StrokeWear: A Novel Wrist Wearable Sensor System to Promote Hemiparetic Upper Extremity Use in Home Daily Life.

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Abstract Stroke survivors often experience a debilitating loss of motor control typically affecting one side of the body. When performing upper-extremity (UE) movements during activities of daily living (ADLs), stroke survivors naturally favor using the more functional UE, thus leading to restricted use of the hemiparetic UE thereby hindering motor recovery. While therapists use conventional techniques to target the hemiparetic UE during clinical visits, patients receive limited direct training on the use of their hemiparetic UE in their home environment. The lack of therapeutic training in the home environment negatively impacts the recovery of UE motor function. Yet, motor improvements are achievable with sufficient motor practice. Based on this body of evidence, through our completed SBIR Fast-Track study, we developed a patented sensor-based technology, called StrokeWearTM. StrokeWearTM consists of a proprietary software and bilateral wrist-worn sensors to continuously monitor UE movements performed by patients in their home and community environments. The system also generates real- time feedback on the performance of goal directed movements (GDM). The objective of this Phase IIB is to further develop StrokeWearTM for commercialization by enhancing the platform with features that will empower and encourage patients to engage in GDM with their hemiparetic UE in the home and to support expert clinicians to foster increased activity in a telehealth environment. The system promotes behavior changes that optimize UE movement patterns for neuro-recovery. In this project, we will integrate goal setting, self-efficacy, behavioral achievements, and movement feedback into StrokeWearTM. To better engage the users, we will develop a companion smartphone application that will encourage patients to be active in monitoring their progress. Finally, we will develop a web-portal that will allow patients and clinicians to be more engaged and interactive during the rehabilitation program through on-demand goal setting and consultation. We will conduct two 6-month randomized clinical trials to assess the efficacy of this integrated platform in both chronic and subacute stroke survivors. The control group will receive usual care, while the intervention group will receive the StrokeWearTM platform in addition to a motor and behavioral home-based intervention.