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Mobile Rehabilitation for Daily Life Participation Post-Stroke

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Principal Investigator

Alex Wong, PhD

As stroke mortality has declined, a growing number of stroke survivors are returning to the community. Most survivors continue to experience functional limitations in their day-to-day lives. 嫩B研究院 has focused on neurocognitive impairment (NCI) as an important driver of functional limitation. However, the contribution of NCI to functional limitation is not well characterized, with existing research showing no consistent relationships.

The researchers will use Ecological Momentary Assessment (EMA) as a technology-based ambulatory assessment to prospectively measure daily life activities and behavioral factors among 115 stroke survivors. In comparison to standard clinic-based assessments, EMA allows for real-time, repeated, within-person sampling of daily function, including participation in cognitive, social, physical, and passive leisure activities in real-world environments. EMA also assesses time spent in, and performance appraisals of, daily activities, as well as time-varying behaviors to understand dynamic relationships among study constructs and uncover within-person trends over time. The researchers will focus on variability in depressed mood and quality of life among stroke survivors, and social support, a protective factor with a potential buffering effect on daily function and mood. 

Their pilot study has demonstrated strong support for the acceptability of mobile device use for stroke rehabilitation, and the researchers have developed an EMA daily function survey tailored for stroke survivors which they will use in this study to establish the most pertinent future treatment targets. Goals of this study are to determine both treatment targets and how and when to intervene to enhance stroke survivors’ daily function.

There are two main aims:

Aim 1: Use EMA to compare patters of daily function between survivors with and without NCI, and determine which aspects of NCI have greater effects on daily function.

Aim 2: Determine the impact of EMA-measured depressed mood and social support in explaining the temporal associations between NCI and daily function. 

This research is funded by a K01 嫩B研究院 Scientist Development Award from the National Institutes of Health to Alex Wong, PhD, CROR 嫩B研究院 Scientist and 嫩B研究院 Associate Professor in Physical Medicine and Rehabilitation at Northwestern University’s Feinberg School of Medicine.

Publications

  • Yun Shi, Mandy W.M. Fong, Christopher L. Metts, Sherri L. LaVela, Charles Bombardier, Lu Hu, Alex W.K. Wong,
    . Archives of Physical Medicine and Rehabilitation,
    2024, ISSN 0003-9993.
     
  • Alex W.K. Wong, Rachel Tomazin, Kim Walker, Rachel Heeb Desai, Holly Hollingsworth, Pamela K. Newland, Kerri A. Morgan, . Disability and Health Journal, 2023, 101549, ISSN 1936-6574.
     
  • Shi Y, Lenze EJ, Mohr DC, Lee JM, Hu L, Metts CL, Fong MWM, Wong AWK. . Arch Phys Med Rehabil. 2023 Oct 24:S0003-9993(23)00592-0. doi: 10.1016/j.apmr.2023.10.006. Epub ahead of print. PMID: 37884084.
     

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  • Zhaoying Li, Yating Lei, Quoc Bui, Olivia DePaul, Ginger Nicol, David Mohr, Sunghoon Lee, Mandy Fong, Christopher Metts, Stephanie Tomazin, Alex Wong. JMIR Rehabilitation Assistive Technology. Feb., 2024.
     
  • Elizabeth Munsell, Quoc Bui, Katherine Kaufman, Stephanie Tomazin, Bridget Regan, Eric Lenze, Jin-Moo Lee, David Mohr, Mandy Fong, Christopher Metts, Vy Pham, Alex Wong. Topics in Stroke Rehabilitation. Jan., 2024.
     
  • . Alex Wong, Mandy Fong, Elizabeth Munsell, Christopher Metts, Sunghoon Lee, Ginger Nicol, Olivia DePaul, Stephanie Tomazin, Katherone Kaufman, David Mohr. JMIR Human Factors. July 24, 2023.
     
  • Lee, Y., Walsh, R.J., Fong, M.W.M., Sykora, M., Doering, M.M., & Wong, A.W.K. (2021). Heart rate variability as a biomarker of functional outcomes in persons with acquired brain injury: Systematic review and meta-analysis. Neuroscience and Biobehavioral Reviews, 131, 737-754. PMID: 34626686
     
  • Lau, S.C.L., Judycki, S., Mix, M., DePaul, O., Tomazin, R., Hardi, A., Wong, A.W.K., & Baum, C.M. (2022). Theory-based self-management interventions for community-dwelling stroke survivors: A systematic review and meta-analysis. American Journal of Occupational Therapy, 76(4). PMID: 35772070

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