Prompting arm activity after stroke: a clinical proof of concept study of wrist-worn accelerometers with a vibrating alert function

Ruth H. Da-Silva, Frederike van Wijck, Lisa Shaw, Helen Rodgers, Madeline Balaam, Lianne Brkic, Thomas Ploetz, Dan Jackson, Karim Ladha, Christopher I. Price

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Abstract

Background
Frequent practice of functional movements after stroke may optimise motor recovery; however, it is challenging for patients to remember to integrate an impaired limb into daily activities. We report the activity responses of stroke patients receiving a vibrating alert delivered by a tri-axial accelerometer wristband to prompt movement of the impaired arm if hourly activity levels fell.

Methods
Adults with upper limb impairment =28 days post-stroke wore the device for four weeks. Therapists and patients reviewed movement activity data twice weekly to agree ongoing rehabilitation activities and programme the wristband with a personalised prompt threshold (median baseline activity¿+¿5%, 25% or 50%).

Results: Seven patients completed the programme (five males; mean¿±¿standard deviation (age) 64¿±¿5 years; days post-stroke 13¿±¿7; baseline/four-week Action Research Arm Test median (Interquartile range (IQR)) 39 (8, 44)/56 (11, 57)). Wristbands were worn for 89% of programme duration. A total of 1,288 prompts were delivered, with a median of four (IQR 3,7) prompts per patient per day. Mean activity increases following a prompt ranged from 11% to 29%.

Conclusions
Feedback delivered by a programmable accelerometer increased impaired arm activity. Improvements are required in device reliability before conducting a pragmatic clinical trial to examine the impact upon recovery.
Original languageEnglish
JournalJournal of Rehabilitation and Assistive Technologies Engineering
Issue number5
DOIs
Publication statusPublished - 7 Mar 2018

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