Smartphone-Based Ecological Momentary Assessment as the New Standard Measure for Post-Stroke Functioning (Preprint)

BACKGROUND Functional disability is common after stroke. To inform new treatments, better measures are needed to advance our understanding of post-stroke functioning. Ecological momentary assessment (EMA) provides a putatively valid measure of everyday functioning by assessing patients during their lived experiences. OBJECTIVE This study aims to validate the smartphone-based EMA to characterize post-stroke everyday functioning and symptoms. METHODS Participants (N=212) with mild to moderate stroke were assessed five times daily for 14 days with EMA surveys to appraise mental, somatic, and cognitive symptoms, and what, with whom, and where participants were doing activities. Participants also completed standardized assessments during lab visits. RESULTS Most participants (median age = 60 years) were ischemic stroke (90%) and neurologically mild (median NIHSS = 2). Total 14,140 EMA surveys were analyzed. Participants were home 78% of the time and primarily participated in passive, unproductive activities, especially watching television and resting. EMA was sensitive to indicators of post-stroke disability; unemployed participants reported fewer vocational activities (W =12183.5, P < .001) but more activities of daily living (ADL) (W =6995, P < .001) and passive activities (W =7499.5, P =.003) than employed counterparts. Users of mobility devices and participants with cognitive problems spent significantly less time on vocational activities (W =2717, P< .0001 for mobility devices; W =7278, P= .03 for cognitive problems) and more on ADL (W =4807.5, P= .010 for mobility devices; W =9516.5, P< .001 for cognitive problems) than non-users and those without cognitive problems. Our data supported the validity of EMA methods in stroke, with small-to-moderate correlations of EMA with in-lab measures of daily functioning and very large correlations between EMA and in-lab measures of symptoms, especially those measuring the same constructs. CONCLUSIONS Our findings reveal that EMA tracked post-stroke functioning precisely. EMA may be beneficial in examining post-stroke functional recovery, monitoring patients for home-based interventions, and for longitudinal research. CLINICALTRIAL NA

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Bridging the gap between performance-based assessment and self-reported everyday functioning: An ecological momentary assessment approach

The Clinical Neuropsychologist ◽

10.1080/13854046.2020.1733097 ◽

2020 ◽

Vol 34 (4) ◽

pp. 678-699 ◽

Cited By ~ 2

Author(s):

Maureen Schmitter-Edgecombe ◽

Catherine Sumida ◽

Diane J. Cook

Keyword(s):

Ecological Momentary Assessment ◽

Everyday Functioning ◽

Performance Based Assessment ◽

Assessment Approach ◽

Ecological Momentary ◽

Momentary Assessment

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A Novel Combination of Accelerometry and Ecological Momentary Assessment for Post-Stroke Paretic Arm/Hand Use: Feasibility and Validity

Journal of Clinical Medicine ◽

10.3390/jcm10061328 ◽

2021 ◽

Vol 10 (6) ◽

pp. 1328

Author(s):

Yi-An Chen ◽

Marika Demers ◽

Rebecca Lewthwaite ◽

Nicolas Schweighofer ◽

John R. Monterosso ◽

...

Keyword(s):

