Monitoring of Everyday Motor activitiEs to support iNdependence of sTrOke survivors – Actiphyz

The functional independence of stroke patients is usually assessed using scales such as the Barthel Index (BI). However, since these scales are based on models based on average data, they are of little interest to an individual requiring a personalized assessment of his or her level of independence. This type of scale evaluation has important limitations that make its diagnostic power weak enough to differentiate finely from difficulties in everyday life. In addition, these scales are based on subjective data provided by patients themselves or their caregivers. It would be appropriate to base the assessment of stroke patient independence on objective data describing daily activities through a number of non-intrusive sensors. Actiphyz will provide a more accurate assessment of the difficulties of daily living, based on data directly from the physical activity of patients with stroke, physiological data and neuropsychological assessments.

- Formalization of user needs, definition of use cases, definition of functionalities to be covered by the measurement approaches to be implemented.

- Prototypes of sensors (bracelets and insoles) for quantifing the motor activity, data aggregation box collecting data from a number of sensors, first implementation of the expert system and serious games.

- Definition of the usability tests

- Presented the project and its results through various communication channels (press release, participation in conferences on the topic of health, etc.). There was a lot of interest in the project.

The Actiphyz project opens new possibilities for monitoring the physical activity of stroke survivors under ecological conditions and thus leads to a better assessment of the functional independence of stroke patients.

Two patents are being filed by the CEA and covering the development of the physical activity sensors. One of the patents will be a joint application with the Hopale Foundation.

Stroke a leading cause of death and disability, with an estimated total cost of €65 billion per year in Europe. Even though preventive measures are in place by national health systems to reduce the incidence of stroke, the number of persons having a stroke in Europe is likely to increase from 1.1 million per year in 2000 to more than 1.5 million per year in 2025 because of the increasing ageing population. When not fatal, stroke is very heterogeneous in terms of recovery outcome, but, generally, it is estimated that 24% to 74% of the 50 million stroke survivors worldwide require some assistance or are fully-dependent on caregivers for Activities of Daily Life (ADL) such as walking, toileting, dressing, preparing meals, sleeping. Thus, stroke is a chronic condition, which negatively influences independence in daily life.

The assessment of stroke survivors’ functional independence in daily activities is usually done by scales such as the Barthel Index (BI) and the Functional Independence Measure. However, as these scales rely on average recovery patterns, they might have little relevance for an individual patient or clinician, who need a personalised evaluations of their independence levels based on their living environments and habits. Furthermore, these scales are based on subjective first-person or carers’ accounts. On the contrary, it would be interesting and useful for the stroke survivors, their carers and clinicians to base the evaluation on objective data on daily activities provided by a number of non-obtrusive sensors. Such sensors may provide information on the number of steps a person walks, activity duration, the time in sedentary versus upright position, as well as energy expenditure.
Thus, the main goal of MEMENTO (Monitoring of Everyday Motor activitiEs to support iNdependence of sTrOke survivors) project is to provide patients, carers and clinicians with objective and timely data on stroke survivor’s daily physical activities once at home. This information will facilitate patients, carers’ and clinicians’ understanding of the level of physical independence achieved by the individual and will thus support the tailoring of monitoring and, eventually, rehabilitation programs to every person’s needs. These data will be collected by unobtrusive sensors, preserving as much as possible stroke survivors’ privacy. Based on existing technologies and knowledge in the partners’ institutions, we will integrate and test an affordable and easy-to-use monitoring system informing stroke survivors and their carers about daily physical activities and the relations that these activities have with functional independence.

The Consortium is formed by 5 Partners. There are 2 research institutions, namely CEA (coordinator) working on sensing and patient-centred evaluation, and IFSTTAR working on innovative measures for patient independence evaluation. There are also 2 industrial partners providing technological solutions. Thus, Magillem Design Services provides a software for data analysis and Bluelinea provides remote monitoring services. These partners will also exploit the technological solutions to be developed by CEA. Finally, there is one user organisation (Fondation Hopale) working on end-user needs elicitation and technology evaluation. Thus, the development and evaluation of the MEMENTO system will be achieved thanks to the various individual partner competences and expertise which result in a coherent global task force going beyond the individual partners’ expertise sum. The diversity of technical skills, business development experiences and user knowledge represented by the consortium will ensure that all the driving forces of a successful product development are properly addressed (user needs, usability, efficiency, regulatory constraints, and market up-take).