Sensor Measures of Symmetry Quantify Upper Limb Movement in the Natural Environment Across the Lifespan.
Beth A Smith, Catherine E Lang
PMID 30703350WHAT IT FOUND
Wearable wrist sensors may track how much people use both arms in daily life, but the paper says more work is needed before it can guide clinical decisions.
Key findings
01Self-report and wrist sensor measures of upper limb activity are not interchangeable: among 64 persons with upper limb paresis at least 6 months post stroke, only one third had self-report values within 10% of sensor values, while 17% over-reported and 50% under-reported.
02The use ratio, a symmetry measure from wrist sensors, is narrow in typical people: adults averaged 0.95 ± 0.06 and infants averaged 0.94 (SD 0.04), while adults with stroke could have values as low as 0.3 and children with hemiparesis from cerebral palsy had lower than normal ratios.
03The paper proposes symmetry as a useful variable now, but says more work is needed to determine whether it can identify a typical or atypical person, detect change, or show that change is beneficial.
STILL TO COME
How it was doneWhat they foundWhat it means for OTs
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What it does not show
The paper summarizes evidence and proposes a measure, so it does not test whether a rehabilitation intervention changes arm use. The symmetry measure is proposed, but the paper says more work is needed to know whether it can identify a typical or atypical person, detect change, or show that change is beneficial. Wrist sensors measure movement above a threshold, not whether movement is functional or purposeful, and they cannot distinguish passive from active movement. Most sensors are worn on the wrist and do not measure finger movements. Self-report and sensor measures are not interchangeable, so one cannot substitute a questionnaire for daily sensor data. The infant examples are preliminary, and the paper says relationships between full-day sensor data and developmental outcomes are not yet known.
Declared interests
The authors declare no conflicts of interest. The article is marked as receiving NIH extramural and non-U.S. government research support.
The easy way to misread this
Do not conclude that wearable sensor symmetry is ready to use as a clinical outcome or to judge whether a patient has improved. The paper proposes the measure and reports preliminary group differences, but it says more work is needed to know whether it can identify a typical or atypical person, detect change, or show that change is beneficial.