Upper limb activity in chronic post-stroke survivors: A comparison of accelerometry data with the Action Research Arm Test (ARAT)

Abstract

Only 5–20% of stroke survivors will regain full function of the upper limb (UL) with up to 60% still being impaired in the chronic phase. A plethora of outcome measures are used to assess UL function. However, they are often only a snap shot in time of the stroke survivor's capability and do not always reflect the stroke survivor's UL use in everyday real-world settings and contexts. The use of technologies has become a viable option for quantifying movements and activities during post-stroke rehabilitation in real-world contexts. This research compares the use of accelerometry with the ARAT over 96 hours with chronic stroke survivors and age-matched controls. Thirty chronic stroke survivors and 30 age-matched controls wore an accelerometer on each wrist for 96 hours. Stroke survivors were also assessed using the ARAT and reported their functional ability. Data were analysed to compare affected UL v non-affected UL, stroke survivor movement v control, and hand dominance v non-dominance. Accelerometry data were compared with the stroke survivors’ functional capability. Findings suggest there is an association between the ARAT and accelerometry; the greater the capability score the higher the usage of the affected UL. Controls carryout more bi-lateral activities compared to the stroke survivors who tend to use each arm independently. However, despite full functional capability scores, stroke survivors still do not use their impaired UL compared to their non-affected UL. This is due to sensory loss or mistrust of their affected UL. Compared to controls, chronic stroke survivors do not use their affected UL, nor do they carry out as much bi-lateral activity despite full capability. Accelerometry has the potential to measure UL movement and movement characteristics over long periods, which can provide essential feedback for both clinicians and stroke survivors.