Quantification of the relative arm use in patients with hemiparesis using inertial measurement units

Abstract

Introduction Accelerometry-based activity counting for measuring arm use is prone to overestimation due to non-functional movements. In this paper, we used an inertial measurement unit (IMU)-based gross movement (GM) score to quantify arm use. Methods In this two-part study, we first characterized the GM by comparing it to annotated video recordings of 5 hemiparetic patients and 10 control subjects performing a set of activities. In the second part, we tracked the arm use of 5 patients and 5 controls using two wrist-worn IMUs for 7 and 3 days, respectively. The IMU data was used to develop quantitative measures (total and relative arm use) and a visualization method for arm use. Results From the characterization study, we found that GM detects functional activities with 50–60% accuracy and eliminates non-functional activities with >90% accuracy. Continuous monitoring of arm use showed that the arm use was biased towards the dominant limb and less paretic limb for controls and patients, respectively. Conclusions The gross movement score has good specificity but low sensitivity in identifying functional activity. The at-home study showed that it is feasible to use two IMU-watches to monitor relative arm use and provided design considerations for improving the assessment method. Clinical trial registry number: CTRI/2018/09/015648

Quantification of Movement in Stroke Patients under Free Living Conditions Using Wearable Sensors: A Systematic Review

“…One study was excluded due to poor methodological quality, scoring only four points ( Supplementary Materials ). Out of the remaining 32 studies that were included for data synthesis, 29 (91%) were of high quality [ 5 , 8 , 9 , 10 , 11 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 ] and three (9%) of moderate quality [ 43 , 44 , 45 ]. This inclusion process is described in Figure 1 .…”

“…In total 1076 stroke patients were included in the 32 studies, ranging from four to 169 stroke patients per study. Ten studies included data of in total 236 healthy controls in their analysis [ 5 , 8 , 20 , 23 , 29 , 33 , 35 , 36 , 40 , 44 , 45 ]. The reported average age of the stroke participants was 61 years while healthy participants were usually younger with a reported average of 55.8 years.…”

“…Reported Time After Stroke (TAS) was highly different between studies: five studies took place during the acute phase of stroke [ 33 , 38 , 40 , 42 , 43 ]—less than a week, as defined by Bernhardt et al [ 46 ]—another eight included patients during the early sub-acute phase [ 5 , 10 , 21 , 22 , 25 , 30 , 34 , 39 ] and eleven focused on chronic stroke patients [ 8 , 9 , 11 , 20 , 26 , 27 , 28 , 29 , 36 , 41 , 44 ]. The remaining articles included patients which were in different phases after stroke onset: acute and early sub-acute [ 23 , 24 ], early-subacute and late subacute [ 19 ], late sub-acute and chronic [ 35 ] or early, late and chronic phase [ 31 , 32 , 37 , 45 ]. See Appendix A for details.…”

“…Accelerometers and activity monitors—with embedded accelerometer sensors—were used in all studies ( Figure 2 ). Five studies used inertial measurement units (IMUs) [ 19 , 31 , 32 , 34 , 45 ] that combine tri-axial accelerometers, gyroscopes and magnetometers, although three of them [ 19 , 34 , 45 ] did not include the data from the magnetometer in their analysis. The other two studies [ 31 , 32 ] used IMUs as part of a full body motion measuring system.…”

“…Additionally, six studies [ 19 , 29 , 31 , 32 , 44 , 45 ], analyzed the quality of movement by calculating kinematic measures from IMUs and electrohydraulic sensors, and one study [ 36 ] focused on the number of hand movements using a custom setup and algorithm.…”