Validity of accelerometry for monitoring real-world arm activity in patients with subacute stroke: evidence from the extremity constraint-induced therapy evaluation trial.
OBJECTIVE
To examine the psychometric properties of an objective method for assessing real-world arm activity in a large sample with subacute stroke.


METHODS
Validation study.


METHODS
Community.


METHODS
Persons 3 to 9 months poststroke (N=169) with mild to moderate motor impairment of their hemiparetic arm enrolled in a multisite, randomized clinical trial of constraint-induced movement therapy.


METHODS
Not applicable.


METHODS
Participants wore an accelerometer on each arm outside the laboratory for 3 days before and after treatment or an equivalent no-treatment period. They also completed the Actual Amount of Use Test (AAUT), which is an observational measure of spontaneous more-impaired arm use, and the Motor Activity Log (MAL), which is an interview assessing more-impaired arm use in daily life.


RESULTS
Low-pass-filtered accelerometer recordings were reliable (r range, >.8) and stable (P range, >.48). Their validity was also supported. Correlations calculated across all participants at baseline between the ratio of more-impaired to less-impaired arm accelerometer recordings and AAUT and MAL scores were .60 and .52, respectively.


CONCLUSIONS
Accelerometry provides an objective, real-world index of more-impaired arm activity with good psychometric properties.
Uswatte
Gitendra
G
Department of Psychology, University of Alabama, Birmingham, AL 35294, USA. guswatte@uab.edu
Giuliani
Carol
C
Winstein
Carolee
C
Zeringue
Angelique
A
Hobbs
Laura
L
Wolf
Steven L
SL
D000203:Activities of Daily Living; D001132:Arm / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018670:Monitoring, Ambulatory; D009068:Movement; D010291:Paresis / Q000209:etiology / Q000503:physiopathology*; D011594:Psychometrics; D015203:Reproducibility of Results; D020521:Stroke / Q000150:complications; D000071939:Stroke Rehabilitation