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. 2021 Mar 19;18(1):51.
doi: 10.1186/s12984-021-00847-x.

Objectively measured arm use in daily life improves during the first 6 months poststroke: a longitudinal observational cohort study

G R H Regterschot  1 , J B J Bussmann  2 , Malou H J Fanchamps  2 , Carel G M Meskers  3 , Gerard M Ribbers  2   4 , Ruud W Selles  2   5
Affiliations

Objectively measured arm use in daily life improves during the first 6 months poststroke: a longitudinal observational cohort study

G R H Regterschot et al. J Neuroeng Rehabil. .

Abstract

Background: It is unclear how arm use in daily life changes after stroke since studies investigating the change in arm use poststroke are scarce. The aim of this study was to investigate the change in arm use during the first six months poststroke. Secondary aim was to compare arm use changes between arm recovery clusters.

Methods: Arm use was measured during week 3, 12, and 26 poststroke with accelerometers on the wrists and the nonaffected leg. Outcomes were the amount of affected and nonaffected arm use during sitting and standing per day and per sit/stand hour, and the daily ratio between arms. Arm function was measured with the Fugl-Meyer Upper Extremity Scale to identify recovery clusters (poor/moderate/excellent). Generalized estimating equations compared arm use outcomes between time points and between recovery clusters.

Results: Thirty-three stroke patients participated. Affected arm use per day increased between week 3 and 12 (30 %; p = 0.04) and it increased per sit/stand hour between week 3-12 (31 %; p < 0.001) and between week 3 and 26 (48 %; p = 0.02). Nonaffected arm use per day decreased between week 3 and 12 (13 %; p < 0.001) and between week 3 and 26 (22 %; p < 0.001) and it decreased per sit/stand hour between week 3 and 26 (18 %; p = 0.003). The daily ratio increased between week 3 and 12 (43 %; p < 0.001) and between week 3 and 26 (95 %; p < 0.001). Changes in arm use did not differ significantly between recovery clusters (p = 0.11-0.62). Affected arm use was higher in the excellent recovery cluster (p < 0.001).

Conclusions: Affected arm use and the ratio between arms increase during the first 26 weeks poststroke especially in patients with excellent arm recovery.

Keywords: Accelerometry; Ambulatory monitoring; Rehabilitation; Sensor; Stroke; Upper extremity.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
The arm use monitor [7]. The system consists of two wrist-worn accelerometers and an accelerometer on the upper leg. The wrist-worn sensors measure arm movements and the leg sensor determines body postures and movements
Fig. 2
Fig. 2
Boxplots showing the Fugl-Meyer Upper Extremity scores. Data are measured at 3, 12 and 26 weeks poststroke in the poor/moderate and excellent arm recovery cluster
Fig. 3
Fig. 3
Boxplots showing the daily monitor wearing time, daily sitting/standing duration, and daily walking duration. Data are measured with the arm use monitor in week 3, 12 and 26 poststroke. The percentage between brackets indicates the difference in median value between time points or between clusters. The upper row shows the results for the whole sample (n = 33), the lower row shows the results for the arm recovery clusters
Fig. 4
Fig. 4
Boxplots showing the daily arm use at week 3, 12 and 26 poststroke. Data are measured with the arm use monitor. The percentage between brackets indicates the difference in median value between time points or between clusters. The upper row shows the results for the whole sample (n = 33), the lower row shows the results for the different arm recovery clusters
Fig. 5
Fig. 5
Boxplots showing the arm use per sitting and standing hour. Data are measured with the arm use monitor at week 3, 12 and 26 poststroke. The percentage between brackets indicates the difference in median value between time points or between clusters. The upper row shows the results for the whole sample (n = 33), the lower row shows the results for the different arm recovery clusters
Fig. 6
Fig. 6
Individual changes in arm use are shown for all patients. Each line represents one patient
See this image and copyright information in PMC

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