The stroke upper-limb activity monitor: its sensitivity to measure hemiplegic upper-limb activity during daily life.

OBJECTIVE

To test the Stroke Upper-Limb Activity Monitor (Stroke-ULAM), which uses electrogoniometry and accelerometry to measure the amount of upper-limb usage in stroke patients in daily life conditions, for its sensitivity to discriminate between moderately recovered and well-recovered stroke patients and control subjects.

DESIGN

Cross-sectional study.

SETTING

At home or a rehabilitation center.

PARTICIPANTS

Seventeen patients with stroke and 5 control subjects.

INTERVENTIONS

Not applicable.

MAIN OUTCOME MEASURE

Level of usage of upper limb and the percentage of affected upper-limb activity compared with unaffected upper-limb activity (proportion).

RESULTS

The level of usage of the affected upper limb of stroke patients was lower than that of the nondominant upper limb of control subjects (electrogoniometry, 97.8 degrees+/-92.3 degrees/min vs 286.2 degrees+/-46.5 degrees/min, P<.01; accelerometry 1.0+/-0.5 g/min vs 2.4+/-0.8 g/min, P<.01). Stroke patients had lower proportions than control subjects in both electrogoniometry (22.6%+/-18.0% vs 84.6%+/-9.8%, P<.01) and accelerometry (39.2%+/-21.4% vs 93.3%+/-5.0%, P<.01). Well-recovered stroke patients had significantly higher proportions compared with moderately recovered patients on both electrogoniometry and accelerometry.

CONCLUSIONS

The Stroke-ULAM sensitively measures actual performance, and therefore can be a valuable addition to the mostly capacity-oriented tools currently used to evaluate upper-limb function. Proportion is preferred to the level of usage.