Accelerometer assessed upper limb activity in people with stroke: a validation study considering ambulatory and non-ambulatory activities

Abstract

Purpose Accelerometry measurements are a promising method to provide quantitative information of upper limb function in daily life post stroke. Our purpose was to investigate i) the validity of accelerometer-based vector magnitude ratios (VMR) to distinguish upper limb function between individuals post-stroke and healthy controls during ambulatory and non-ambulatory activities and, ii) the association between the VMR and clinical assessment of upper limb function for individuals post-stroke. Methods Forty persons with stroke and 32 healthy controls wore wrist and hip accelerometers while performing three upper limb activities in a clinical setting and during three days in daily living. Clinical assessment of upper limb function was assessed with the Chedoke-McMaster Stroke Assessment measure and ABILHand. Results In the clinical setting and daily living, the VMR was significantly lower for individuals post-stroke compared to controls during non-ambulatory activities but not during ambulatory activities. There was a moderate to strong association between VMR and clinical assessment of upper limb function during all conditions, except for walking in the clinical setting. Conclusion The VMR could be used as a sensitive objective marker to measure upper limb function post-stroke during ambulatory and non-ambulatory daily activities. Implications for rehabilitation Accelerometer-based assessment of upper limb function is a sensitive measure of upper limb function post stroke during different activity domains. Accelerometers-based assessment of arm function can detect differences in arm function outside the clinical setting (daily living) over a prolonged period that are not always identified by clinical assessment or perceived ability.