Ambulatory monitoring of arm movement using accelerometry: an objective measure of upper-extremity rehabilitation in persons with chronic stroke.
OBJECTIVE
To evaluate the reliability and validity of accelerometry for measuring upper-extremity rehabilitation outcome.


METHODS
Validation study.


METHODS
Data recorded in the community.


METHODS
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.


METHODS
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).


METHODS
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.
Uswatte
Gitendra
G
Department od Psychology, University of Alabama, Birmingham, AL 35294, USA. guswatte@uab.edu
Foo
Wai Leong
WL
Olmstead
Harry
H
Lopez
Kristine
K
Holand
Ashleigh
A
Simms
Leslie Box
LB
D000203:Activities of Daily Living; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018670:Monitoring, Ambulatory / Q000379:methods*; D009068:Movement / Q000502:physiology*; D015203:Reproducibility of Results; D020521:Stroke / Q000503:physiopathology; D000071939:Stroke Rehabilitation; D034941:Upper Extremity / Q000503:physiopathology*