserUniversity of California, Los Angeles, CA, USA.
Bruce H Dobkin
SIRRACT investigators

Funding

UCLA Clinical and Translational Science InstituteUL1TR000124 · NCATS · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI DUBINETT, STEVEN M. · 2012 to 2015
$57.0M
Transcranial Direct Current Stimulation and Robotic Training in Chronic StrokeR01HD069776 · NICHD · WINIFRED MASTERSON BURKE MED RES INST · PI EDWARDS, DYLAN JAMES · 2012 to 2016
$3.2M
Sensor Activity Monitoring, Feedback, and Outcome Measures, Stroke RehabilitationR01HD071809 · NICHD · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI DOBKIN, BRUCE H · 2012 to 2014
$1.2M
NIH INTRAMURAL NRSA INSTITUTIONAL TRAINING PROGRAMF35HD007809 · NICHD · U.S. NATIONAL INST/CHILD HLTH/HUMAN DEV · PI LUO, XUN · 1993 to 1995
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NCATS NIH HHS UL1 TR000124NCATS NIH HHS UL1TR000124NICHD NIH HHS F35 HD007809NICHD NIH HHS R01 HD069776NICHD NIH HHS R01 HD071809NICHD NIH HHS R01 HD07809
6 · The paper itself

Abstract

backgroundWalking-related disability is the most frequent reason for inpatient stroke rehabilitation. Task-related practice is a critical component for improving patient outcomes.

objectiveTo test the feasibility of providing quantitative feedback about daily walking performance and motivating greater skills practice via remote sensing.

methodsIn this phase III randomized, single blind clinical trial, patients participated in conventional therapies while wearing wireless sensors (triaxial accelerometers) at both ankles. Activity-recognition algorithms calculated the speed, distance, and duration of walking bouts. Three times a week, therapists provided either feedback about performance on a 10-meter walk (speed only) or walking speed feedback plus a review of walking activity recorded by the sensors (augmented). Primary outcomes at discharge included total daily walking time, derived from the sensors, and a timed 15-meter walk.

resultsSixteen rehabilitation centers in 11 countries enrolled 135 participants over 15 months. Sensors recorded more than 1800 days of therapy, 37 000 individual walking bouts, and 2.5 million steps. No significant differences were found between the 2 feedback groups in daily walking time (15.1 ± 13.1 vs 16.6 ± 14.3 minutes, P = .54) or 15-meter walking speed (0.93 ± 0.47 vs 0.91 ± 0.53 m/s, P = .96). Remarkably, 30% of participants decreased their total daily walking time over their rehabilitation stay.

conclusionsIn this first trial of remote monitoring of inpatient stroke rehabilitation, augmented feedback beyond speed alone did not increase the time spent practicing or improve walking outcomes. Remarkably modest time was spent walking. Wireless sensing, however, allowed clinicians to audit skills practice and provided ground truth regarding changes in clinically important, mobility-related activities.

Indexed as

Stroke RehabilitationWireless TechnologyAgedBiofeedback, PsychologyFemaleHumansInpatientsInternational CooperationMaleMiddle AgedRehabilitation CentersSingle-Blind MethodStatistics, NonparametricTreatment OutcomeWalkingaccelerometerrehabilitationstroketelemedicinewalkingwireless technology

Identifiers

PMID25261154
PMCPMC4375021

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.