Validity of Accelerometry for Monitoring Real-World Arm Activity in Patients With Subacute Stroke: Evidence From the Extremity Constraint-Induced Therapy Evaluation Trial
Abstract
Uswatte G, Giuliani C, Winstein C, Zeringue A, Hobbs L, Wolf SL. Validity of accelerometry for monitoring real-world arm activity in patients with subacute stroke: evidence from the Extremity Constraint-Induced Therapy Evaluation trial.
Objective
To examine the psychometric properties of an objective method for assessing real-world arm activity in a large sample with subacute stroke.
Design
Validation study.
Setting
Community.
Participants
Persons 3 to 9 months poststroke (N=169) with mild to moderate motor impairment of their hemiparetic arm enrolled in a multisite, randomized clinical trial of constraint-induced movement therapy.
Interventions
Not applicable.
Main Outcome Measures
Participants wore an accelerometer on each arm outside the laboratory for 3 days before and after treatment or an equivalent no-treatment period. They also completed the Actual Amount of Use Test (AAUT), which is an observational measure of spontaneous more-impaired arm use, and the Motor Activity Log (MAL), which is an interview assessing more-impaired arm use in daily life.
Results
Low-pass–filtered accelerometer recordings were reliable (r range, >.8) and stable (P range, >.48). Their validity was also supported. Correlations calculated across all participants at baseline between the ratio of more-impaired to less-impaired arm accelerometer recordings and AAUT and MAL scores were .60 and .52, respectively.
Conclusions
Accelerometry provides an objective, real-world index of more-impaired arm activity with good psychometric properties.
aDepartment of Psychology, University of Alabama, Birmingham, AL
bDepartment of Physical Therapy, University of Alabama, Birmingham, AL
cCurriculum in Human Movement Science, University of North Carolina, Chapel Hill, NC
dDepartment of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, CA
eDivision of Biostatistics, Washington University School of Medicine, St. Louis, MO
fDepartment of Rehabilitation Medicine, Emory University School of Medicine, Atlanta, GA
Reprint requests to Gitendra Uswatte, PhD, Psychology, University of Alabama, 1530 3rd Ave S, CH415, Birmingham, AL 35294
Supported by the National Center for Medical Rehabilitation Research of the National Institute of Child Health and Human Development and National Institute for Neurological Diseases and Stroke, National Institutes of Health (grant no. HD 37606), and the American Heart Association Southeast Affiliate (grant no. 0365163B).
No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the author(s) or upon any organization with which the author(s) is/are associated.
ABSTRACT