title: Accelerometer-Based Monitoring of Upper Limb Movement in Older Adults With Acute and Subacute Stroke.
abstract: OBJECTIVE
  Use of the affected extremity during daily life is important if disuse atrophy is to be prevented after stroke. This study examined whether objectively measured real-world upper limb movement is associated with the amount of use of the affected upper limb, as assessed by a standardized assessment tool in older adults with acute or subacute stroke. This study also examined whether the real-world upper limb movement is associated with the extent of impairment of upper and lower extremities.
  
  
  METHODS
  The participants were 19 older adults with hemiparesis from acute or subacute stroke [17 (7) days after the stroke]. All the participants wore 3 accelerometers-1 on each wrist (bilateral accelerometry) and 1 on the waist-throughout a 24-hour period. They were interviewed about use of their upper limb in the real-world setting using a Motor Activity Log. Functions of the affected upper limb or upper and lower limbs were assessed using the National Institute of Health Stroke Scale, the Brunnstrom Recovery Stage (BRS), the Simple Test for Evaluating Hand Function, and the Functional Independence Measure tests.
  
  
  CONCLUSIONS
  Movement counts measured with the wrist accelerometer on the affected upper limb (unilateral accelerometry) over 24 hours and during the 12-hour daytime period (08:00 to 20:00) were significantly correlated with scores for affected upper limb use (the Motor Activity Log) and functions (the upper extremity BRS and the affected side Simple Test for Evaluating Hand Function), upper and lower extremity functions (the National Institute of Health Stroke Scale, the lower extremity BRS, and the motor Functional Independence Measure), and step counts measured over the same period. To estimate the affected upper limb use or disuse, we subtracted the movement counts of the unaffected upper limb from those of the affected upper limb. As a result, the subtracted counts over 24 hours and during the 12-hour daytime period were only related to scores for affected upper limb use and functions.
  
  
  CONCLUSIONS
  Bilateral accelerometry for monitoring upper limb movements in a real-world setting might be useful to clinicians for objective assessment of affected upper limb use or disuse and function among older adults with hemiparesis from acute or subacute stroke.
authors.affiliation: 1School of Health Science, Department of Fundamental Nursing and Rehabilitation Division, Tottori University, Japan. 2School of Health Science, Department of Physical Therapy, Tokyo University of Technology, Japan. 3Educational Physiology Laboratory, Graduate School of Education, The University of Tokyo, Japan.
authors.forename: Emi
authors.initials: E
authors.lastname: Narai
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Hagino
authors.forename: Taiki
authors.initials: T
authors.lastname: Komatsu
authors.forename: Fumiharu
authors.initials: F
authors.lastname: Togo
mesh_terms: D061725:Accelerometry; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D009068:Movement / Q000502:physiology*; D010291:Paresis / Q000534:rehabilitation*; D000071939:Stroke Rehabilitation / Q000295:instrumentation* / Q000379:methods*; D034941:Upper Extremity / Q000502:physiology*