Article

OBJECTIVE: To investigate the predictive validity, responsiveness, and minimal
clinically important difference of arm accelerometer in real-world activity of
patients with chronic stroke. DESIGN: Validation and psychometric study. SETTING:
Three medical centers. SUBJECTS: Patients with chronic stroke came from three
separated randomized controlled trials. INTERVENTIONS:
Patients with stroke
received upper extremity rehabilitation programs for four weeks. MAIN MEASURES:
Real-world arm movements were measured by an arm accelerometer and three clinical
measurement tools-the Motor Activity Log, Stroke Impact Scale, and Nottingham
Extended Activities of Daily Living-administered before and after treatment.
RESULTS: A total of 82 subjects were recruited in the study (mean age: 55.32
years; mean score of Fugl-Meyer Assessment: 39.91). Correlations between the arm
accelerometer and three clinical measurement tools were fair to moderate
(Pearson's r = 0.47, 0.42, and 0.34, respectively). The correlation between the
arm accelerometer and the quality of use of Motor Activity Log subscale was
moderate to good (Pearson's r = 0.57). The responsiveness of the arm
accelerometer from pretreatment to posttreatment was medium (standardized
response mean = 0.72). The minimal clinically important difference range for the
arm accelerometer was 547-751 mean counts. CONCLUSION: The arm accelerometer
demonstrated acceptable predictive validity and responsiveness in patients with
chronic stroke. The affected arm activity measured by the arm accelerometer was
sensitive to change. The change score of a patient with chronic stroke on the arm
accelerometer should reach 574-751 mean counts to be regarded as a minimal
clinically important difference.

Langue : ANGLAIS