Quantifying the reach-and-grasp practice using novel wearable technology: Application in a stroke rehabilitation setting.

Abstract

Background: Wrist-worn accelerometers have been used to measure the intensity of upper extremity (UE) practice, but their primary focus is on general arm usage, lacking the ability to capture reaching and grasping of the hand that are relevant for rehabilitation.

Purpose: We aimed to explore the potential of a novel wrist-worn sensor as a meaningful measure for quantifying the amount of reaching and grasping practice during a structured UE exercise session for stroke.

Study design: A cross-sectional study.

Methods: Fourteen individuals with stroke wore sensor devices (TENZR) on both wrists while performing a structured UE exercise program comprising of 35 exercises. Counts recorded from observation (observed repetitions) and counts from the sensor device (sensor counts) were used to describe the amount of UE practice. The level of agreement between the observed repetitions and sensor counts were examined to determine if the TENZR is a meaningful measure. We also explore if the sensor counts were affected by the level of UE impairment.

Results: The participants performed 792 observed reach and grasp repetitions, with corresponding 711 and 465 sensor counts for the paretic hand and nonparetic hand, respectively, over the hour practice session. The TENZR and the observational method might measure UE movement differently, as evidenced by a lack of agreement between observed repetitions and sensor counts in the paretic hand. No significant relationship between the sensor counts in the paretic hand and the level of impairment was found.

Conclusions: This study used the TENZR to quantify reaching and grasping practice and characterize individual participation pattern for both paretic and nonparetic hands in stroke rehabilitation. The device is an alternative to direct observation for quantifying the intensity of reach-and-grasp practice. In the future, this device could expand to home-based rehabilitation and telehealth services, enabling objective monitoring and tracking of UE training progress.