Effects of in home high dose accelerometer-based feedback on perceived and actual use in participants chronic post-stroke

ABSTRACT

Purpose To explore the effects of home-based high dose accelerometer-based feedback on (1) perception of paretic upper extremity (UE) use; (2) actual amount of use (AOU); and (3) capability. The secondary purpose was to characterize paretic UE use in the home setting. Materials and Methods: Prospective experimental pre/post design (trial reg: NCT02995213). Eight participants chronic post-stroke (57.03 ± 6.64 y.o.) wore bilateral wrist accelerometers for 3 weeks during which seven sessions of accelerometer-based feedback were administered in the home. Accelerometer data (overall use, unimanual use, bimanual use, paretic/nonparetic use ratio, different intensities of use) were collected at all follow-up visits; clinical outcomes/questionnaires were collected at baseline, mid-study, and post-intervention. Results: After receiving high dose accelerometer-based feedback, participants had significant perceived gains in how much (p = 0.017) and how well (p = 0.050) they used the paretic UE. However, there were no significant group changes in actual paretic UE AOU or capability. Conclusions: In home high dose accelerometer-based feedback increased perceived paretic UE use and overall awareness of paretic UE use. Perception of use may serve as a first step to promote the behavioral change necessary to encourage actual paretic UE use, potentially decreasing the maladaptive effects of learned nonuse on participation.

KEYWORDS:

• Stroke
• upper extremity
• accelerometer
• feedback
• learned nonuse
• forced use

Acknowledgments

The authors would like to acknowledge the participants and their significant others for the time and energy they devoted to this study. We would also like to thank Mishgan Abdullah, Andrea Matanovic, Amanda Videmsek, and Elise Colacicco for their assistance with data collection data, processing, and/or drafting. This work was supported in part by the Ohio Physical Therapy Association Research Grant.

Declaration of interest

The authors report no conflicts of interest.

Additional information

Funding

This work was supported by the Ohio Physical Therapy Association.