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Fast Facts About Precision Medicine: How Do Patients Recover Following Stroke?

Fast Facts About Precision Medicine: How Do Patients Recover Following Stroke?


Wearable activity trackers could provide clinicians with clues to how survivors of stroke are faring during their recovery.

In an ongoing precision medicine project, Johns Hopkins physical medicine and rehabilitation specialists provided 100 survivors of strokes with wearable activity trackers to monitor their motions over the course of a year. After collecting data on survivors’ heart rate and number of steps taken — uploaded automatically to Johns Hopkins’ Precision Medicine Analytics Platform for study — researchers so far have found that survivors tend to fall into one of three categories: people who get a lot of activity each day, and whose heart rate rises and falls appropriately along with their level of activity; people who are more sedentary, but whose heart rate also responds well to their level of activity; and a so-called “deconditioned” group, who are relatively sedentary but whose heart rate rises significantly even from low levels of activity.

Precision Medicine at Work

Each group potentially could benefit from different types of interventions, explains movement scientist Ryan Roemmich, Ph.D., co-director of the Johns Hopkins Precision Rehabilitation Center of Excellence. For example, members of the active group could be checked to see how they are moving, and if any physical therapy is needed to strengthen certain muscles. The sedentary group could receive a lifestyle intervention to encourage more daily activity, while the deconditioned group might benefit from a lifestyle intervention to encourage activity plus aerobic exercise training to improve their heart health.

Roemmich and colleagues are now looking to study recovery in the first year after stroke, ideally outfitting patients with an activity tracker as soon as the day they’re admitted to the hospital, to see if they can gain better insight into recovery patterns.

“Those really early periods right after stroke are actually when people tend to show the steepest curves of recovery,” he says. “They tend to regain a lot of function back quickly early on and plateau later. We’d like to investigate whether these same subgroups still exist early on, and if they have predictive value about a patient’s trajectory of recovery.”

They also will evaluate if the periodic psychosocial and cognitive assessments that stroke survivors complete provide any clues to patterns of recovery. Meanwhile, other investigators in the physical medicine and rehabilitation department will test activity trackers in a group of adolescents recovering from traumatic brain injuries such as concussions, to see if similar subgroups emerge.

More information on stroke and the Comprehensive Stroke Center

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