Department of Geriatrics, Neurosciences and Orthopedics, Università Cattolica del Sacro Cuore, L. Go F. Vito, 1-00168 Rome, Italy.
Unità Operativa Complessa Neuroriabilitazione ad Alta Intensità, Largo A. Gemelli, Fondazione Policlinico Universitario A. Gemelli IRCCS, 8-00168 Rome, Italy.
Sensors (Basel). 2021 Apr 2;21(7):2479. doi: 10.3390/s21072479.
It is often challenging to formulate a reliable prognosis for patients with acute ischemic stroke. The most accepted prognostic factors may not be sufficient to predict the recovery process. In this view, describing the evolution of motor deficits over time via sensors might be useful for strengthening the prognostic model. Our aim was to assess whether an actigraphic-based parameter (Asymmetry Rate Index for the 24 h period (AR2_24 h)) obtained in the acute stroke phase could be a predictor of a 90 d prognosis.
In this observational study, we recorded and analyzed the 24 h upper limb movement asymmetry of 20 consecutive patients with acute ischemic stroke during their stay in a stroke unit. We recorded the motor activity of both arms using two programmable actigraphic systems positioned on patients' wrists. We clinically evaluated the stroke patients by NIHSS in the acute phase and then assessed them across 90 days using the modified Rankin Scale (mRS).
We found that the AR2_24 h parameter positively correlates with the 90 d mRS (r = 0.69, < 0.001). Moreover, we found that an AR2_24 h > 32% predicts a poorer outcome (90 d mRS > 2), with sensitivity = 100% and specificity = 89%.
Sensor-based parameters might provide useful information for predicting ischemic stroke prognosis in the acute phase.
为急性缺血性脑卒中患者制定可靠的预后常常具有挑战性。最被接受的预后因素可能不足以预测恢复过程。从这个角度来看，通过传感器描述随时间推移的运动缺陷的演变可能有助于增强预后模型。我们的目的是评估在急性脑卒中阶段获得的基于动作传感器的参数（24 小时不对称率指数（AR2_24 h））是否可以预测 90 天的预后。
在这项观察性研究中，我们在卒中单元中连续记录并分析了 20 例急性缺血性脑卒中患者的 24 小时上肢运动不对称性。我们使用两个可编程的动作传感器系统在患者手腕上记录双臂的运动活动。我们在急性阶段通过 NIHSS 对脑卒中患者进行临床评估，然后在 90 天内使用改良 Rankin 量表（mRS）进行评估。
我们发现 AR2_24 h 参数与 90 d mRS 呈正相关（r = 0.69，< 0.001）。此外，我们发现 AR2_24 h > 32%可预测较差的预后（90 d mRS > 2），具有 100%的敏感性和 89%的特异性。
基于传感器的参数可能为急性阶段缺血性脑卒中的预后提供有用的信息。
