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A Novel Combination of Accelerometry and Ecological Momentary Assessment for Post-Stroke Paretic Arm/Hand Use: Feasibility and Validity

Use of the paretic arm and hand is a key indicator of recovery and reintegration after stroke. A sound methodology is essential to comprehensively identify the possible factors impacting daily arm/hand use behavior. We combined ecological momentary assessment (EMA), a prompt methodology capturing re...

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Autores principales: Chen, Yi-An, Demers, Marika, Lewthwaite, Rebecca, Schweighofer, Nicolas, Monterosso, John R., Fisher, Beth E., Winstein, Carolee
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8005066/
https://www.ncbi.nlm.nih.gov/pubmed/33807014
http://dx.doi.org/10.3390/jcm10061328
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author Chen, Yi-An
Demers, Marika
Lewthwaite, Rebecca
Schweighofer, Nicolas
Monterosso, John R.
Fisher, Beth E.
Winstein, Carolee
author_facet Chen, Yi-An
Demers, Marika
Lewthwaite, Rebecca
Schweighofer, Nicolas
Monterosso, John R.
Fisher, Beth E.
Winstein, Carolee
author_sort Chen, Yi-An
collection PubMed
description Use of the paretic arm and hand is a key indicator of recovery and reintegration after stroke. A sound methodology is essential to comprehensively identify the possible factors impacting daily arm/hand use behavior. We combined ecological momentary assessment (EMA), a prompt methodology capturing real-time psycho-contextual factors, with accelerometry to investigate arm/hand behavior in the natural environment. Our aims were to determine (1) feasibility and (2) measurement validity of the combined methodology. We monitored 30 right-dominant, mild-moderately motor impaired chronic stroke survivors over 5 days (6 EMA prompts/day with accelerometers on each wrist). We observed high adherence for accelerometer wearing time (80.3%), EMA prompt response (84.6%), and generally positive user feedback upon exit interview. The customized prompt schedule and the self-triggered prompt option may have improved adherence. There was no evidence of EMA response bias nor immediate measurement reactivity. An unexpected small but significant increase in paretic arm/hand use was observed over days (12–14 min), which may be the accumulated effect of prompting that provided a reminder to choose the paretic limb. Further research that uses this combined methodology is needed to develop targeted interventions that effectively change behavior and enable reintegration post-stroke.
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spelling pubmed-80050662021-03-29 A Novel Combination of Accelerometry and Ecological Momentary Assessment for Post-Stroke Paretic Arm/Hand Use: Feasibility and Validity Chen, Yi-An Demers, Marika Lewthwaite, Rebecca Schweighofer, Nicolas Monterosso, John R. Fisher, Beth E. Winstein, Carolee J Clin Med Article Use of the paretic arm and hand is a key indicator of recovery and reintegration after stroke. A sound methodology is essential to comprehensively identify the possible factors impacting daily arm/hand use behavior. We combined ecological momentary assessment (EMA), a prompt methodology capturing real-time psycho-contextual factors, with accelerometry to investigate arm/hand behavior in the natural environment. Our aims were to determine (1) feasibility and (2) measurement validity of the combined methodology. We monitored 30 right-dominant, mild-moderately motor impaired chronic stroke survivors over 5 days (6 EMA prompts/day with accelerometers on each wrist). We observed high adherence for accelerometer wearing time (80.3%), EMA prompt response (84.6%), and generally positive user feedback upon exit interview. The customized prompt schedule and the self-triggered prompt option may have improved adherence. There was no evidence of EMA response bias nor immediate measurement reactivity. An unexpected small but significant increase in paretic arm/hand use was observed over days (12–14 min), which may be the accumulated effect of prompting that provided a reminder to choose the paretic limb. Further research that uses this combined methodology is needed to develop targeted interventions that effectively change behavior and enable reintegration post-stroke. MDPI 2021-03-23 /pmc/articles/PMC8005066/ /pubmed/33807014 http://dx.doi.org/10.3390/jcm10061328 Text en © 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Chen, Yi-An
Demers, Marika
Lewthwaite, Rebecca
Schweighofer, Nicolas
Monterosso, John R.
Fisher, Beth E.
Winstein, Carolee
A Novel Combination of Accelerometry and Ecological Momentary Assessment for Post-Stroke Paretic Arm/Hand Use: Feasibility and Validity
title A Novel Combination of Accelerometry and Ecological Momentary Assessment for Post-Stroke Paretic Arm/Hand Use: Feasibility and Validity
title_full A Novel Combination of Accelerometry and Ecological Momentary Assessment for Post-Stroke Paretic Arm/Hand Use: Feasibility and Validity
title_fullStr A Novel Combination of Accelerometry and Ecological Momentary Assessment for Post-Stroke Paretic Arm/Hand Use: Feasibility and Validity
title_full_unstemmed A Novel Combination of Accelerometry and Ecological Momentary Assessment for Post-Stroke Paretic Arm/Hand Use: Feasibility and Validity
title_short A Novel Combination of Accelerometry and Ecological Momentary Assessment for Post-Stroke Paretic Arm/Hand Use: Feasibility and Validity
title_sort novel combination of accelerometry and ecological momentary assessment for post-stroke paretic arm/hand use: feasibility and validity
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8005066/
https://www.ncbi.nlm.nih.gov/pubmed/33807014
http://dx.doi.org/10.3390/jcm10061328
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