http://www.jneuroengrehab.com/content/11/1/144
1
Stroke Research Group, Institute of Ageing and Health, Newcastle
University, Newcastle upon Tyne, UK
2 Adeli International Rehabilitation Centre, Valge 13, Tallinn 11415, Estonia
2 Adeli International Rehabilitation Centre, Valge 13, Tallinn 11415, Estonia
Journal of NeuroEngineering and Rehabilitation 2014, 11:144
doi:10.1186/1743-0003-11-144
The electronic version of this article is the complete one and can be found online at: http://www.jneuroengrehab.com/content/11/1/144
The electronic version of this article is the complete one and can be found online at: http://www.jneuroengrehab.com/content/11/1/144
| Received: | 29 May 2014 |
| Accepted: | 2 October 2014 |
| Published: | 9 October 2014 |
© 2014 Noorkõiv et al.; licensee BioMed Central Ltd.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
Abstract
The aim of this review was to identify and summarise publications, which have reported
clinical applications of upper limb accelerometry for stroke within free-living environments
and make recommendations for future studies. Data was searched from MEDLINE®, Scopus,
IEEExplore and Compendex databases. The final search was 31st October 2013. Any study was included which reported clinical assessments in parallel
with accelerometry in a free-living hospital or home setting. Study quality is reflected
by participant numbers, methodological approach, technical details of the equipment
used, blinding of clinical measures, whether safety and compliance data was collected.
First author screened articles for inclusion and inclusion of full text articles and
data extraction was confirmed by the third author. Out of 1375 initial abstracts,
8 articles were included. All participants were stroke patients. Accelerometers were
worn for either 24 hours or 3 days. Data were collected as summed acceleration counts
over a specified time or as the duration of active/inactive periods. Activity in both
arms was reported by all studies and the ratio of impaired to unimpaired arm activity
was calculated in six studies. The correlation between clinical assessments and accelerometry
was tested in five studies and significant correlations were found. The efficacy of
a rehabilitation intervention was assessed using accelerometry by three studies: in
two studies both accelerometry and clinical test scores detected a post-treatment
difference but in one study accelerometry data did not change despite clinical test
scores showing motor and functional improvements. Further research is needed to understand
the additional value of accelerometry as a measure of upper limb use and function
in a clinical context. A simple and easily interpretable accelerometry approach is
required.
Conclusions
Real-world usage of the upper extremity during stroke rehabilitation is still not
yet well described and we require better knowledge of how to interpret different variables
of accelerometry against clinical measures which holds meaning for clinicians and
patients. Recommendations from this review of recent studies are:
– Clinical measures are still required to provide context for interpretation in case
the individual’s recovery is not reflected through real world accelerometer data e.g.
due to learned non-use
– The ratio between impaired and unimpaired sides is the standard approach for upper
limb accelerometry but hand dominance might require further consideration depending
upon individually chosen rehabilitation goals
– Diaries should be used for at least a proportion of the monitoring period in order
to relate individual accelerometer data to background levels of activity.
– Simple, user-friendly cost-effective and easily interpretable upper limb accelerometry
methods are still required if this is to be a useful tool to monitor patients’ progress
alongside clinical assessments of motor recovery.
More detail at link.
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