Assessments are completely worthless unless they point directly to the 100% recovery protocols. I see nothing here that suggests you go from the assessment to the chosen 100% recovery protocol. When the hell will the stroke medical world do ANYTHING TO GET STROKE SOLVED? I'd have you all fired! A lot of dead wood needs to removed in stroke and until that occurs stroke will never be solved!
Look how bad this is; NOT EVEN MEASURING 100% RECOVERY!
Are you that blitheringly stupid? 100% recovery is the only goal in stroke, if you don't measure that you'll never get there!
You measure RESULTS AND RECOVERY! Not this accelerometer crap!
“What's measured, improves.” So said management legend and author Peter F. Drucker
The latest crapola here:
The use of accelerometer bracelets to evaluate arm motor function over a stroke rehabilitation period – an explorative observational study
Journal of NeuroEngineering and Rehabilitation volume 21, Article number: 82 (2024)
Abstract
Background
Assessments of arm motor function are usually based on clinical examinations or self-reported rating scales. Wrist-worn accelerometers can be a good complement to measure movement patterns after stroke. Currently there is limited knowledge of how accelerometry correlate to clinically used scales. The purpose of this study was therefore to evaluate the relationship between intermittent measurements of wrist-worn accelerometers and the patient’s progression of arm motor function assessed by routine clinical outcome measures during a rehabilitation period.
Methods
Patients enrolled in in-hospital rehabilitation following a stroke were invited. Included patients were asked to wear wrist accelerometers for 24 h at the start (T1) and end (T2) of their rehabilitation period. On both occasions arm motor function was assessed by the modified Motor Assessment Scale (M_MAS) and the Motor Activity Log (MAL). The recorded accelerometry was compared to M_MAS and MAL.
Results
20 patients were included, of which 18 completed all measurements and were therefore included in the final analysis. The resulting Spearman’s rank correlation coefficient showed a strong positive correlation between measured wrist acceleration in the affected arm and M-MAS and MAL values at T1, 0.94 (p < 0.05) for M_MAS and 0.74 (p < 0.05) for the MAL values, and a slightly weaker positive correlation at T2, 0.57 (p < 0.05) for M_MAS and 0.46 − 0.45 (p = 0.06) for the MAL values. However, no correlation was seen for the difference between the two sessions.
Conclusions
The results confirm that the wrist acceleration can differentiate between the affected and non-affected arm, and that there is a positive correlation between accelerometry and clinical measures. Many of the patients did not change their M-MAS or MAL scores during the rehabilitation period, which may explain why no correlation was seen for the difference between measurements during the rehabilitation period. Further studies should include continuous accelerometry throughout the rehabilitation period to reduce the impact of day-to-day variability.
Introduction
Assessment of motor function and motion pattern is a central part of evaluation of neurological conditions.(NO, it's not you blithering idiots, it's completely useless without having protocols to followup!) Currently, such evaluation is largely based on self-reported rating scales and clinical examination by healthcare professionals. However, clinical examination is limited to assessing impairments or activity limitations but not the motion pattern in an objective way. Another limiting factor is that currently it is not possible to evaluate the patients in an in-home environment apart from self-reporting rating scales.
With the introduction of comfortable and affordable wearable sensors, detailed kinetic data can be a useful complement to clinical outcome measures, and continuously recorded with a low level of intrusiveness for the patient in an in-home environment. Such sensors include accelerometers [1,2,3,4], EMG sensors [5, 6] and magnets [7]. Sensors can be worn on the body [1, 8, 9], integrated in bracelets [2, 3, 7], or in gloves [10]. Sensors can be used for many purposes, such as activity monitoring of elderly [11], oncology patients [12], or to monitor vital signs in surgical patients [13].
One field where measurement of motor function with sensors is of great importance is within stroke rehabilitation, where long-term improvements may be difficult to quantify and separate from compensatory movement patterns and a learned non-use behavior [14]. Wearable sensors have been used within rehabilitation to monitor gait [8, 15], fall risk [1] and arm motor function [1, 6, 7] and are shown to be appreciated by rehabilitation professionals as well as by patients [16]. Sensors have also been combined with in-app training programs for home rehabilitation [2, 17] of chronic stroke patients to improve participation. Such in-app training programs can help measure and improve adherence to the training by providing instructions and guidance, but also providing an accessible communication platform with the rehabilitation team. Potentially, it could measure the training dose as well as the use of the affected arm in daily activities during the rehabilitation.
Sensors have also been used in stroke care, for diagnostic purposes by identifying unliteral arm motor deficit [3, 18,19,20], and for monitoring and evaluation of rehabilitation following stroke [21,22,23,24]. However, a study by Rand et al. 2012 on 60 stroke patients receiving rehabilitation, showed that upper extremity activity measured by activity monitors was not correlated to increased functional status of the affected arm [21]. Similar result has been seen in several other studies where functional recovery has not been correlated to increased arm movement as measured by accelerometry [23, 24]. Contradictory to this, Gohlke et al. showed that functional recovery was associated with increased arm movement when measured by bilateral wrist accelerometry at multiple times during the rehabilitation of 14 stroke patients [22]. Since the results of the various studies differ, more studies are needed within this area.
The purpose of this study was to evaluate the relationship between intermittent measurements of wrist-worn accelerometers and the patient’s progression of arm motor function as assessed by the clinical outcome measures Motor Assessment Scale (MAS) [25, 26] and Motor Activity Log (MAL) [27, 28] during an active rehabilitation period.
Our hypothesis was that an improvement in MAL and MAS would correlate with an increase in upper limb activity, as measured by the accelerometers, and normalization in the balance between right and left arm activity.
More at link.
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