Abstract
Knowledge of upper limb activity in the natural environment is critical for evaluating
the effectiveness of rehabilitation services. Wearable sensors allow efficient collection
of these data and have the potential to be less burdensome than self-report measures
of activity. Sensors can capture many different variables of activity and daily performance,
many of which could be useful in identifying deviation from typical movement behavior
or measuring outcomes from rehabilitation interventions. Although it has potential,
sensor measurement is just emerging, and there is a lack of consensus regarding which
variables of daily performance are valid, sensitive, specific, and useful. We propose
that symmetry of full-day upper limb movement is a key variable. We describe here
that symmetry is valid, robustly observed within a narrow range across the lifespan
in typical development, and shows evidence of being different in populations with
neuromotor impairment. Key next steps include the determination of sensitivity, specificity,
minimal detectable change, and minimal clinically important change/difference. This
information is needed to determine whether an individual belongs to the typical or
atypical group, whether change has occurred, and whether that change is beneficial.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Archives of Physical Medicine and RehabilitationAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- International Classification of Functioning, Disability and Health (ICF).(Available at:)http://www.who.int/classifications/icf/en/Date accessed: September 26, 2018
- Valid and reliable instruments for arm-hand assessment at ICF activity level in persons with hemiplegia: a systematic review.BMC Neurol. 2012; 12: 21
- Accelerometer measurement of upper extremity movement after stroke: a systematic review of clinical studies.J Neuroeng Rehabil. 2014; 11: 144
- Everyday movement and use of the arms: relationship in children with hemiparesis differs from adults.J Pediatr Rehabil Med. 2015; 8: 197-206
- The Pediatric Motor Activity Log-Revised: assessing real-world arm use in children with cerebral palsy.Rehabil Psychol. 2012; 57: 149-158
- Wearable sensors.(Available at:)https://www.apdm.com/wearable-sensors/Date accessed: September 26, 2018
- ActiGraph wGT3X-BT.(Available at:)https://www.actigraphcorp.com/actigraph-wgt3x-bt/Date accessed: September 26, 2018
- Kinematic characteristics of infant leg movements produced across a full day.JRATE. 2017; 4: 1-10
- Daily quantity of infant leg movement: wearable sensor algorithm and relationship to walking onset.Sensors. 2015; 15: 19006-19020
- Gait analysis using wearable sensors.Sensors. 2012; 12: 2255-2283
- Accuracy and precision of consumer-level activity monitors for stroke detection during wheelchair propulsion and arm ergometry.PLoS One. 2018; 13e0191556
- Limits to the measurement of habitual physical activity by questionnaires.Br J Sports Med. 2003; 37: 197-206
- A comparison of indirect versus direct measures for assessing physical activity in the pediatric population: a systematic review.Int J Pediatr Obes. 2009; 4: 2-27
- Self-report Pregnancy Physical Activity Questionnaire overestimates physical activity.Can J Public Health. 2015; 106: 1-7
- A comparison of direct versus self-report measures for assessing physical activity in adults: a systematic review.Int J Behav Nutr Phys Act. 2008; 5: 1-24
- Comparison of self-report versus sensor-based methods for measuring the amount of upper limb activity outside the clinic.Arch Phys Med Rehabil. 2018; 99: 1913-1916
- Development of a wearable sensor algorithm to detect the quantity and kinematic characteristics of infant arm movement bouts produced across a full day in the natural environment.Technologies. 2017; 5: 1-16
- Upper-limb activity in adults: referent values using accelerometry.J Rehabil Res Dev. 2013; 50: 1213-1222
- Validity of body-worn sensor acceleration metrics to index upper extremity function in hemiparetic stroke.J Neurol Phys Ther. 2015; 39: 111-118
- Acceleration metrics are responsive to change in upper extremity function of stroke survivors.Arch Phys Med Rehabil. 2015; 96: 854-861
