The Stroke Upper-Limb Activity Monitor: Its Sensitivity to Measure Hemiplegic Upper-Limb Activity During Daily Life

Abstract 

de Niet M, Bussmann JB, Ribbers GM, Stam HJ. The Stroke Upper-Limb Activity Monitor: its sensitivity to measure hemiplegic upper-limb activity during daily life.

Objective

To test the Stroke Upper-Limb Activity Monitor (Stroke-ULAM), which uses electrogoniometry and accelerometry to measure the amount of upper-limb usage in stroke patients in daily life conditions, for its sensitivity to discriminate between moderately recovered and well-recovered stroke patients and control subjects.

Design

Cross-sectional study.

Setting

At home or a rehabilitation center.

Participants

Seventeen patients with stroke and 5 control subjects.

Interventions

Not applicable.

Main Outcome Measure

Level of usage of upper limb and the percentage of affected upper-limb activity compared with unaffected upper-limb activity (proportion).

Results

The level of usage of the affected upper limb of stroke patients was lower than that of the nondominant upper limb of control subjects (electrogoniometry, 97.8°±92.3°/min vs 286.2°±46.5°/min, P<.01; accelerometry 1.0±0.5g/min vs 2.4±0.8g/min, P<.01). Stroke patients had lower proportions than control subjects in both electrogoniometry (22.6%±18.0% vs 84.6%±9.8%, P<.01) and accelerometry (39.2%±21.4% vs 93.3%±5.0%, P<.01). Well-recovered stroke patients had significantly higher proportions compared with moderately recovered patients on both electrogoniometry and accelerometry.

Conclusions

The Stroke-ULAM sensitively measures actual performance, and therefore can be a valuable addition to the mostly capacity-oriented tools currently used to evaluate upper-limb function. Proportion is preferred to the level of usage.

Key Words: Cerebrovascular accident, Monitoring, ambulatory, Rehabilitation, Upper extremity