Quantitative measurement of finger usage in stroke hemiplegia using ring-shaped wearable devices

Abstract

Background: In post-stroke rehabilitation, positive use of affected limbs in daily life is important to improve affected upper-limb function. Several studies have quantitatively evaluated the amount of upper-limb activity, but few have measured finger usage. In this study, we used a ring-shaped wearable device to measure upper-limb and finger usage simultaneously in hospitalized patients with hemiplegic stroke and investigated the association between finger usage and general clinical evaluation. Methods: Twenty patients with hemiplegic stroke in an inpatient hospital participated in this study. All patients wore a ring-shaped wearable device on both hands for 9 h on the day of the intervention, and their finger and upper-limb usage were recorded. For the rehabilitation outcome assessments, the Fugl-Meyer Assessment of the Upper Extremity (FMA-UE), Simple Test for Evaluating Hand Function (STEF), Action Research Arm Test (ARAT), Motor Activity Log-14 (MAL), and Functional Independence Measure Motor (FIM-m) were performed and evaluated on the same day as the intervention. Results: Finger usage of the affected hand was moderately correlated with STEF (r= 0.48 , p< 0.05) and STEF ratio (r= 0.47 , p< 0.05). The finger-usage ratio was moderately correlated with FMA-UE (r= 0.56 , p< 0.05) and ARAT (r= 0.53 , p< 0.05), and strongly correlated with STEF (r= 0.80 , p< 0.01) and STEF ratio (r= 0.80 , p< 0.01). The upper-limb usage of the affected side was moderately correlated with FMA-UE (r= 0.46 , p< 0.05), STEF (r= 0.55 , p< 0.05) and STEF ratio (r= 0.54 , p< 0.05), and strongly correlated with ARAT (r= 0.57 , p< 0.01). The upper-limb usage ratio was moderately correlated with ARAT (r= 0.48 , p< 0.05) and STEF (r= 0.55 , p< 0.05), and strongly correlated with the STEF ratio (r= 0.61 , p< 0.01). By contrast, there was no correlation between MAL and any of the measurements. Conclusions: This measurement technique provided useful information that was not biased by the subjectivity of the patients and therapists.