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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Wrist
Arm
Stroke
Pragmatic Clinical Trials
Equipment and Supplies
Health Services Research
Upper Extremity
Rehabilitation
Extremities

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Da-Silva, Ruth H. ; van Wijck, Frederike ; Shaw, Lisa ; Rodgers, Helen ; Balaam, Madeline ; Brkic, Lianne ; Ploetz, Thomas ; Jackson, Dan ; Ladha, Karim ; Price, Christopher I. / Prompting arm activity after stroke: a clinical proof of concept study of wrist-worn accelerometers with a vibrating alert function. In: Journal of Rehabilitation and Assistive Technologies Engineering. 2018 ; No. 5.
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title = "Prompting arm activity after stroke: a clinical proof of concept study of wrist-worn accelerometers with a vibrating alert function",
abstract = "BackgroundFrequent 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.MethodsAdults 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{\%}.ConclusionsFeedback 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.",
author = "Da-Silva, {Ruth H.} and {van Wijck}, Frederike and Lisa Shaw and Helen Rodgers and Madeline Balaam and Lianne Brkic and Thomas Ploetz and Dan Jackson and Karim Ladha and Price, {Christopher I.}",
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Prompting arm activity after stroke: a clinical proof of concept study of wrist-worn accelerometers with a vibrating alert function. / Da-Silva, Ruth H.; van Wijck, Frederike; Shaw, Lisa; Rodgers, Helen; Balaam, Madeline; Brkic, Lianne; Ploetz, Thomas; Jackson, Dan; Ladha, Karim; Price, Christopher I.

In: Journal of Rehabilitation and Assistive Technologies Engineering, No. 5, 07.03.2018.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Prompting arm activity after stroke: a clinical proof of concept study of wrist-worn accelerometers with a vibrating alert function

AU - Da-Silva, Ruth H.

AU - van Wijck, Frederike

AU - Shaw, Lisa

AU - Rodgers, Helen

AU - Balaam, Madeline

AU - Brkic, Lianne

AU - Ploetz, Thomas

AU - Jackson, Dan

AU - Ladha, Karim

AU - Price, Christopher I.

N1 - Acceptance from webpage OA article

PY - 2018/3/7

Y1 - 2018/3/7

N2 - BackgroundFrequent 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.MethodsAdults 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%.ConclusionsFeedback 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.

AB - BackgroundFrequent 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.MethodsAdults 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%.ConclusionsFeedback 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.

U2 - 10.1177/2055668318761524

DO - 10.1177/2055668318761524

M3 - Article

JO - Journal of Rehabilitation and Assistive Technologies Engineering

JF - Journal of Rehabilitation and Assistive Technologies Engineering

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