Exploring Motio Functional Report Metrics – Detailed Activity

Image 1 - Prosthetic user wearing a Motio StepWatch device

As previously published in different blog posts, the Motio Functional Report includes different sections:

• Patient information

  • To ensure patient-centered care, it is essential to integrate data sources and track progress, combining data-driven metrics with historical patient information.

• Functional Level Assessment 

  • Clinician Recommendation: emphasizes the clinician's suggested K-Level for the patient based on the analysis of the results provided by the evaluation with the Motio StepWatch System.

  • Motio Functional Level: represents the average of the clinician recommendation and the activity scores.

  • In-clinic tests: presents the results of the optional Outcome Measures included in the Motio App, that can be conducted in-clinic.  

• Daily Activity Highlights: Average and best days are divided into four different categories (steps, top speed, top cadence and maximum continuous walking distance).

• Activity Scores: Specific proprietary algorithms are used to calculate scores related to Ambulation Energy, Cadence Variability and Peak Performance.

• Overall Activity Description: provides an overall activity description of the long-term acquisition with two different visuals: calendar and active time.

• Blind Outcome Evaluations: showcases the results of three different blind evaluations performed during the acquisition period - Two-minute of continuous walk, Six-minute of continuous walk and 10-meters of continuous walk.

• Detailed Activity: summarizes the activity observed throughout the acquisition period using two distinct visuals (bar graphs and histogram graphs) with three detailed values: the daily number of steps, daily activity intensity, and daily step activity.   

This blog post concludes the series “Exploring Motio Functional Report Metrics”, centering our attention on the detailed activity section and the different visuals it presents.

Significance of the Detailed Activity Section

An interpretation of the outcome measures must take day-to-day variations in activity into consideration, as lower limb prosthetic users may experience “good days” and “bad days”. Interpreting these differences may facilitate communication with the patient, enabling a better understanding of the reasons behind changes in their daily activities.

Detailed Activity Section: what does it offer? 

Daily Steps Graph 

The first bar graph presents a visual representation of the daily number of steps taken by the patient during the acquisition period. This visual allows clinicians to observe the variation in step count on a day-to-day basis, providing insights into the highest, lowest, and most common values throughout the acquisition period. This can be used to view a patient’s consistency from day to day.

Figure 1 - Example of a daily number of steps graph.

The daily step count is an objective measure of success in prosthetic rehabilitation that can be used to monitor mobility, optimize prosthetic functionality, and enhance general health. Lower-limb prosthetic users' comfort and abilities improve as they adjust to their prosthetic limbs, allowing both the individual and their healthcare team to establish reasonable goals, progressively increasing step counts and distances as their comfort and abilities improve.

Daily Activity Intensity Graph 

The second bar graph depicts the daily activity intensity, showcasing the distribution of time spent in low, moderate, and high-intensity activity throughout the acquisition period. By presenting this information visually, clinicians can easily identify the patterns and trends in the patient's activity intensity levels each day, gaining a deeper understanding of their activity profile. This visual allows the clinician to understand how much the patient was able to vary their cadence and how active they were during the acquisition period.

Figure 2 - Example of a daily activity intensity graph.

Daily Step Activity Graph 

The last visual displays the daily step activity data (Figure 3) as histograms of steps per minute over 24-hour periods.  Each day of the acquisition period, beginning at midnight and ending 24 hours later, is represented by a single histogram. 

The number of steps in each one-minute interval is represented by a thin vertical line for each minute, with the length of this line representing the number of steps in that minute.   These graphs represent the number of steps taken during each minute of activity and they are a visual representation of Cadence Variability, Potential to Ambulate, and Energy Level. Multiple varying peaks and valleys are a visual representation of high potential.

Figure 3 - Example of daily step activity data. 

How to understand these graphs? 

• Cadence Variability (Figure 4): defined as the ratio of Low: Medium: High step rates. Low is defined as less than 30 steps per minute; medium is 31–80 steps per minute; and high is more than 80 steps per minute. A more balanced ratio with more steps at the high and medium step rates indicates a greater cadence variability score.

Figure 4 - Example of Cadence Variability. On the left, high cadence variability - step rate distribution balanced between Low: Medium: High. On the right, low cadence variability – step rate distribution based toward Low: Medium. 

• Potential to Ambulate (Figure 5): the indicator of this characteristic comes from the highest single minute of activity that the prosthetic users achieve through the acquisition period. Each histogram contains colored bands that correlate to different activity intensities. It is possible to determine the users' ability to ambulate based on how many steps they took in their best single minute: high, medium, or low potential.

Figure 5 - Example of high (left) and low (right) potential to ambulate. 

• Energy Level - estimating the total number of steps. Prosthetic users whose activity comprised high step density (lots of steps close together in time) show greater energy expenditure levels than those whose activity spread throughout the acquisition period.

Figure 6 - Example of energy level. On the left, high energy level – ambulates often and demonstrates high energy level requirements. On the right, low energy level – ambulates infrequently and demonstrates low energy requirements.

 A Complete Approach to Prosthetic Rehabilitation    

Driven by the Motio StepWatch System, the Motio Functional Report enables rehabilitation teams to make more informed decisions in prosthetic care. By comprehensively analyzing the different sections, clinicians gain a detailed understanding of each person's daily activities and capabilities. This not only helps in establishing achievable rehabilitation goals but also enriches the overall quality of life for prosthetic users. With current guidelines lacking specific recommendations for lower-limb prosthetic users, the Motio Functional Report stands out as a valuable tool for tailored and efficient prosthetic rehabilitation.

Stay tuned for our upcoming blog posts, where we'll delve into various case studies utilizing the Motio StepWatch System!