Premium
An accelerometry and observational study to quantify upper limb use after stroke during inpatient rehabilitation
Author(s) -
Chin Lay Fong,
Hayward Kathryn S.,
Soh Aloysius Jun An,
Tan Chin Mei,
Wong Cheryl Jing Ru,
Loh Jia Wei,
Loke Genevieve Jia Hui,
Brauer Sandra
Publication year - 2019
Publication title -
physiotherapy research international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.509
H-Index - 49
eISSN - 1471-2865
pISSN - 1358-2267
DOI - 10.1002/pri.1784
Subject(s) - observational study , medicine , rehabilitation , physical medicine and rehabilitation , cohort , cohort study , stroke (engine) , physical therapy , functional impairment , mechanical engineering , engineering
Objectives The objectives of the study are to characterize paretic upper limb (UL) use in people with different levels of impairment 4 weeks poststroke and to compare accelerometry and direct observational approaches. Methods Twelve stroke inpatients (five mild, three moderate, and four severe UL impairment) were recruited from a rehabilitation hospital. UL use was measured using accelerometry (24 hr) and direct observation (12 hr of behavioural mapping). Accelerometry variables included duration of use, use ratio, magnitude ratio, bilateral magnitude, and variation ratio. Direct observation recorded the duration of use and type of UL movement (e.g., functional vs. non‐functional). Results From accelerometry data, people with mild, moderate, and severe UL impairments used their paretic UL 59%, 45%, and 22% of a 24 hr‐day, respectively. People with severe UL impairment had the lowest paretic UL use duration (median 1.49 hr/day), magnitude ratio, and variation ratio compared with people with mild and moderate UL impairment. From 12 hr of observational data, people with mild impairment were using their UL for 37.8% of the observed time, whereas the people with moderate and severe impairment were using their UL 15.8% and 4.9%, respectively. UL movements for the mild cohort were mainly functional, whereas UL movements of the moderate and severe cohorts were mainly non‐functional. UL movements were predominantly active for the mild and moderate cohorts but passive for the severe cohort. Duration of paretic UL use from accelerometry and observation data were highly correlated (ICC > 0.8), but the absolute percentage error between methods ranged from 34.2% to 42.7%. Conclusions Paretic UL use within the first 4 weeks poststroke differs across levels of impairment in this exploratory study. Accelerometry and observation findings of paretic UL use were correlated and may be needed in different situations as they capture different information.