Comparing Home Upper Extremity Activity with Clinical Evaluations of Arm Function in Chronic Stroke.
Kavita Bhatnagar, Christopher T Bever, Jing Tian and 2 others
PMID 33336184WHAT IT FOUND
Home accelerometer data correlated with clinical arm impairment scores, but not consistently with self-reported use.
Some patients with good clinical scores used their affected arm very little at home. Clinical tests alone may miss habitual non-use.
Key findings
01Accelerometer measures of paretic arm movement intensity correlated significantly with clinical impairment and performance tests (FMA, WMFT, ARAT).
02The ratio of paretic to nonparetic arm use duration correlated with self-reported amount and quality of movement, while intensity measures did not.
03A subanalysis identified higher-functioning participants who exhibited low home use of their affected arm, suggesting clinical scores may not reflect habitual activity.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
Small sample size (n=20) limits generalizability. Short recording window (3 days) may not capture weekly variations in activity. No formal assessment of unilateral neglect, which may explain low use in some participants. Accelerometers were placed proximal to the wrist, potentially missing fine hand movements. Depression confounded many relationships, suggesting mood affects both clinical scores and home activity.
Declared interests
None reported in the provided text.
The easy way to misread this
Do not assume that high clinical scores guarantee good home arm use. Several participants with moderate-to-high FMA scores used their affected arm very little at home. Clinical tests measure capacity; they do not measure habitual behavior or participation in daily life.