Insights Gained From Activity Monitors for Upper Limb Stroke Rehabilitation

Abstract

<h3>Research Objectives</h3> To determine if measures derived from wrist-worn activity monitors can be used as a proxy for functional arm/hand behaviors of chronic stroke survivors. <h3>Design</h3> Cross-sectional study. <h3>Setting</h3> Laboratory. <h3>Participants</h3> Chronic stroke survivors (n=20; 7 females, age: 58.4 (SD=8.9) years with mild-severe arm motor impairments (Fugl-Meyer Assessment (FMA) score: 39.4 (17.3) [1]). <h3>Interventions</h3> N/A. <h3>Main Outcome Measures</h3> The Chedoke Arm and Hand Activity Inventory-7 (CAHAI), the FMA and the Reaching Performance Scale (RPS) were administered. For the CAHAI, participants were outfitted with two wrist-worn activity monitors (MiGo, Flint Rehabilitation Devices) and video recorded. Each video was annotated to identify movements of each arm and time in active movements. For each arm, time in active movement, movement counts, and percentage of arm use were computed from the MiGo and compared to the video recording metrics [2-3]. <h3>Results</h3> Movement metrics derived from the MiGo were strongly related to metrics from the video annotations (active movement time: r2=0.946; movement counts: r2=0.893). Asymmetries in arm use for bimanual tasks were quantified as a ratio (paretic/total movements) and expressed as a percentage of paretic arm use: 28.6 (12.6)%; and time in active movement for the paretic arm: 37.5 (10.6)% (neurotypical symmetry ratio: ∼50% [4]). Altogether, the relationship between each of the three clinical measures and MiGo metrics (Movement count, Movement time) ranged from moderate to strong (r2=0.539-0.746). <h3>Conclusions</h3> Time in active movements may be a more intuitive outcome than movement count for stroke survivors, and a valid proxy for the more standard movement count metric. Perspectives from users would provide insight about the meaningfulness of each metric for future efforts to effect durable gains in paretic arm use in the natural environment [5]. <h3>Author(s) Disclosures</h3> JR is a full-time employee of Flint Rehabilitation Devices, LLC. DZ is a full-time employee and co-owner of Flint Rehabilitation Devices, LLC.