Ambulatory Monitoring of Arm Movement Using Accelerometry: An Objective Measure of Upper-Extremity Rehabilitation in Persons With Chronic Stroke
Abstract
Objective To evaluate the reliability and validity of accelerometry for measuring upper-extremity rehabilitation outcome.Design Validation study.Setting Data recorded in the community.Participants Consecutive Constraint-Induced Movement therapy (CIMT) patients (n = 10) and volunteer community residents with stroke (n = 10). All participants were more than 1 year poststroke and had mild to moderate motor impairment of the more affected arm.Intervention All study participants were asked to wear accelerometers outside the laboratory for 3 days immediately before and after treatment, or for an approximately equivalent no-treatment period (controls).Main outcome measures Participants wore an accelerometer on each arm, the chest, and the more affected leg and completed the Motor Activity Log (MAL), which is a semistructured interview of real-world arm use.Results Test-retest reliability of transformed accelerometer recordings was greater than .86. There was also a large increase in the ratio of transformed more- to less-impaired arm recordings in CIMT therapy patients (d' = 0.9, P < .05), while there was no change for controls. The correlation between this parameter and the MAL was .74 (P < .001).Conclusions Accelerometry provides an objective, real-world index of upper-extremity rehabilitation outcome and has good psychometric properties.
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In stroke, upper extremity activity, walking, and physical activity levels were investigated using step and activity counts.
“In stroke, upper extremity activity [40–51], walking, and physical activity levels were investigated in several studies using step and activity counts [52–62].”
From Wearable sensors for clinical applications in epilepsy, Parkinson’s disease, and stroke: A mixed-methods systematic review (2018) · cites this paper as [48]
Arm activity measures discriminated effectively between different motor impairment levels in stroke.
“In stroke, arm activity measures discriminated effectively between individuals with stroke and healthy controls [45], and between different motor impairment levels [45, 47, 48].”
From Wearable sensors for clinical applications in epilepsy, Parkinson’s disease, and stroke: A mixed-methods systematic review (2018) · cites this paper as [48]
An intervention study with stroke showed that participants wore accelerometers 76-89% of waking hours in a 3-day measurement.
“An intervention study with stroke showed that participants wore accelerometers 76–89% of waking hours in a 3-day measurement [48, 49].”
From Wearable sensors for clinical applications in epilepsy, Parkinson’s disease, and stroke: A mixed-methods systematic review (2018) · cites this paper as [48]
In stroke, the step counts and measures of upper extremity and physical activity were shown to be reliable.
“In stroke, the step counts and measures of upper extremity and physical activity were shown to be reliable [48, 49, 52, 56–59]”
From Wearable sensors for clinical applications in epilepsy, Parkinson’s disease, and stroke: A mixed-methods systematic review (2018) · cites this paper as [48]
In 169 stroke survivors undergoing constraint-induced movement therapy, taking the ratio of activity recorded on the impaired and unimpaired arm using accelerometers can gather clinically-relevant information about upper extremity motor status.
“In their study, 169 stroke survivors undergoing constraint-induced movement therapy wore an accelerometer on both wrists for a period of 3 days. The results indicated good patient compliance and showed that by simply taking the ratio of activity recorded on impaired and unimpaired arm using accelerometers, one can gather clinically-relevant information about upper extremity motor status.”
From A review of wearable sensors and systems with application in rehabilitation (2012) · cites this paper as [106]
Uswatte et al have shown that accelerometer data can provide objective information about real-world arm activity in stroke survivors.
“Uswatte et al. [106,107] have shown that accelerometer data can provide objective information about real-world arm activity in stroke survivors.”
From A review of wearable sensors and systems with application in rehabilitation (2012) · cites this paper as [106]
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- Authors
- Uswatte, G., Foo, W. L., Olmstead, H., Lopez, K., Holand, A., & Simms, L. B.
- Affiliations
- University of Alabama (US)
- ORCID
- Uswatte, Gitendra
- Venue
- Archives of Physical Medicine and Rehabilitation
- Publisher
- Elsevier BV
- Published
- 2005-07
- Volume
- 86
- Issue
- 7
- Pages
- 1498-1501
- ISSN
- 0003-9993 (ISSN-L)
- OpenAlex
- W2014857359
- Cited by
- 233
- References
- 8
- Citations by year
- 2026: 8 · 2025: 7 · 2024: 17 · 2023: 8 · 2022: 15 · 2021: 14 · 2020: 10 · 2019: 15 · 2018: 11 · 2017: 15 · 2016: 10 · 2015: 17 · 2014: 16 · 2013: 13 · 2012: 11
- FWCI
- 8.13
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Archives of Physical Medicine and Rehabilitation (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (HD 34273, R01HD034273)
- Topics
- Health Sciences › Medicine › Rehabilitation › Stroke Rehabilitation and Recovery
- Health Sciences › Medicine › Psychiatry and Mental health › Cerebral Palsy and Movement Disorders
- Life Sciences › Neuroscience › Cognitive Neuroscience › Motor Control and Adaptation
- Keywords
- accelerometry, ambulatory monitoring, upper limb rehabilitation, chronic stroke, constraint-induced movement therapy, arm use, Motor Activity Log, test-retest reliability, outcome measure validity, objective outcome measures
- MeSH terms
- Stroke Rehabilitation, Activities of Daily Living, Female, Humans, Male, Middle Aged, Movement, Reproducibility of Results, Case-Control Studies, Monitoring, Ambulatory, Stroke, Upper Extremity
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