Quantifying Real-World Upper-Limb Activity in Nondisabled Adults and Adults With Chronic Stroke.
Quantifying Real-World Upper-Limb Activity in Nondisabled Adults and Adults With Chronic Stroke.
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DOI：
10.1177/1545968315583720
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发表时间：
2015-11
影响因子：
4.2
通讯作者：
Lang CE
中科院分区：
文献类型：
--
作者：
Bailey RR;Klaesner JW;Lang CE
运动能力通常在诊所内进行评估，但由于缺乏测量工具，因此很少评估真实世界环境（即诊所外）中的运动表现。使用最近开发的基于加速度计的方法量化非残疾成人和卒中成人的真实双侧上肢（UL）活动。非残疾成人（n=74）和慢性卒中成人（n=48）在两个手腕上佩戴加速度计25-26小时。使用行动研究手臂测试（ARAT）评估运动能力。计算加速度计衍生的变量，以量化双侧UL活动的强度（即双侧幅度）和每秒活动的两个UL对活动的贡献（幅度比）。密度图被用来检查一天中每秒钟的双侧UL活动。非残疾成年人表现出显性和非显性UL的等效使用，由对称密度图和-0.1（四分位距：0.3）的中位幅度比表示，其中0值表示UL之间的活动相等。双侧UL活动强度较低（p<0.001），并且如不对称密度图和较低的中值幅度比（-2.2，四分位距：6.2，p<0.001）所示，中风成人患者的双侧UL活动强度更偏侧。许多ARAT评分不同的中风参与者之间的密度图相似，表明尽管运动能力不同，但真实世界的双侧UL活动相似。定量和可视化的真实世界双边UL活动可以使用这种新的加速度计为基础的方法，并补充从临床功能测试中获得的结果时，评估恢复的UL活动神经损伤。
Motor capability is commonly assessed inside the clinic, but motor performance in real-world settings (i.e. outside of the clinic) is seldom assessed because measurement tools are lacking. To quantify real-world bilateral upper limb (UL) activity in nondisabled adults and adults with stroke using a recently-developed accelerometry-based methodology. Nondisabled adults (n=74) and adults with chronic stroke (n=48) wore accelerometers on both wrists for 25-26 hours. Motor capability was assessed using the Action Research Arm Test (ARAT). Accelerometry-derived variables were calculated to quantify intensity of bilateral UL activity (i.e. Bilateral Magnitude) and the contribution of both ULs to activity (Magnitude Ratio) for each second of activity. Density plots were used to examine each second of bilateral UL activity throughout the day. Nondisabled adults demonstrated equivalent use of dominant and nondominant ULs, indicated by symmetrical density plots and a median Magnitude Ratio of -0.1 (Interquartile Range: 0.3) where a value of 0 indicates equal activity between ULs. Bilateral UL activity intensity was lower (p<0.001) and more lateralized in adults with stroke as indicated by asymmetrical density plots and a lower median Magnitude Ratio (-2.2, Interquartile Range: 6.2, p<0.001). Density plots were similar between many stroke participants who had different ARAT scores, indicating that real-world bilateral UL activity was similar despite different motor capabilities. Quantification and visualization of real-world bilateral UL activity can be accomplished using this novel accelerometry-based methodology, and complements results obtained from clinical tests of function when assessing recovery of UL activity following neurologic injury.