Objectives
The objectives of the study are to characterize paretic
upper limb (UL) use in people with different levels of impairment
4 weeks poststroke and to compare accelerometry and direct observational
approaches.
Methods
Twelve stroke inpatients (five mild, three moderate, and
four severe UL impairment) were recruited from a rehabilitation
hospital. UL use was measured using accelerometry (24 hr) and direct
observation (12 hr of behavioural mapping). Accelerometry variables
included duration of use, use ratio, magnitude ratio, bilateral
magnitude, and variation ratio. Direct observation recorded the duration
of use and type of UL movement (e.g., functional vs. non‐functional).
Results
From accelerometry data, people with mild, moderate, and
severe UL impairments used their paretic UL 59%, 45%, and 22% of a
24 hr‐day, respectively. People with severe UL impairment had the lowest
paretic UL use duration (median 1.49 hr/day), magnitude ratio, and
variation ratio compared with people with mild and moderate UL
impairment. From 12 hr of observational data, people with mild
impairment were using their UL for 37.8% of the observed time, whereas
the people with moderate and severe impairment were using their UL 15.8%
and 4.9%, respectively. UL movements for the mild cohort were mainly
functional, whereas UL movements of the moderate and severe cohorts were
mainly non‐functional. UL movements were predominantly active for the
mild and moderate cohorts but passive for the severe cohort. Duration of
paretic UL use from accelerometry and observation data were highly
correlated (ICC > 0.8), but the absolute percentage error between
methods ranged from 34.2% to 42.7%.
Conclusions
Paretic UL use within the first 4 weeks poststroke
differs across levels of impairment in this exploratory study.
Accelerometry and observation findings of paretic UL use were correlated
and may be needed in different situations as they capture different
information.
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