Development and validation of a clinically applicable arm use monitor for people after stroke
Malou H.J. Fanchamps, Ruud W. Selles, Henk J. Stam, Johannes B.J Bussmann
Rehabilitation Medicine, Erasmus MC, 3000 CA Rotterdam, The Netherlands. E-mail: firstname.lastname@example.org
Objective: To develop and validate a clinically applicable and easy-to-use accelerometry-based device to measure arm use in people after stroke; the Activ8 arm use monitor (Activ8-AUM).
Design: Development and validation study.
Patients: A total of 25 people at different stages of rehabilitation after stroke were included in this study.
Methods: The Activ8-AUM consists of 3 single-sensor Activ8s: one on the unaffected thigh and one on each wrist. Arm use was calculated by combining movement intensity of the arms with data from body posture and movements on the leg sensor. Data were divided into 2 sets: one for determining situation-specific movement intensity thresholds for arm use, and the other to validate the Activ8-AUM using video recordings.
Results: Overall agreement between the Activ8-AUM and video recordings was 75%, sensitivity was 73% and specificity was 77%. Agreement between the different categories of arm use ranged from 42% to 93% for the affected arm and from 24% to 82% for the unaffected arm.
Conclusion: By combining the movement intensity threshold with body posture and movements, good agreement was reached between the Activ8-AUM and video recordings. This result, together with the easy-to-use configuration, makes the Activ8-AUM a promising device to measure arm use in people after stroke.
After a stroke most people suffer from an impaired arm resulting in limitations in daily life activities, greater dependency, and restrictions in social participation. Objectively measured arm use is important to evaluate the effect of motor rehabilitation. In addition, it can be used for personalized feedback and coaching for stimulating sufficient arm use. Therefore, we developed and validated a new easy-to-use and clinically applicable arm use monitor. This Activ8-AUM consists of three single-sensor accelerometers (Activ8) combining movement intensity of the arms (one sensor on each wrist) with data of body postures and movements (one sensor unaffected thigh). Combining these data, good agreement was reached between the Activ8-AUM data and reference video data. Therefore, this arm use monitor is a promising device to measure arm use in daily life after a stroke.
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