Lee Sunghoon Ivan, Liu Yunda, Vergara-Díaz Gloria, Pugliese Benito Lorenzo, Black-Schaffer Randie, Stoykov Mary Ellen, Bonato Paolo
College of Information and Computer Sciences, University of Massachusetts Amherst, Amherst, MA, USA.
Department of Physical Medicine and Rehabilitation, Harvard Medical School at Spaulding Rehabilitation Hospital, Boston, MA, USA.
Neurorehabil Neural Repair. 2024 Sep;38(9):659-669. doi: 10.1177/15459683241270066. Epub 2024 Aug 7.
Frequent and objective monitoring of motor recovery progression holds significant importance in stroke rehabilitation. Despite extensive studies on wearable solutions in this context, the focus has been predominantly on evaluating limb activity. This study aims to address this limitation by delving into a novel measure of wrist kinematics more intricately related to patients' motor capacity.
To explore a new wearable-based approach for objectively and reliably assessing upper-limb motor ability in stroke survivors using a single inertial sensor placed on the stroke-affected wrist.
Seventeen stroke survivors performed a series of daily activities within a simulated home setting while wearing a six-axis inertial measurement unit on the wrist affected by stroke. Inertial data during point-to-point upper-limb movements were decomposed into movement segments, from which various kinematic variables were derived. A data-driven approach was then employed to identify a kinematic variable demonstrating robust internal reliability, construct validity, and convergent validity.
We have identified a key kinematic variable, namely the 90th percentile of movement segment distance during point-to-point movements. This variable exhibited robust reliability (intra-class correlation coefficient of .93) and strong correlations with established clinical measures of motor capacity (Pearson's correlation coefficients of .81 with the Fugl-Meyer Assessment for Upper-Extremity; .77 with the Functional Ability component of the Wolf Motor Function Test; and -.68 with the Performance Time component of the Wolf Motor Function Test).
The findings underscore the potential for continuous, objective, and convenient monitoring of stroke survivors' motor progression throughout rehabilitation.
在中风康复中,频繁且客观地监测运动恢复进程至关重要。尽管在此背景下对可穿戴解决方案进行了广泛研究,但重点主要集中在评估肢体活动上。本研究旨在通过更深入地探究一种与患者运动能力更密切相关的腕部运动学新测量方法来解决这一局限性。
探索一种基于可穿戴设备的新方法,使用放置在中风患侧手腕上的单个惯性传感器,客观、可靠地评估中风幸存者的上肢运动能力。
17名中风幸存者在模拟家庭环境中进行一系列日常活动,同时在受中风影响的手腕上佩戴六轴惯性测量单元。将点对点上肢运动期间的惯性数据分解为运动段,从中导出各种运动学变量。然后采用数据驱动方法识别一个具有强大内部可靠性、结构效度和收敛效度的运动学变量。
我们确定了一个关键运动学变量,即点对点运动期间运动段距离的第90百分位数。该变量表现出强大的可靠性(组内相关系数为0.93),并与既定的运动能力临床测量指标具有强相关性(与上肢Fugl-Meyer评估的Pearson相关系数为0.81;与Wolf运动功能测试的功能能力成分的Pearson相关系数为0.77;与Wolf运动功能测试的执行时间成分的Pearson相关系数为-0.68)。
研究结果强调了在整个康复过程中持续、客观、方便地监测中风幸存者运动进展的潜力。