- Quantifying real-world upper-limb activity in nondisabled adults and adults with chronic stroke.Neurorehabil Neural Repair. 2015; 29: 969-978
- An accelerometry-based methodology for assessment of real-world bilateral upper extremity activity.PLoS One. 2014; 9e103135
- Ambulatory monitoring of arm movement using accelerometry: an objective measure of upper-extremity rehabilitation in persons with chronic stroke.Arch Phys Med Rehabil. 2005; 86: 1498-1501
- Validity of accelerometry for monitoring real-world arm activity in patients with subacute stroke: evidence from the extremity constraint-induced therapy evaluation trial.Arch Phys Med Rehabil. 2006; 87: 1340-1345
- A method for quantifying upper limb performance in daily life using accelerometers.J Vis Exp. 2017;
- Wearable sensing for rehabilitation after stroke: bimanual jerk asymmetry encodes unique information about the variability of upper extremity recovery.IEEE Int Conf Rehabil Robot. 2017; 2017: 1603-1608
- Visualisation of upper limb activity using spirals: a new approach to the assessment of daily prosthesis usage.Prosthet Orthot Int. 2018; 42: 37-44
- Relationships between sensorimotor impairments and reaching deficits in acute hemiparesis.Neurorehabil Neural Repair. 2006; 20: 406-416
- Recovery of grasp versus reach in people with hemiparesis poststroke.Neurorehabil Neural Repair. 2006; 20: 444-454
- Objective measurement of functional upper-extremity movement using accelerometer recordings transformed with a threshold filter.Stroke. 2000; 31: 662-667
- Exploring the role of accelerometers in the measurement of real world upper-limb use after stroke.Brain Impair. 2015; 17: 16-33
- Assessment of upper extremity impairment, function, and activity after stroke: foundations for clinical decision making.J Hand Ther. 2013; 26: 104-115
- Using accelerometry to detect upper extremity motor deficits and delays in early childhood.2017 (Poster presented at: American Occupational Therapy Association Annual Conference. March 30-April 2, 2017; Philadelphia, PA)
- Lateral biases and fluctuations in infants’ spontaneous arm movements and reaching.Dev Psychobiol. 1999; 34: 237-255
- Seeing and touching: the role of sensory-motor experience on the development of infant reaching.Inf Behav Dev. 2009; 32: 44-58
- Relationships between full-day arm movement characteristics and developmental status in infants with typical development as they learn to reach: an observational study.Gates Open Res. 2018; 2: 17
- Disparity between functional recovery and daily use of the upper and lower extremities during subacute stroke rehabilitation.Neurorehabil Neural Repair. 2012; 26: 76-84
- Predicting daily use of the affected upper extremity 1 year after stroke.J Stroke Cerebrovasc Dis. 2015; 24: 274-283
- Does task-specific training improve upper limb performance in daily life poststroke?.Neurorehabil Neural Repair. 2017; 31: 290-300
- Development of the Hand Assessment for Infants: evidence of internal scale validity.Dev Med Child Neurol. 2017; 59: 1276-1283
- Development, and construct validity and internal consistency of the Grasp and Reach Assessment of Brisbane (GRAB) for infants with asymmetric brain injury.Inf Behav Dev. 2016; 45: 110-123
- Activity identification using body-mounted sensors—a review of classification techniques.Physiol Meas. 2009; 30: R1-R33
- Recognition of elementary arm movements using orientation of a tri-axial accelerometer located near the wrist.Physiol Meas. 2014; 35: 1751-1768
- Recognizing complex upper extremity activities using body worn sensors.PLoS One. 2015; 10e0118642
- The Manumeter: a non-obtrusive wearable device for monitoring spontaneous use of the wrist and fingers.IEEE Int Conf Rehabil Robot. 2013; 2013: 6650397
Article info
Publication history
Published online: January 28, 2019
Footnotes
Supported by the American Physical Therapy Association Section on Research Traveling Fellow Award and in part by the National Institutes of Health (grant no. R01HD068290) and the Bill & Melinda Gates Foundation (grant no. OPP1119189).
Disclosures: none.
Identification
Copyright
© 2019 by the American Congress of Rehabilitation Medicine
