Abstract
BackgroundIn both clinical and occupational settings, ambulatory sensors are becoming common for assessing all day measurements of arm motion. In order for the motion of a healthy, contralateral side to be used as a control for the involved side, the inherent side to side differences in arm usage must be minimal. The goal of the present study was to determine the reliability of side to side measurements of upper extremity activity levels in healthy subjects.MethodsThirty two subjects with no upper extremity pathologies were studied. Each subject wore a triaxial accelerometer on both arms for three and a half hours. Motion was assessed using parameters previously reported in the literature. Side to side differences were compared with the intraclass correlation coefficient, standard error of the mean, minimal detectable change scores and a projected sample size analysis.ResultsThe variables were ranked based on their percentage of minimal detectable change scores and sample sizes needed for paired t-tests. The order of these rankings was found to be identical and the top ranked parameters were activity counts per hour (MDC% = 9.5, n = 5), jerk time (MDC% = 15.8, n = 8) and percent time above 30 degrees (MDC% = 34.7, n = 9).ConclusionsIn general, the mean activity levels during daily activities were very similar between dominant and non-dominant arms. Specifically, activity counts per hour, jerk time, and percent time above 30 degrees were found to be the variables most likely to reveal significant difference or changes in both individuals and groups of subjects. The use of ambulatory measurements of upper extremity activity has very broad uses for occupational assessments, musculoskeletal injuries of the shoulder, elbow, wrist and hand as well as neurological pathologies.
Highlights
In both clinical and occupational settings, ambulatory sensors are becoming common for assessing all day measurements of arm motion
The activity of the pathological side is generally compared to that of the uninvolved side. This has been used in patients with stroke [3,4,5] and complex regional pain syndrome [6]. Another approach for assessing arm motion is to place a sensor on the humerus for direct assessment of arm elevation
One would need to determine the minimal clinically important difference (MCID), [27] which is beyond the scope of the present study
Summary
In both clinical and occupational settings, ambulatory sensors are becoming common for assessing all day measurements of arm motion. Originally developed for placement on the trunk to serve as surrogate measurements of energy expenditure, this methodology has been adapted for assessing movement of the upper extremity. For this approach, the activity of the pathological side is generally compared to that of the uninvolved side. This has been used in patients with stroke [3,4,5] and complex regional pain syndrome [6] Another approach for assessing arm motion is to place a sensor on the humerus for direct assessment of arm elevation. More recent studies have used linear accelerometers as tilt sensors for both ergonomic assessments [11,12,13,14] as well as assessing arm position during the course of daily activities [15]
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