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      Call for Papers: Sex and Gender in Neurodegenerative Diseases

      Submit here before September 30, 2024

      About Neurodegenerative Diseases: 3.0 Impact Factor I 4.3 CiteScore I 0.695 Scimago Journal & Country Rank (SJR)

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      Actigraphic Measurement of Motor Deficits in Acute Ischemic Stroke

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          Abstract

          Background: This study aimed to investigate the use of actigraphy (accelerometry) to measure disuse of the impaired arm in acute stroke patients. We correlated the National Institute of Health Stroke Scale (NIHSS) and the Fugl-Meyer Assessment arm section (FMA) findings with actigraphic data as a measure of validity. Methods: Thirty-nine acute ischemic stroke patients were included within 1 week after stroke onset. At inclusion, motor deficits were assessed by the NIHSS, FMA and 48-hour actigraphic recordings of both wrists were performed. Results: Moderate but highly significant correlations (Spearman’s rho) between actigraphic recordings and total NIHSS (ratio r = –0.59 and activity of impaired arm r = –0.75; p < 0.001) and FMA (ratio r = 0.54 and activity of impaired arm r = 0.69; p < 0.001) scores were found. Based on actigraphic motor activity scores, ROC curves were calculated following dichotomization of the population based on NIHSS = 7 and FMA = 45, showing good sensitivity and specificity, with negative predictive value of 100% and positive predictive value of 91% for the ratio variable. Conclusions: Moderate but highly significant correlations were found between actigraphy and the stroke scales NIHSS and FMA. Actigraphy was able to reliably discriminate less impaired from more impaired stroke patients with excellent sensitivity and specificity values. Actigraphy is a simple, valid, objective and reliable clinical research tool that can be used to determine motor impairment of the upper limb in stroke patients.

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          The Fugl-Meyer Assessment of Motor Recovery after Stroke: A Critical Review of Its Measurement Properties

          Cynthia J. Danells, Sandra Black, David J Gladstone (2016)
          Measurement of recovery after stroke is becoming increasingly important with the advent of new treatment options under investigation in stroke rehabilitation research. The Fugl-Meyer scale was developed as the first quantitative evaluative instrument for measuring sensorimotor stroke recovery, based on Twitchell and Brunnstrom's concept of sequential stages of motor return in the hemiplegic stroke patient. The Fugl-Meyer is a well-designed, feasible and efficient clinical examination method that has been tested widely in the stroke population. Its primary value is the 100-point motor domain, which has received the most extensive evaluation. Excellent interrater and intrarater reliability and construct validity have been demonstrated, and preliminary evidence suggests that the Fugl-Meyer assessment is responsive to change. Limitations of the motor domain include a ceiling effect, omission of some potentially relevant items, and weighting of the arm more than the leg. Further study should test performance of this scale in specific subgroups of stroke patients and better define its criterion validity, sensitivity to change, and minimal clinically important difference. Based on the available evidence, the Fugl-Meyer motor scale is recommended highly as a clinical and research tool for evaluating changes in motor impairment following stroke.
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            The technology of accelerometry-based activity monitors: current and future.

            Kong Y Chen, David R Bassett (2005)
            This paper reviews accelerometry-based activity monitors, including single-site first-generation devices, emerging technologies, and analytical approaches to predict energy expenditure, with suggestions for further research and development. The physics and measurement principles of the accelerometer are described, including the sensor properties, data collections, filtering, and integration analyses. The paper also compares these properties in several commonly used single-site accelerometers. The emerging accelerometry technologies introduced include the multisensor arrays and the combination of accelerometers with physiological sensors. The outputs of accelerometers are compared with criterion measures of energy expenditure (indirect calorimeters and double-labeled water) to develop mathematical models (linear, nonlinear, and variability approaches). The technologies of the sensor and data processing directly influence the results of the outcome measurement (activity counts and energy expenditure predictions). Multisite assessment and combining accelerometers with physiological measures may offer additional advantages. Nonlinear approaches to predict energy expenditure using accelerometer outputs from multiple sites and orientation can enhance accuracy. The development of portable accelerometers has made objective assessments of physical activity possible. Future technological improvements will include examining raw acceleration signals and developing advanced models for accurate energy expenditure predictions.
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              Intensity of leg and arm training after primary middle-cerebral-artery stroke: a randomised trial.

