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Updated: May 10, 2025

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Association Between Real-World Actigraphy and Poststroke Motor Recovery.

Keith R Lohse1,2, Allison E Miller1, Marghuretta D Bland1,2,3

  • 1Program in Physical Therapy (K.R.L., A.E.M., M.D.B., C.E.L.), Washington University School of Medicine, St Louis, MO.

Stroke
|April 23, 2025
PubMed
Summary

Remote wearable sensors show strong validity for measuring arm recovery after stroke, especially early on. This technology can help track motor recovery in large studies with minimal participant burden.

Keywords:
actigraphyarmremote patient monitoringstrokeupper extremity

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Area of Science:

  • Neuroscience
  • Rehabilitation Medicine
  • Biomedical Engineering

Background:

  • Stroke rehabilitation advances have lagged acute treatment, necessitating scalable methods for collecting recovery data.
  • Large-scale biological studies require efficient, low-burden methods for phenotyping motor recovery post-stroke.
  • Wearable sensor technology offers potential for remote, objective measurement of motor function.

Purpose of the Study:

  • To investigate the concurrent validity of remotely collected wearable sensor data against in-clinic assessments of motor recovery post-stroke.
  • To assess the utility of the use ratio (paretic vs. non-paretic arm activity) as a measure of motor recovery.
  • To evaluate the reliability of these measures across different stages of stroke recovery.

Main Methods:

  • Utilized a large, harmonized multisite dataset of adults at various stages of stroke recovery (N=198 cross-sectional, N=98 longitudinal).
  • Analyzed the use ratio, Action Research Arm Test (ARAT), and Fugl-Meyer Assessment (FMA-UE) for concurrent validity.
  • Compared cross-sectional and longitudinal changes in these measures from 0 to over 52 weeks post-stroke.

Main Results:

  • Strong concurrent validity was observed between the use ratio, ARAT, and FMA-UE, both cross-sectionally and longitudinally.
  • High correlations were found early post-stroke (e.g., r=0.87 between use ratio and ARAT at 0-6 weeks).
  • Correlations between the use ratio and clinical assessments decreased over time (e.g., r=0.58 at ≥52 weeks).

Conclusions:

  • The use ratio derived from wearable sensors demonstrates strong concurrent validity for assessing motor recovery post-stroke, particularly in the early stages.
  • While correlations decrease over time, the use ratio remains a valuable tool for large-scale recovery studies.
  • Personal and environmental factors may increasingly influence motor recovery and measurement validity as time progresses post-stroke.