Fell D1, Dale RB1, Saale B1, Girardeau S1, Nix G1, Roddam S1, Salisbury L1
1University of South Alabama, Physical Therapy, Mobile, AL, United States
Background: Cerebrovascular accident (CVA), or stroke, is a common cause of disability in the U.S. with more than half of individuals suffering from hemiparesis and motor control deficits. Motor control is one of the most important outcomes for clinical rehabilitation. Currently, there are no objective measures for motor control that have been validated in the research.
Purpose: This study attempted to validate the use of an accelerometer, 2D video app, and the Modified Boyd and Graham scale for measuring motor control in patients with stroke, within the rehabilitation setting.
Methods: Seven participants with a history of a stroke were recruited to perform isolated joint movements at the elbow and knee. Voluntary movements of elbow flexion and knee extension were captured via the Hudl Technique App and the Sensor Kinetics Pro App (accelerometer) on affected and unaffected sides in order to identify onset of loss of motor control. The accelerometer data was analyzed and compared to the Hudl Technique App and the Modified Boyd and Graham scale as rated by two researchers.
Results: Novice and experienced examiners' scores were significantly correlated with the accelerometer for the elbow (r=.954), but no such findings were captured for the knee. A significant inverse correlation (r=-.967) was found regarding the experienced examiner scores and the knee composite amplitude index (CAI) scores of the accelerometer. No significant difference was noted between the CAI scores, from the accelerometer data across the entire trial, for the affected versus the unaffected, elbow or knee. Lastly, decreased motor control was observed for each Hudl video trial, however the angle from Hudl was not significant when compared to the entire accelerometer trial.
Conclusion(s): Accelerometer data correlates with the amount of range performed with prior to onset of synergy.
Implications: Future studies could be increased in power with a larger sample size. Some limitations with the accelerometer data include needed comparisons of the CAI during portions of movement with normal control to portions with loss of selective control. Windowing may provide a better correlation between unaffected and affected limbs. Also, using patient reported affected versus unaffected limb comparisons may not be an accurate reflection of a more impaired side. Lastly, there was a relative amount of subjectivity regarding the timestamp of when each synergy began on the Hudl videos, for each trial.
Keywords: Neurology, Examination, Motor Control
Funding acknowledgements: None
Purpose: This study attempted to validate the use of an accelerometer, 2D video app, and the Modified Boyd and Graham scale for measuring motor control in patients with stroke, within the rehabilitation setting.
Methods: Seven participants with a history of a stroke were recruited to perform isolated joint movements at the elbow and knee. Voluntary movements of elbow flexion and knee extension were captured via the Hudl Technique App and the Sensor Kinetics Pro App (accelerometer) on affected and unaffected sides in order to identify onset of loss of motor control. The accelerometer data was analyzed and compared to the Hudl Technique App and the Modified Boyd and Graham scale as rated by two researchers.
Results: Novice and experienced examiners' scores were significantly correlated with the accelerometer for the elbow (r=.954), but no such findings were captured for the knee. A significant inverse correlation (r=-.967) was found regarding the experienced examiner scores and the knee composite amplitude index (CAI) scores of the accelerometer. No significant difference was noted between the CAI scores, from the accelerometer data across the entire trial, for the affected versus the unaffected, elbow or knee. Lastly, decreased motor control was observed for each Hudl video trial, however the angle from Hudl was not significant when compared to the entire accelerometer trial.
Conclusion(s): Accelerometer data correlates with the amount of range performed with prior to onset of synergy.
Implications: Future studies could be increased in power with a larger sample size. Some limitations with the accelerometer data include needed comparisons of the CAI during portions of movement with normal control to portions with loss of selective control. Windowing may provide a better correlation between unaffected and affected limbs. Also, using patient reported affected versus unaffected limb comparisons may not be an accurate reflection of a more impaired side. Lastly, there was a relative amount of subjectivity regarding the timestamp of when each synergy began on the Hudl videos, for each trial.
Keywords: Neurology, Examination, Motor Control
Funding acknowledgements: None
Topic: Neurology: stroke; Human movement analysis
Ethics approval required: Yes
Institution: University of South Alabama
Ethics committee: Institutional Review Board
Ethics number: None
All authors, affiliations and abstracts have been published as submitted.
