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Abstract
Stroke is a main cause of long-term disability worldwide, placing a large burden on individuals and health care systems. Wearable technology can potentially objectively assess and monitor patients outside clinical environments, enabling a more detailed evaluation of their impairment and allowing individualization of rehabilitation therapies. The aim of this review is to provide an overview of setups used in literature to measure movement of stroke patients under free living conditions using wearable sensors, and to evaluate the relation between such sensor-based outcomes and the level of functioning as assessed by existing clinical evaluation methods. After a systematic search we included 32 articles, totaling 1076 stroke patients from acute to chronic phases and 236 healthy controls. We summarized the results by type and location of sensors, and by sensor-based outcome measures and their relation with existing clinical evaluation tools. We conclude that sensor-based measures of movement provide additional information in relation to clinical evaluation tools assessing motor functioning and both are needed to gain better insight in patient behavior and recovery. However, there is a strong need for standardization and consensus, regarding clinical assessments, but also regarding the use of specific algorithms and metrics for unsupervised measurements during daily life.
Highlights
Stroke is classically characterized as a neurological deficit attributed to an acute focal injury of the central nervous system by a vascular cause and is a major cause of disability and death worldwide [1]
The aim of this review is : (1) to provide an overview of setups used in literature to measure the quantitative and qualitative aspects of movements of stroke patients under free living conditions using wearable sensors, and (2) to evaluate the relation between the sensor-based outcomes that are obtained from moving in a free living environment and the level of functioning as assessed by existing clinical evaluation methods
A summary of all included studies is presented in Appendix A in Table A1 and Table A2
Summary
Stroke is classically characterized as a neurological deficit attributed to an acute focal injury of the central nervous system by a vascular cause and is a major cause of disability and death worldwide [1]. Around 80% of stroke victims survive [2], but their quality of life can be severely impacted in both physical and physical-emotional domains [3]. Motor functioning of stroke patients is typically assessed in the controlled environment of a clinic, hospital or research laboratory, usually by asking the patient to perform standard clinical assessment tests which include repetitive tasks or isolated movements. This functional assessment is not representative of individual free-living behavior [5]. Because daily life functioning is severely affected by stroke [3], monitoring patients during their activities of daily living (ADL) could provide more valid information about patients’
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