Ecological Momentary Assessment ◽

Targeted Interventions ◽

Post Stroke ◽

Key Indicator ◽

Change Behavior ◽

Paretic Limb ◽

Measurement Reactivity ◽

Use Behavior ◽

Ecological Momentary ◽

Momentary Assessment

Use of the paretic arm and hand is a key indicator of recovery and reintegration after stroke. A sound methodology is essential to comprehensively identify the possible factors impacting daily arm/hand use behavior. We combined ecological momentary assessment (EMA), a prompt methodology capturing real-time psycho-contextual factors, with accelerometry to investigate arm/hand behavior in the natural environment. Our aims were to determine (1) feasibility and (2) measurement validity of the combined methodology. We monitored 30 right-dominant, mild-moderately motor impaired chronic stroke survivors over 5 days (6 EMA prompts/day with accelerometers on each wrist). We observed high adherence for accelerometer wearing time (80.3%), EMA prompt response (84.6%), and generally positive user feedback upon exit interview. The customized prompt schedule and the self-triggered prompt option may have improved adherence. There was no evidence of EMA response bias nor immediate measurement reactivity. An unexpected small but significant increase in paretic arm/hand use was observed over days (12–14 min), which may be the accumulated effect of prompting that provided a reminder to choose the paretic limb. Further research that uses this combined methodology is needed to develop targeted interventions that effectively change behavior and enable reintegration post-stroke.

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Emotionsregulation bei Depression

Psychologische Rundschau ◽

10.1026/0033-3042/a000172 ◽

2013 ◽

Vol 64 (4) ◽

pp. 235-243 ◽

Cited By ~ 14

Author(s):

Sven Barnow ◽

Maren Aldinger ◽

Ines Ulrich ◽

Malte Stopsack

Keyword(s):

Ecological Momentary Assessment ◽

Ecological Momentary ◽

Momentary Assessment

Die Anzahl der Studien, die sich mit dem Zusammenhang zwischen Emotionsregulation (ER) und depressiven Störungen befassen, steigt. In diesem Review werden Studien zusammengefasst und metaanalytisch ausgewertet, die den Zusammenhang zwischen ER und Depression mittels Fragebögen bzw. Ecological Momentary Assessment (EMA) erfassen. Dabei zeigt sich ein ER-Profil welches durch die vermehrte Nutzung von Rumination, Suppression und Vermeidung bei gleichzeitig seltenerem Einsatz von Neubewertung und Problemlösen gekennzeichnet ist. Mit mittleren bis großen Effekten, ist der Zusammenhang zwischen Depression und maladaptiven Strategien besser belegt als bei den adaptiven Formen, wo die Effekte eher moderat ausfielen. EMA-Messungen bestätigen dieses Profil. Da EMA-Studien neben der Häufigkeit des Strategieeinsatzes auch die Erfassung anderer ER-Parameter wie Effektivität und Flexibilität ermöglichen, sollten solche Designs in der ER-Forschung zukünftig vermehrt Einsatz finden.

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Using Personal Cell Phones for Ecological Momentary Assessment

European Psychologist ◽

10.1027/1016-9040/a000127 ◽

2013 ◽

Vol 18 (1) ◽

pp. 3-11 ◽

Cited By ~ 42

Author(s):

Emmanuel Kuntsche ◽

Florian Labhart

Keyword(s):

Data Collection ◽

Ecological Momentary Assessment ◽

Communication Systems ◽

Cell Phones ◽

Personal Digital Assistants ◽

Natural Environments ◽

Mobility Patterns ◽

Standard Data ◽

Ecological Momentary ◽

Momentary Assessment

Ecological Momentary Assessment (EMA) is a way of collecting data in people’s natural environments in real time and has become very popular in social and health sciences. The emergence of personal digital assistants has led to more complex and sophisticated EMA protocols but has also highlighted some important drawbacks. Modern cell phones combine the functionalities of advanced communication systems with those of a handheld computer and offer various additional features to capture and record sound, pictures, locations, and movements. Moreover, most people own a cell phone, are familiar with the different functions, and always carry it with them. This paper describes ways in which cell phones have been used for data collection purposes in the field of social sciences. This includes automated data capture techniques, for example, geolocation for the study of mobility patterns and the use of external sensors for remote health-monitoring research. The paper also describes cell phones as efficient and user-friendly tools for prompt manual data collection, that is, by asking participants to produce or to provide data. This can either be done by means of dedicated applications or by simply using the web browser. We conclude that cell phones offer a variety of advantages and have a great deal of potential for innovative research designs, suggesting they will be among the standard data collection devices for EMA in the coming years.

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