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From: Accelerometer measurement of upper extremity movement after stroke: a systematic review of clinical studies

  Uswatte et al. (2006)[6] Lang et al. (2007)[11] Thrane et al. (2011)[12] Van der Pas et al. (2011)[8] Wang et al. (2011)[13] Rand et al. (2012)[16] Liao et al. (2012)[17] Taub et al. (2013)[15]
Aim To study the reliability and validity of the Motor Activity Log for assessing real-world quality of a movement scale (QOM) and amount of use scale (AOU) of the hemiparetic arm in stroke survivors. To determine the amount of arm use in people with hemiparesis post stroke during inpatient rehabilitation. To examine the relationships between upper extremity use, impairments and activity limitations. To investigate the correlations between arm motor impairment and real-world use. To analyse whether arm movement ratio (AMR) is correlated with impairment or duration of arm use. To assess the influence of motor impairment on self-care activities. To test whether triaxial arm accelerometry is a valid method to measure the amount of upper extremity activity in the daily life of adult stroke survivors. To investigate the criterion-related validity, responsiveness, and clinically important differences of the ABILHAND questionnaire in patients with stroke. To determine the change in daily use of the upper and lower extremities of stroke patients during subacute rehabilitation. To compare the effects of robot-assisted therapy on real-world arm activity and daily function in a dose-matched (in amount of hours) control treatment group. To determine whether patients with functionless hands would improve everyday use using a combination of Constraint-Induced Movement Therapy (CIMT) and conventional techniques for regulating tone.
Study design Multicenter clinical trial. Report. Cross-sectional study. Cross-sectional concurrent validity study. Validation and clinimetric study. Observational cohort. Prospective randomized controlled trial. Case series.
Blinding Single-blinded (raters). No. No. Not reported. Blinded raters. No. Double-blinded No.
Safety data Not reported. Not reported. Not reported. Not reported. Not reported. Not reported. Not reported. Not reported.
Sensors Two-axial accelerometers (Manufacturing Technologies Inc., Fort Walton Beach, FL). Uni-axial accelerometers (model 7164–2.4 Activity Monitors, MTI Health Services, FL). Uni-axial ActiGraph GT1M Accelerometers (ActiGraph Inc., Pensacola, USA). Tri-axial watch-like, water-resistant accelerometers (Actiwatch AW7a). Accelerometers about the size of a large wristwatch. The type was not reported. Tri-axial accelerometers (ActicalTM, Mini Mitter Co). Tri-axial MicroMini-Motion logger (Ambulatory Monitoring, New York, NY, USA). Accelerometers were not defined.
Placement 1 on each wrist. 1 on each wrist. 1 on each wrist. 1 around each wrist. 1 on each wrist. 1 on each wrist. 1 on each wrist. 1 on each arm.
Wearing time 3 days during all waking hours, except when in contact with water. Single 24 h period, except for times when the devices would be exposed to water. Single 24 h period. Continuously for 3 days. All day (not specified by authors for how long). 3 days on admission for rehabilitation and 3 weeks later prior to discharge. Could remove at night. 3 days before/after the intervention, except when in contact with large amounts of water. 3 days before and after each phase of the treatment.
Participants 222 34 31 45 51 60 20 6
Age 62.2 ± 13.0 63.9 ± 14.8 (range: 39–94) 65 ± 14 59.4 ± 9.2 (range: 39–80) 55.26 ± 10.31 61.0 ± 13.3 55.51 ± 11.17 56.9 ± 9.8
Men (%) 64 41 71 64 67 68 60 83
Time since stroke 3-12 months 9.3 ± 4.2 days 10.6 ± 6 days 2.6 ± 1.6 years 17.57 ± 13.43 months 33.4 ± 2.7 days 23.90 ± 13.39 months 5.1 ± 6.8 years
Setting Outside the laboratory. During in-patient rehabilitation. Normal community-dwelling activity. Normal community-dwelling activity. Normal community-dwelling activity. Normal community-dwelling activity. Normal community-dwelling activity. Normal community-dwelling daily activity.
Accelerometer activity measures The ratio of duration of more- to less-impaired arm activity. Duration of less-impaired-arm activity as a% of the recording period (the number of epochs in the less-impaired arm data with above-threshold values divided by the total number of epochs). Duration of impaired and unimpaired upper extremity usage during a 24 hr period. (1) Duration of arm use, (2) The ratio of arm use duration between the more and less affected arm (AMR). (1) The total sum of acceleration counts during waking hours divided by the number of waking hours. (2) Bilateral arm activity: the ratio of the sum of daytime accele-ration of the impaired arm to the unimpaired arm. Ratio of affected to unaffected arm recordings. The mean activity counts for the upper extremity for 1) an entire day, 2) a PT session, 3) an OT session and 4) daily use not including the OT/PT sessions. Ratio of mean activity between the impaired and unimpaired arm. The ratio of more-affected to less-affected arm recordings.
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