Validation Study of the Marianjoy Fall Risk Assessment Tool.

Evaluation of fall risk in acute inpatient rehabilitation poses unique challenges. The purpose of this study was to validate an assessment tool for inpatient rehabilitation fall risk identification. This retrospective, descriptive study used a cohort of inpatient rehabilitation patients to evaluate the Marianjoy Fall Risk Assessment Tool reliability and validity. Following implementation of this Tool, fall rates steadily decreased to 49% over 6 years.

Monitoring community mobility with global positioning system technology after a stroke: a case study.

BACKGROUND: Stroke survivors often experience difficulty returning to activities and places they deem important to their social, leisure, and occupational aspirations. The extent to which stroke survivors return to community mobility and their ability to navigate and access locations they deem meaningful have not been objectively measured. PURPOSE: We used global positioning system technology (GPSt) to measure the community mobility of a person poststroke, and assess the relationship between GPSt measures and clinical measures of mobility. METHODS: : The participant was a 56-year-old man who sustained a right pontine stroke. At discharge from rehabilitation, his Six-Minute Walk Test distance was 73 m. He was fitted with a GPS unit and an accelerometer attached to a single belt and instructed to wear the devices at all times when out of bed. After identifying 10 locations that were important to his goals, he was monitored for 5 separate 1-week periods, on the first, fifth, and ninth weeks and at 6 and 12 months after discharge. RESULTS: During the first 10 weeks, he averaged 7.6 target visits (70%) and 26.7 trips per week. At 1 year, his Six-Minute Walk distance score was 287.5 m. Accelerometry data revealed that he remained primarily sedentary. Target visits and trips per week did not change substantially over the course of 1 year, and compliance wearing the GPS unit was variable. CONCLUSIONS: Given the limited correlation in gait speed and distance with target attainment and trips, these outcomes likely measure different constructs for this subject. GPSt may offer insights into participation for stroke survivors following rehabilitation.

Use of the Wii Gaming System for Balance Rehabilitation: Establishing Parameters for Healthy Individuals.

OBJECTIVE: This study was designed to establish balance parameters for the Nintendo(®) (Redmond, WA) "Wii Fit™" Balance Board system with three common games, in a sample of healthy adults, and to evaluate the balance measurement reproducibility with separation by age. SUBJECTS AND METHODS: This was a prospective, multivariate analysis of variance, cohort study design. Seventy-five participants who satisfied all inclusion criteria and completed an informed consent were enrolled. Participants were grouped into age ranges: 21-35 years (n=24), 36-50 years (n=24), and 51-65 years (n=27). Each participant completed the following games three consecutive times, in a randomized order, during one session: "Balance Bubble" (BB) for distance and duration, "Tight Rope" (TR) for distance and duration, and "Center of Balance" (COB) on the left and right sides. RESULTS: COB distributed weight was fairly symmetrical across all subjects and trials; therefore, no influence was assumed on or interaction with other "Wii Fit" measurements. Homogeneity of variance statistics indicated the assumption of distribution normality of the dependent variables (rates) were tenable. The multivariate analysis of variance included dependent variables BB and TR rates (distance divided by duration to complete) with age group and trials as the independent variables. The BB rate was statistically significant (F=4.725, P<0.005), but not the TR rate. The youngest group's BB rate was significantly larger than those of the other two groups. CONCLUSIONS: "Wii Fit" can discriminate among age groups across trials. The results show promise as a viable tool to measure balance and distance across time (speed) and center of balance distribution.