OTOtherJournal of neuroengineering and rehabilitation2025

The association of upper limb sensorimotor capacity, everyday inpatient behavior, and the effects of neurorehabilitation in persons with multiple sclerosis and stroke: a mixed-design study.

Philipp Gulde, Heike Vojta, Stephanie Schmidle and 2 others

PMID 40045323

WHAT IT FOUND

In inpatient rehab, people with MS or stroke made fewer upper-limb movements per minute than healthy adults.

Everyday movement matched lab tests only weakly, and rehab gains did not clearly translate into daily behavior.

Key findings

01Healthy adults showed more upper-limb activities per minute than persons with MS or stroke, and persons with MS had longer average activity durations than healthy adults.

02Everyday upper-limb movement measures were weak to moderately related to lab tests of capacity, and not related to coordination measures.

03Over the rehabilitation interval, overall sensorimotor severity did not show a change, some individual capacity tests changed differently by group, and smartwatch behavior parameters did not change.

STILL TO COME

How it was doneWhat they foundWhat it means for OTs

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What it does not show

The sample was small and convenience-based, so the findings may not represent all people with MS or stroke. Longitudinal data were available for only 8 persons with MS and 7 persons with stroke, and the interval between assessments varied from 10 to 27 days. The short rehab window and small sample mean only moderate to strong effects could be detected. Behavior was recorded in an inpatient setting, not at home, so movement therapy and routines may have inflated activity levels. The smartwatches recorded for about 8 hours per upper limb, not a full day at home. The activity algorithm used fixed thresholds, so one activity with hesitations may have been logged as several activities. Stroke and MS subtypes and time since stroke were not analysed.

Declared interests

The work was funded by the Federal Ministry of Education and Research (BMBF), the Free State of Bavaria, and Technische Universität München. No author conflicts of interest are reported in the supplied text.

The easy way to misread this

Do not conclude that improving lab-based upper-limb scores will automatically increase everyday upper-limb use. The study found weak to moderate associations, no reported changes in smartwatch behavior parameters over rehabilitation, and only grip strength and tapping frequency changes were associated with behavior changes.

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The study

Participants
12 healthy adults, 17 persons with MS, 14 persons with stroke; longitudinal data for 8 persons with MS and 7 persons with stroke
Certainty of evidence
Low

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Philipp Gulde, Heike Vojta, Stephanie Schmidle, et al. The association of upper limb sensorimotor capacity, everyday inpatient behavior, and the effects of neurorehabilitation in persons with multiple sclerosis and stroke: a mixed-design study. Journal of neuroengineering and rehabilitation. 2025.

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