              J. Twisk, Timothy R. Wagenaar, Martijn J Koetsier … (1999)
              We investigated the effects of different intensities of arm and leg rehabilitation training on the functional recovery of activities of daily living (ADL), walking ability, and dexterity of the paretic arm, in a single-blind randomised controlled trial. Within 14 days after stroke onset, 101 severely disabled patients with a primary middle-cerebral-artery stroke were randomly assigned to: a rehabilitation programme with emphasis on arm training; a rehabilitation programme with emphasis on leg training; or a control programme in which the arm and leg were immobilised with an inflatable pressure splint. Each treatment regimen was applied for 30 min, 5 days a week during the first 20 weeks after stroke. In addition, all patients underwent a basic rehabilitation programme. The main outcome measures were ability in ADL (Barthel index), walking ability (functional ambulation categories), and dexterity of the paretic arm (Action Research arm test) at 6, 12, 20, and 26 weeks. Analyses were by intention to treat. At week 20, the leg-training group (n=31) had higher scores than the control group (n=37) for ADL ability (median 19 [IQR 16-20] vs 16 [10-19], p<0.05), walking ability (4 [3-5] vs 3 [1-4], p<0.05), and dexterity (2 [0-56] vs 0 [0-2], p<0.01). The arm-training group (n=33) differed significantly from the control group only in dexterity (9 [0-39] vs 0 [0-2], p<0.01). There were no significant differences in these endpoints at 20 weeks between the arm-training and leg-training groups. Greater intensity of leg rehabilitation improves functional recovery and health-related functional status, whereas greater intensity of arm rehabilitation results in small improvements in dexterity, providing further evidence that exercise therapy primarily induces treatment effects on the abilities at which training is specifically aimed.
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                Author and article information

                Journal
                Journal ID (publisher-id): CED
                Journal ID (nlm-ta): Cerebrovasc Dis
                Journal ID (doi): 10.1159/issn.1015-9770
                Title: Cerebrovascular Diseases
                Publisher: S. Karger AG
                ISSN (Print): 1015-9770
                ISSN (Electronic): 1421-9786
                Publication date Subscription-year: 2008
                Publication date (Print): November 2008
                Publication date (Electronic): 06 October 2008
                Volume: 26
                Issue: 5
                Pages: 533-540
                Affiliations
                aDepartment of Health Care Sciences, University College of Antwerp, Merksem, bDepartment of Neurology and Memory Clinic, Middelheim General Hospital (ZNA), cLaboratory of Neurochemistry and Behaviour, Institute Born-Bunge, and dDepartment of Nursing Sciences, Faculty of Medicine, University of Antwerp, Antwerp, and eNational Multiple Sclerosis Center, Melsbroek, Belgium
                Article
                Publisher ID: 160210 Other ID: Cerebrovasc Dis 2008;26:533–540
                DOI: 10.1159/000160210
                PubMed ID: 18836264
                SO-VID: 1f6ad2c5-3ca6-4bd3-9bd5-b99063d6710a
                Copyright © © 2008 S. Karger AG, Basel
                License:

                Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

                History
                Date received : 16 January 2008
                Date accepted : 02 June 2008
                Page count
                Figures: 4, Tables: 2, References: 30, Pages: 8
                Categories
                Subject: Original Paper

                ScienceOpen disciplines: Geriatric medicine,Neurology,Cardiovascular Medicine,Neurosciences,Clinical Psychology & Psychiatry,Public health
                Keywords: Fugl-Meyer Assessment,Stroke,National Institute of Health Stroke Scale,Actigraphy,Accelerometry
                Data availability:
                ScienceOpen disciplines: Geriatric medicine, Neurology, Cardiovascular Medicine, Neurosciences, Clinical Psychology & Psychiatry, Public health
                Keywords: Fugl-Meyer Assessment, Stroke, National Institute of Health Stroke Scale, Actigraphy, Accelerometry

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