Article

OBJECTIVE: To assess the clinimetric properties and clinical applicability of
different accelerometry-based measurement techniques in persons with stroke. DATA
SOURCES: A systematic search of literature was performed using a specific search
strategy by means of different electronic databases until October 2008 (PubMed,
EMBASE, CINAHL, Cochrane Library of Clinical Trials). STUDY SELECTION: A first
selection was made by means of title and abstract. A second selection was
performed by means of predefined inclusion criteria: (1) accelerometry in stroke
population, (2) application of accelerometry in patients with stroke including
clinimetric properties. The exclusion criteria were (1) dysphagia, (2) new
engineering techniques or software alterations, (3) secondary sources, and (4)
Case studies. DATA EXTRACTION: The clinimetric properties and applicability of
accelerometry were described based on the included publications. DATA SYNTHESIS:
Twenty-five articles (4 randomized controlled trials) were included. The
information of the publications was divided into (1) gait, cadence, and
ambulatory activity; (2) upper-extremity activity; and (3) topics related to
stroke other than upper or lower extremity. Accelerometry was shown to be valid
and had good test-retest reliability in a large number of settings. Numerous
studies demonstrated correlations between accelerometry and common stroke scales.
Trunk movements were measured as an outcome of disturbed gait. The vertical
asymmetry index especially was able to differentiate between persons with stroke
and healthy controls. Persons with stroke showed less ambulatory activity,
measured as steps per day, than sedentary controls. Triaxial accelerometry was
able to distinguish between varying activity levels. Upper-extremity use was
lesser in persons with stroke. It was impossible to calculate a minimal clinical
difference for arm use by a uniaxial accelerometer. Evidence was presented that
finger-tapping and sit-to-stand measured by accelerometers could be used to
define recovery from stroke. CONCLUSIONS: The literature concerning accelerometry
incorporated into stroke research is young, limiting the ability to draw
consistent conclusions. Nonetheless, the available evidence suggests that
accelerometers yield valid and reliable data about the physical activity of
patients with stroke. Future research is necessary to investigate clinimetric
properties like predictive value and responsiveness further before implementing
accelerometry in clinical trials as an outcome for change.
CI - Copyright 2010 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS