Accelerometer measurement of upper extremity movement after stroke: a systematic review of clinical studies

Marika Noorkõiv, Helen Rodgers, Christopher I Price, Marika Noorkõiv, Helen Rodgers, Christopher I Price

Abstract

The aim of this review was to identify and summarise publications, which have reported clinical applications of upper limb accelerometry for stroke within free-living environments and make recommendations for future studies. Data was searched from MEDLINE, Scopus, IEEExplore and Compendex databases. The final search was 31st October 2013. Any study was included which reported clinical assessments in parallel with accelerometry in a free-living hospital or home setting. Study quality is reflected by participant numbers, methodological approach, technical details of the equipment used, blinding of clinical measures, whether safety and compliance data was collected. First author screened articles for inclusion and inclusion of full text articles and data extraction was confirmed by the third author. Out of 1375 initial abstracts, 8 articles were included. All participants were stroke patients. Accelerometers were worn for either 24 hours or 3 days. Data were collected as summed acceleration counts over a specified time or as the duration of active/inactive periods. Activity in both arms was reported by all studies and the ratio of impaired to unimpaired arm activity was calculated in six studies. The correlation between clinical assessments and accelerometry was tested in five studies and significant correlations were found. The efficacy of a rehabilitation intervention was assessed using accelerometry by three studies: in two studies both accelerometry and clinical test scores detected a post-treatment difference but in one study accelerometry data did not change despite clinical test scores showing motor and functional improvements. Further research is needed to understand the additional value of accelerometry as a measure of upper limb use and function in a clinical context. A simple and easily interpretable accelerometry approach is required.

Figures

Figure 1
Figure 1
Flow of information through the different search phases of a systematic review based on PRISMA 2009 guidelines. Four search engines (i.e. MEDLINE, Scopus, IEEExplore and Compendex) were used to identify the relevant literature. After the screening based on title and abstract and removal of duplicates, 18 articles were selected. After the selection based on the full text article, 8 final articles were included in the current review.

