Quantification of the relative arm-use in patients with hemiparesis using inertial measurement units
Background: The most popular method for measuring upper limb activity is based on accelerometry. However, this method is prone to overestimation and is agnostic to the functional utility of a movement. In this study, we used an inertial measurement unit(IMU)-based gross movement score to quantify arm-use in hemiparetic patients at home. Objectives: (i) Validate the gross movement score detected by wrist-worn IMUs against functional movements identified by human assessors. (ii) Test the feasibility of using wrist-worn IMUs to measure arm-use in patients' natural settings. Methods: To validate the gross movement score two independent assessors analyzed and annotated the video recordings of 5 hemiparetic patients and 10 healthy controls performing a set of activities while wearing IMUs. The second study tracked arm-use of 5 hemiparetic patients and 5 healthy controls using two wrist-worn IMUs for 7 days and 3 days, respectively. The IMU data obtained from this study was used to develop quantitative measures (total and relative arm-use (RAU)) and a visualization method for arm-use. Results: The gross movement score detects functional movement with 50-60% accuracy in hemiparetic patients, and is robust to non-functional movements. Healthy controls showed a slight bias towards the dominant arm (RAU: 40.52)°. Patients' RAU varied between 15-47° depending upon their impairment level and pre-stroke hand dominance. Conclusions: The gross movement score performs moderately well in detecting functional movements while rejecting non-functional movements. The patients' total arm-use is less than healthy controls, and their relative arm-use is skewed towards the less-impaired arm.