Department of Rehabilitation Medicine, Erasmus University Medical Center Rotterdam, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands.
Department of Plastic and Reconstructive Surgery, Erasmus University Medical Center Rotterdam, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands.
Sensors (Basel). 2021 Jun 25;21(13):4353. doi: 10.3390/s21134353.
Wrist-worn accelerometers are often applied to measure arm use after stroke. They measure arm movements during all activities, including whole-body movements, such as walking. Whole-body movements may influence clinimetric properties of arm use measurements-however, this has not yet been examined. This study investigates to what extent arm use measurements with wrist-worn accelerometers are affected by whole-body movements. Assuming that arm movements during whole-body movements are non-functional, we quantify the effect of whole-body movements by comparing two methods: Arm use measured with wrist-worn accelerometers during all whole-body postures and movements (P&M method), and during sitting/standing only (sit/stand method). We have performed a longitudinal observational cohort study with measurements in 33 stroke patients during weeks 3, 12, and 26 poststroke. The P&M method shows higher daily paretic arm use outcomes than the sit/stand method ( < 0.001), the mean difference increased from 31% at week three to 41% at week 26 ( < 0.001). Differences in daily paretic arm use between methods are strongly related to daily walking time (r = 0.83-0.92). Changes in the difference between methods are strongly related to changes in daily walking time (r = 0.89). We show that not correcting arm use measurements for whole-body movements substantially increases arm use outcomes, thereby threatening the validity of arm use outcomes and measured arm use changes.
腕部佩戴的加速度计常用于测量中风后手臂的使用情况。它们可以测量手臂在所有活动中的运动，包括全身运动，如行走。全身运动可能会影响手臂使用测量的临床测量特性-但是，这尚未得到检验。本研究旨在探讨腕部佩戴的加速度计测量的手臂使用程度受全身运动影响的程度。假设全身运动期间手臂运动是非功能性的，我们通过比较两种方法来量化全身运动的影响：在所有全身姿势和运动期间（P&M 方法）以及仅在坐姿/站立时（坐/站方法）用腕部佩戴的加速度计测量手臂使用情况。我们对 33 名中风患者进行了纵向观察队列研究，在中风后 3 周、12 周和 26 周进行了测量。P&M 方法显示出比坐/站方法更高的日常患侧手臂使用结果（<0.001），差异均值从第 3 周的 31%增加到第 26 周的 41%（<0.001）。两种方法之间日常患侧手臂使用的差异与日常行走时间密切相关（r=0.83-0.92）。两种方法之间差异的变化与日常行走时间的变化密切相关（r=0.89）。我们表明，不校正全身运动对手臂使用测量的影响会大大增加手臂使用结果，从而威胁手臂使用结果和测量的手臂使用变化的有效性。
