The stroke upper-limb activity monitor: Its sensitivity to measure hemiplegic upper-limb activity during daily life

Objective: To test the Stroke Upper-Limb Activity Monitor (Stroke-ULAM), which uses electrogoniometry and accelerometry to measure the amount of upper-lirnb usage in stroke patients in daily life conditions, for its sensitivity to discriminate bet,.veen moderately recovered and well-recovered stroke patients and control subjects.Design: Cross-sectional study.Setting: At home or a rehabilitation center.Participants: Seventeen patients with stroke and 5 control subjects.Interventions: Not applicable.Main Outcome Measure: Level of usage of upper limb and the percentage of affected Upper-limb activity compared with unaffected upper-limb activity (proportion).Results: The level of usage of the affected upper limb of stroke patients was lower than that of the nondominant upper limb of control subjects (electrogoniometry, 97.8 degrees +/- 92.3 degrees/min vs 286.2 degrees +/- 46.5 degrees/min. P <.01; accelerometry 1.0 +/- 0.5g/min vs 2.4 +/- 0.8g/min, P <.01). Stroke patients had lower proportions than control subjects in both electrogoniometry (22.6% +/- 18.0% vs 84.6%+/- 9.8%. P <.01) and accelerometry (39.2%+/- 21.4% vs 93.3%+/- 5.017k, P <.01). Well-recovered stroke patients had signficantly higher proportions compared with moderately recovered patients on both electrogoniometry and accelerometry.Conclusions: The Stroke-ULAM sensitively measures actual performance, and therefore can be a valuable addition to the mostly capacity-oriented tools currently used to evaluate upper-limb function. Proportion is preferred to the level of usage.