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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.

      Key Words

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