Preliminary examination of the ability of a new wearable device to capture functional hand activity after stroke

Abstract

Background and Purpose-A reliable measure of movement repetitions is required to assist in determining the optimaldose for maximizing upper limb recovery after stroke. This study investigated the ability of a new wearable device tocapture reach-to-grasp repetitions in individuals with stroke.Methods-Eight individuals with stroke wore an instrumented wrist bracelet while completing 12 upper limb activities.Participants completed 5 and 10 repetitions of each activity on 2 separate sessions (time 1 and time 2) and completedclinical assessments (Fugl-Meyer Upper Extremity Assessment and Action Research Arm Test). Mean reach-to-graspcounts (ie, hand counts) were compared across activities. Scaling properties were assessed by the ratio of 10 repetitions to5 repetitions for the activities (ie, expected value of 2). Bland-Altman diagrams were used to examine agreement betweentime 1 and time 2 counts.Results-The wrist bracelet averaged 0 to 0.6 hand counts per repetition for the arm-only and hand-only activities andaveraged 1 to 2 counts per repetition of the reach-to-grasp activities. The mean ratio of 10 repetition to 5 repetition countswas 2 for all of the reach-to-grasp activities. Mean differences from time 1 to time 2 were <0.3 counts/repetition for allactivities except one.Conclusions-These preliminary results provide evidence that the wrist bracelet is able to capture hand counts over avariety of tasks in a consistent manner. This wrist bracelet could be further developed as a tool to record dose of upperlimb practice for research or clinical practice, as well as providing motivation and accountability to patients participatingin treatments requiring upper limb movement repetitions. Currently, there are limitations in interpreting the impact ofimpairment and common compensatory movements on hand counts, and it would be valuable for future studies to explorethese effects.