Relationships between accelerometry and general compensatory movements of the upper limb after stroke.
Jessica Barth, Joeseph W Klaesner, Catherine E Lang
PMID 33081783WHAT IT FOUND
Accelerometer data from daily life, but not clinic visits, reflects movement quality.
People who compensated more during tasks used their non-paretic arm more and showed less variability at home. Clinic training masks these patterns, so daily wearables capture compensations that in-clinic tests miss.
Key findings
01Out-of-clinic accelerometer variables showed stronger relationships with compensatory movement scores than in-clinic variables, indicating daily life recordings better reflect movement quality.
02Individuals with more compensatory movements used their non-paretic limb more and had a lower use ratio (less relative paretic activity) out-of-clinic, but these relationships were weak or non-significant in-clinic.
03Higher compensatory movement scores were associated with lower variability of bilateral upper limb movement in both in-clinic and out-of-clinic settings.
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
Compensatory movements were scored only during the ARAT, a standardized test, which may underestimate compensations used during free-living daily activities. The study did not use 3D kinematics (the gold standard for movement quality) to validate the compensatory score, relying instead on video analysis. In-clinic time included intensive therapy, which may have artificially improved movement quality and weakened the relationship between accelerometer data and compensations during that period. This is a secondary analysis of a Phase II trial, so the primary aim was not to validate these specific accelerometer-compensation relationships.
Declared interests
Funded by the Eunice Kennedy Shriver National Institute of Child Health and Human Development and the National Institutes of Health. No other conflicts of interest were declared in the provided text.
The easy way to misread this
Do not assume accelerometers can replace clinical assessment of movement quality. The relationships were moderate (rho 0.32–0.61), and the study did not validate the compensatory score against 3D kinematics. Accelerometry reflects general patterns of compensation, not the specific biomechanical errors a therapist might target.