References

    1. Uswatte G, Foo WL, Olmstead H, Lopez K, Holand A, Simms LB. Ambulatory monitoring of arm movement using accelerometry: An objective measure of upper-extremity rehabilitation in persons with chronic stroke. Arc Phys Med. 2005;86(7):1498–1501. doi: 10.1016/j.apmr.2005.01.010.
    1. Trost SG, McIver KL, Pate RR. Conducting accelerometer-based activity assessments in field-based research. MSSE. 2005;37(11 Suppl):S531–S543.
    1. Wong WY, Wong MS, Lo KH. Clinical applications of sensors for human posture and movement analysis: a review. Prosthet Orthot Int. 2007;31(1):62–75. doi: 10.1080/03093640600983949.
    1. Zhou HY, Hu HS. Human motion tracking for rehabilitation-a survey. Biomed Signal Proces. 2008;3(1):1–18. doi: 10.1016/j.bspc.2007.09.001.
    1. Lawrence ES, Coshall C, Dundas R, Stewart J, Rudd AG, Howard R, Wolfe CD. Estimates of the prevalence of acute stroke impairments and disability in a multiethnic population. Stroke. 2001;32(6):1279–1284. doi: 10.1161/01.STR.32.6.1279.
    1. Uswatte G, Giuliani C, Winstein C, Zeringue A, Hobbs L, Wolf SL. Validity of accelerometry for monitoring real-world arm activity in patients with subacute stroke: evidence from the extremity constraint-induced therapy evaluation trial. Arch Phys Med. 2006;87(10):1340–1345. doi: 10.1016/j.apmr.2006.06.006.
    1. Hester T, Hughes R, Sherrill DM, Knorr B, Akay M, Stein J, Bonato B. International Workshop on Wearable and Implantable Body Sensors Networks (BSN’06) 2006. Using wearable sensors to measure motor abilities following stroke; pp. 5–8.
    1. van der Pas SC, Verbunt JA, Breukelaar DE, van Woerden R, Seelen HA. Assessment of arm activity using triaxial accelerometry in patients with a stroke. Arch Phys Med. 2011;92(9):1437–1442. doi: 10.1016/j.apmr.2011.02.021.
    1. Gebruers N, Truijen S, Engelborghs S, Nagels G, Brouns R, De Deyn PP. Actigraphic measurement of motor deficits in acute ischemic stroke. Cerebrovasc Dis. 2008;26(5):533–540. doi: 10.1159/000160210.
    1. Zhang M, Lange B, Chang CY, Sawchuk AA, Rizzo AA. Beyond the standard clinical rating scales: fine-grained assessment of post-stroke motor functionality using wearable inertial sensors. Conf Proc IEEE Eng Med Biol Soc. 2012;2012:6111–6115.
    1. Lang CE, Wagner JM, Edwards DF, Dromerick AW. Upper extremity use in people with hemiparesis in the first few weeks after stroke. JNPT. 2007;31:56–63.
    1. Thrane G, Emaus N, Askim T, Anke A. Arm use in patients with subacute stroke monitored by accelerometry: Association with motor impairment and influence on self-dependence. J Rehabil Med. 2011;43(4):299–304. doi: 10.2340/16501977-0676.
    1. Wang TN, Lin KC, Wu CY, Chung CY, Pei YC, Teng YK. Validity, responsiveness, and clinically important difference of the ABILHAND questionnaire in patients with stroke. Arch Phys Med. 2011;92(7):1086–1091. doi: 10.1016/j.apmr.2011.01.020.
    1. Uswatte G, Taub E, Morris D, Light K, Thompson PA. The motor activity log-28: Assessing daily use of the hemiparetic arm after stroke. Neurology. 2006;67(7):1189–1194. doi: 10.1212/01.wnl.0000238164.90657.c2.
    1. Taub E, Uswatte G, Bowman MH, Mark VW, Delgado A, Bryson C, Morris D, Bishop-McKay S. Constraint-induced movement therapy combined with conventional neurorehabilitation techniques in chronic stroke patients with plegic hands: A case series. Arch Phys Med. 2013;94(1):86–94. doi: 10.1016/j.apmr.2012.07.029.
    1. Rand D, Eng JJ. Disparity between functional recovery and daily use of the upper and lower extremities during subacute stroke rehabilitation. Neurorehabil Neural Repair. 2012;26(1):76–84. doi: 10.1177/1545968311408918.
    1. Liao WW, Wu CY, Hsieh YW, Lin KC, Chang WY. Effects of robot-assisted upper limb rehabilitation on daily function and real-world arm activity in patients with chronic stroke: a randomized controlled trial. Clin Rehabil. 2012;26(2):111–120. doi: 10.1177/0269215511416383.
    1. Reiterer V, Sauter C, Klosch G, Lalouschek W, Zeitlhofer J. Actigraphy–a useful tool for motor activity monitoring in stroke patients. Eur Neurol. 2008;60(6):285–291. doi: 10.1159/000157882.
    1. Uswatte G, Taub E. Participant-centered and objective measures of real-world arm function in persons with stroke. Circulation. 2004;109(20):E243.
    1. Heil DP, Brage S, Rothney MP. Modeling physical activity outcomes from wearable monitors. MSSE. 2012;44(1 Suppl 1):S50–S60.
    1. Masse LC, Fuemmeler BF, Anderson CB, Matthews CE, Trost SG, Catellier DJ, Treuth M. Accelerometer data reduction: a comparison of four reduction algorithms on select outcome variables. MSSE. 2005;37(11 Suppl):S544–S554.
    1. Matthews CE, Hebert JR, Freedson PS, Stanek EJ, 3rd, Merriam PA, Ebbeling CB, Ockene IS. Sources of variance in daily physical activity levels in the seasonal variation of blood cholesterol study. Am J Epidemiol. 2001;153(10):987–995. doi: 10.1093/aje/153.10.987.
    1. Baranowski T, Smith M, Thompson WO, Baranowski J, Hebert D, de Moor C. Intraindividual variability and reliability in a 7-day exercise record. MSSE. 1999;31(11):1619–1622.
    1. Moran DS, Heled Y, Gonzalez RR. Metabolic rate monitoring and energy expenditure prediction using a novel actigraphy method. Med Sci Monit. 2004;10(11):MT117–MT120.
    1. Harris JE, Eng JJ, Miller WC, Dawson AS. A self-administered graded repetitive arm supplementary program (GRASP) improves arm function during inpatient stroke rehabilitation: a multi-site randomized controlled trial. Stroke. 2009;40(6):2123–2128. doi: 10.1161/STROKEAHA.108.544585.
    1. Sudlow CL, Warlow CP. Comparing stroke incidence worldwide: what makes studies comparable? Stroke. 1996;27(3):550–558. doi: 10.1161/01.STR.27.3.550.

Source: PubMed

Sponsors and Collaborators

Medical Conditions

Drug Interventions

3
Subscribe