Abstract
The aim of this review was to identify and summarise publications, which have reported clinical applications of upper limb accelerometry for stroke within free-living environments and make recommendations for future studies. Data was searched from MEDLINE®, Scopus, IEEExplore and Compendex databases. The final search was 31st October 2013. Any study was included which reported clinical assessments in parallel with accelerometry in a free-living hospital or home setting. Study quality is reflected by participant numbers, methodological approach, technical details of the equipment used, blinding of clinical measures, whether safety and compliance data was collected. First author screened articles for inclusion and inclusion of full text articles and data extraction was confirmed by the third author. Out of 1375 initial abstracts, 8 articles were included. All participants were stroke patients. Accelerometers were worn for either 24 hours or 3 days. Data were collected as summed acceleration counts over a specified time or as the duration of active/inactive periods. Activity in both arms was reported by all studies and the ratio of impaired to unimpaired arm activity was calculated in six studies. The correlation between clinical assessments and accelerometry was tested in five studies and significant correlations were found. The efficacy of a rehabilitation intervention was assessed using accelerometry by three studies: in two studies both accelerometry and clinical test scores detected a post-treatment difference but in one study accelerometry data did not change despite clinical test scores showing motor and functional improvements. Further research is needed to understand the additional value of accelerometry as a measure of upper limb use and function in a clinical context. A simple and easily interpretable accelerometry approach is required.Electronic supplementary materialThe online version of this article (doi:10.1186/1743-0003-11-144) contains supplementary material, which is available to authorized users.
Highlights
Body worn motion sensors provide an opportunity for non-invasive, objective and accurate observation of patients’ movements during research and clinical rehabilitation [1,2,3,4,5,6]
(3) How was data collected and analysed? (4) How do the data measurements obtained relate to clinical assessments in a way that would be useful for clinicians and researchers?
Age range was reported by three studies (35 to 94 years) [8,11,12] and the average age was reported by five studies [13,14,15,16,17] (Table 1)
Summary
Body worn motion sensors provide an opportunity for non-invasive, objective and accurate observation of patients’ movements during research and clinical rehabilitation [1,2,3,4,5,6]. These range from simple physical activity monitors (e.g. pedometers) [1] to more complex instruments that can capture precise limb position in a three-dimensional space (e.g. a combined accelerometergyroscope-magnetic field) [2]. Light and affordable, accelerometers are an attractive technology for measurement of upper extremity movement. The information derived from standard accelerometers is limited to changes in speed and direction, if therapeutic applications are demonstrated in hospital and home settings a large number of patients could benefit
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