Prompting arm activity after stroke: A clinical proof of concept study of wrist-worn accelerometers with a vibrating alert function

• Published in: Journal of rehabilitation and assistive technologies engineering Vol. 5; p. 2055668318761524
• Main Authors: Da-Silva, Ruth H, van Wijck, Frederike, Shaw, Lisa, Rodgers, Helen, Balaam, Madeline, Brkic, Lianne, Ploetz, Thomas, Jackson, Dan, Ladha, Karim, Price, Christopher I
• Format: Journal Article
• Language: English
• Published: London, England SAGE Publications 2018; Sage Publications Ltd
• Subjects: accelerometry; activity; arm; feedback; Special Collection: Wearable Technologies for Active Living and Rehabilitation; Stroke; Stroke rehabilitation; feedback; accelerometry; Stroke rehabilitation; activity; arm
• ISSN: 2055-6683; 2055-6683
• DOI: 10.1177/2055668318761524

Background Frequent practice of functional movements after stroke may optimise motor recovery; however, it is challenging for patients to remember to integrate an impaired limb into daily activities. We report the activity responses of stroke patients receiving a vibrating alert delivered by a tri-axial accelerometer wristband to prompt movement of the impaired arm if hourly activity levels fell. Methods Adults with upper limb impairment ≤28 days post-stroke wore the device for four weeks. Therapists and patients reviewed movement activity data twice weekly to agree ongoing rehabilitation activities and programme the wristband with a personalised prompt threshold (median baseline activity + 5%, 25% or 50%). Results: Seven patients completed the programme (five males; mean ± standard deviation (age) 64 ± 5 years; days post-stroke 13 ± 7; baseline/four-week Action Research Arm Test median (Interquartile range (IQR)) 39 (8, 44)/56 (11, 57)). Wristbands were worn for 89% of programme duration. A total of 1,288 prompts were delivered, with a median of four (IQR 3,7) prompts per patient per day. Mean activity increases following a prompt ranged from 11% to 29%. Conclusions Feedback delivered by a programmable accelerometer increased impaired arm activity. Improvements are required in device reliability before conducting a pragmatic clinical trial to examine the impact upon recovery.