Abstract
Background: Adherence to home practice rehabilitation programs is important for efficacy; however, adherence is challenging for many individuals post-stroke. Accelerometers have emerged as a potential means to support home practice. This secondary data analysis explored the use of a commercially available accelerometer with custom software to collect and analyze data to corroborate self-reported practice collected during a home program.Methods: The initial study was a single subject design trial that investigated the effect of preferred music listening on adherence to an upper extremity home practice program (Trial Number NCT02906956. ClinicalTrials.gov). The participants (n = 7) were post-stroke adults with aphasia and hemiparesis of the upper extremity. Participants completed home program exercises while wearing accelerometers and recorded practice times in a logbook. Data were collected, cleaned, processed, and analyzed to facilitate descriptive comparisons and clinical interpretations of accelerometer output data.Results: Across all participants, an average of 47% of data were captured and usable for analysis. Five out of seven participants self-reported longer practice times compared to accelerometer duration output by a mean of 66.5 s. Individual exercise set mean total angular velocity and standard deviation of acceleration demonstrated potential for use across time to monitor change.Conclusions: One challenge of integrating accelerometers into clinical practice is the amount of data loss and the steps for data processing. The comparisons of available accelerometer data to the self-reported logs, however, were generally representative. Future investigations should explore ways to increase data capture and accessibility of the data for feedback to the client and practitioner.
Highlights
Hemiparesis is the most common post-stroke neurological impairment and affects participation in activities of daily living (ADLs) and meaningful occupations (Reiterer et al, 2008)
This paper presents the secondary analysis of data captured via a commercially available accelerometer during completion of an upper extremity home program for individuals with chronic stroke
Our study explored duration, angular velocity, and standard deviation of acceleration outputs, which can provide key feedback regarding practice times, quality of practice, and improvement in function over time during poststroke rehabilitation programs
Summary
Hemiparesis is the most common post-stroke neurological impairment and affects participation in activities of daily living (ADLs) and meaningful occupations (Reiterer et al, 2008). One effective rehabilitation approach to increase motor function and prevent learned non-use involves rebuilding neural connections through task repetitive practice (Lang and Birkenmeier, 2014). While this approach shows promise, clinicians have limited time to provide direct services to clients. This barrier often leads to the use of home programs to extend treatment through unsupervised practice. There are two approaches commonly reported in the literature to measure adherence to home programs: self-report via journal/diary/logbook or use of a technological method to track activity (Frost et al, 2017; Donoso Brown et al, 2020a). This secondary data analysis explored the use of a commercially available accelerometer with custom software to collect and analyze data to corroborate self-reported practice collected during a home program
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