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.