title: Acceleration metrics are responsive to change in upper extremity function of stroke survivors.
abstract: OBJECTIVE
  To (1) determine whether acceleration metrics derived from monitoring outside of treatment are responsive to change in upper extremity (UE) function; and secondarily to (2) compare metric values during task-specific training and while in the free-living environment, and (3) establish metric associations with an in-clinic measure of movement capabilities.
  
  
  METHODS
  Before-after observational study.
  
  
  METHODS
  Inpatient hospital (primary purpose); outpatient hospital (secondary purpose).
  
  
  METHODS
  Individuals (n=8) with UE hemiparesis <30 days poststroke (primary purpose); individuals (n=27) with UE hemiparesis ≥6 months poststroke (secondary purpose).
  
  
  METHODS
  The inpatient sample was evaluated for UE movement capabilities and monitored with wrist-worn accelerometers for 22 hours outside of treatment before and after multiple sessions of task-specific training. The outpatient sample was evaluated for UE movement capabilities and monitored during a single session of task-specific training and the subsequent 22 hours outside clinical settings.
  
  
  METHODS
  Action Research Arm Test (ARAT) and acceleration metrics quantified from accelerometer recordings.
  
  
  RESULTS
  Five metrics improved in the inpatient sample, along with UE function as measured on the ARAT: use ratio, magnitude ratio, variation ratio, median paretic UE acceleration magnitude, and paretic UE acceleration variability. Metric values were greater during task-specific training than in the free-living environment, and each metric was strongly associated with ARAT score.
  
  
  CONCLUSIONS
  Multiple metrics that characterize different aspects of UE movement are responsive to change in function. Metric values are different during training than in the free-living environment, providing further evidence that what the paretic UE does in the clinic may not generalize to what it does in everyday life.
authors.affiliation: Program in Physical Therapy, Washington University School of Medicine, St. Louis, MO. Electronic address: urbinm@wusm.wustl.edu.
authors.forename: M A
authors.initials: MA
authors.lastname: Urbin
authors.affiliation: Program in Physical Therapy, Washington University School of Medicine, St. Louis, MO.
authors.forename: Kimberly J
authors.initials: KJ
authors.lastname: Waddell
authors.affiliation: Program in Physical Therapy, Washington University School of Medicine, St. Louis, MO; Program in Occupational Therapy, Washington University School of Medicine, St. Louis, MO; Department of Neurology, Washington University School of Medicine, St. Louis, MO.
authors.forename: Catherine E
authors.initials: CE
authors.lastname: Lang
mesh_terms: D061725:Accelerometry; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010291:Paresis / Q000209:etiology* / Q000534:rehabilitation*; D026741:Physical Therapy Modalities; D020127:Recovery of Function; D020521:Stroke / Q000150:complications*; D034941:Upper Extremity; D014953:Wrist
keywords: Accelerometry; Neurology; Paresis; Rehabilitation; Stroke