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Comparing Home Upper Extremity Activity with Clinical Evaluations of Arm Function in Chronic Stroke
Kavita Bhatnagar1, Christopher T Bever2,3, Jing Tian4
1University of Maryland School of Medicine.
Archives of Rehabilitation Research and Clinical Translation
|December 18, 2020
Summary
Clinical arm function tests correlate with accelerometer-measured arm use in stroke survivors. Home accelerometry can reveal discrepancies between clinical scores and daily arm activity, aiding personalized rehabilitation strategies.
Area of Science:
- Neuroscience
- Rehabilitation Medicine
- Biomedical Engineering
Background:
- Stroke often results in chronic arm motor deficits affecting daily function.
- Clinical assessments of arm function may not fully capture real-world motor performance.
- Objective measurement of arm use in the home environment is needed.
Purpose of the Study:
- To evaluate the correlation between standard clinical assessments of post-stroke arm function and objective measures of everyday arm motor performance obtained via accelerometry.
- To investigate if arm accelerometry can provide a more accurate reflection of functional arm use in community-dwelling stroke survivors.
Main Methods:
- A cross-sectional study analyzed baseline data from 20 community-dwelling adults with chronic stroke (≥6 months post-stroke).
- Participants underwent 72-hour wrist-worn accelerometry during their normal daily routines.
- Clinical evaluations included the Fugl-Meyer Assessment (FM), Action Research Arm Test (ARAT), Wolf Motor Function Test (WMFT), Motor Activity Log (MAL), and Stroke Impact Scale (SIS).
Main Results:
- Accelerometer-derived movement intensity (magnitude ratio) significantly correlated with FM (ρ=0.60), WMFT (ρ=0.59), and ARAT (ρ=0.50) scores.
- Accelerometer-derived arm use duration (hours of use ratio) correlated with MAL amount (ρ=0.58) and quality of movement (ρ=0.61).
- Total paretic arm use duration and intensity variables did not consistently correlate with all clinical or self-reported measures.
Conclusions:
- Higher baseline clinical function in stroke survivors was associated with greater intensity of paretic arm movement during daily activities.
- Self-perceived disability correlated with relative arm use, suggesting subjective experience aligns with objective measures.
- Discrepancies between clinical scores and home arm use highlight potential issues like neglect or learned non-use, underscoring the value of individualized accelerometry for tailoring rehabilitation.
