Whole-body movements increase arm use outcomes of wrist-worn accelerometers in stroke patients

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Abstract

Wrist-worn accelerometers are often applied to measure arm use after stroke. They measure arm movements during all activities, including whole-body movements, such as walking. Wholebody movements may influence clinimetric properties of arm use measurements—however, this has not yet been examined. This study investigates to what extent arm use measurements with wrist-worn accelerometers are affected by whole-body movements. Assuming that arm movements during whole-body movements are non-functional, we quantify the effect of whole-body movements by comparing two methods: Arm use measured with wrist-worn accelerometers during all wholebody postures and movements (P&M method), and during sitting/standing only (sit/stand method). We have performed a longitudinal observational cohort study with measurements in 33 stroke patients during weeks 3, 12, and 26 poststroke. The P&M method shows higher daily paretic arm use outcomes than the sit/stand method (p < 0.001), the mean difference increased from 31% at week three to 41% at week 26 (p < 0.001). Differences in daily paretic arm use between methods are strongly related to daily walking time (r = 0.83–0.92). Changes in the difference between methods are strongly related to changes in daily walking time (r = 0.89). We show that not correcting arm use measurements for whole-body movements substantially increases arm use outcomes, thereby threatening the validity of arm use outcomes and measured arm use changes.

Original languageEnglish
Article number4353
JournalSensors
Volume21
Issue number13
DOIs
Publication statusPublished - 25 Jun 2021

Bibliographical note

Funding Information:
Funding: This research was funded by the ZonMW Innovative Medical Devices Initiative program (title: “PROFITS—Precision profiling to improve long-term outcome after stroke”; project number 104003008) and Rijndam Rehabilitation. The collaboration project is co-funded by the PPP Allowance made available by Health~Holland, Top Sector Life Sciences & Health, to stimulate public-private partnerships.

Funding Information:
This research was funded by the ZonMW Innovative Medical Devices Initiative program (title: ?PROFITS?Precision profiling to improve long-term outcome after stroke?; project number 104003008) and Rijndam Rehabilitation. The collaboration project is co-funded by the PPP Allowance made available by Health~Holland, Top Sector Life Sciences & Health, to stimulate public-private partnerships.

Publisher Copyright:
© 2021 by the authors. Licensee MDPI, Basel, Switzerland.

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