Quantification of energy expenditure during daily living activities after stroke by multi-sensor

Objective: To explore the validity of energy expenditure estimates using the SenseWear Armband during a sequence of four daily living activities in patients post-stroke. Method: Patients with stroke who were able to walk during 6 min without human assistance were asked to wear the SenseWear Armband on the non-paretic arm while performing transfers, a manual task, walking, and walking up and down stairs. The energy expenditure estimated using the SenseWear Armband was compared to the energy expenditure calculated from oxygen consumption, measured by a portable indirect calorimeter (Metamax 3B). The mean of energy expenditure was pooled for each task. Accuracy was explored by mean bias (MB) of Bland-Altman analysis and root mean square error (RMSE), agreement by 95% of limits of agreement (95%LoA) and coefficient of correlation (r). Results: Thirty-eight participants (65.7 ± 13.5 years) were included. The SenseWear Armband globally underestimated energy expenditure, MB = 9.77 kcal for the whole sequence. RMSE were large, accounting for 15% to 41% of the measured energy expenditure. Agreement was low with r < 0.70 and 95%LoA from 42% to 93% of the measured energy expenditure. Conclusions: This study reported a global underestimation and a low level of agreement of the energy expenditure estimated by SenseWear Armband in four daily living activities in patients after stroke. Abbreviations: EE: Energy Expenditure; NIHSS: National Institute of Health Stroke Score.