Ambulatory assessment of motor performance after stroke

Abstract

Stroke is the leading cause of serious and long-term disabilities in developed countries. Of those who survive a stroke, common disabilities are upper and lower extremity motor deficits. Despite intensive training programs, stroke survivors regularly show deterioration of motor function during or after their rehabilitation period. In order to explain any functional progress or decline of motor function, information on body movements performed during daily life is necessary. However, regularly used standardized lab-based systems for the evaluation of body movements are not suitable for measurements of body movements in a daily life setting. Within the international project: ‘INTERACTION’ a wearable sensing system is developed for the ambulatory monitoring and assessment of upper and lower extremity motor performance. The final version of the system consists of multiple sensors integrated in clothing and shoes. Challenging in monitoring body movements in a daily life setting over a longer period of time, is the complexity and the amount of data such a system generates. The main goal of this dissertation therefore was to develop clinically relevant metrics for the ambulatory assessment of stroke survivors' quality of upper and lower extremity motor performance, using wearable sensors. The newly developed data analysis processes enable the assessment of motor performance on a level of body function during functional tasks in a daily life setting. Furthermore, data processing methods are proposed to present all measured data into concise functional reports. The automatically generated reports make it more feasible for the health care professional to evaluate large sets of movement data. In future, these reports may be used to objectively describe any progress or deterioration in motor performance and optimize individual rehabilitation processes. The presented methods are not limited to the evaluation of motor performance in stroke survivors, but could also be used in other clinical cases to objectively evaluate motor performance.