Comparison of accelerometer-based arm, leg and trunk activity at weekdays and weekends during subacute inpatient rehabilitation after stroke
Margit Alt Murphy, Sofi Andersson, Anna Danielsson, Jan Wipenmyr, Fredrik Ohlsson
Department of Clinical Neuroscience and Rehabilitation, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden. E-mail: margit.alt-murphy@neuro.gu.se
DOI: 10.2340/16501977-2553
Abstract
Objective: To determine whether there are differences in arm, leg and trunk activity measured by acceleration between weekdays and weekends in people undergoing rehabilitation in the subacute stage after stroke.
Design: Cross-sectional study.
Patients: Twenty-eight individuals with stroke (mean age 55. 4 years; severe to mild impairment) and 10 healthy controls.
Methods: A set of 5 3-axial accelerometers were used on the trunk, wrists and ankles during 2 48-h sessions at weekdays and over a weekend. Day-time acceleration raw data were expressed as the signal magnitude area. Asymmetry between the affected and less-affected limb was calculated as a ratio.
Results: Participants with stroke used their both arms and legs less at weekends than on weekdays (p < 0. 05, effect size 0. 32–0. 57). Asymmetry between the affected and less-affected arm was greater at weekends (p < 0. 05, effect size 0. 32). All activity measures, apart from the less-affected arm on weekdays, were lower in stroke compared with controls (p < 0. 05, effect size 0. 4–0. 8). No statistically significant differences were detected between weekday and weekend activity for the control group. One-third of participants perceived the trunk sensor as inconvenient to wear.
Conclusion: Increased focus needs to be applied on activities carried out during weekends at rehabilitation wards.
Lay Abstract
Individuals with stroke have difficulty achieving the recommended levels of physical activity. The physical environment and support provided can also influence activity levels. This study aimed to determine whether there are differences between weekdays and weekends in arm, leg and trunk activity measured by acceleration in people undergoing rehabilitation in the subacute stage after stroke. The results showed that people with hemiparesis in the inpatient rehabilitation setting use not only their more-affected, but also their less-affected arm and leg less at weekends than on weekdays. Thus, the challenge during inpatient rehabilitation is to identify patients who might need extra support to be able to maintain their physical activities at weekends, facilitate activity on all days of the week, and take full advantage of the recovery process.
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