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Providing Real-Time Wearable Feedback to Increase Hand Use after Stroke: A Randomized, Controlled Trial

After stroke, many people substantially reduce use of their impaired hand in daily life, even if they retain even a moderate level of functional hand ability. Here, we tested whether providing real-time, wearable feedback on the number of achieved hand movements, along with a daily goal, can help pe...

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Detalles Bibliográficos
Autores principales: Schwerz de Lucena, Diogo, Rowe, Justin B., Okita, Shusuke, Chan, Vicky, Cramer, Steven C., Reinkensmeyer, David J.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9505054/
https://www.ncbi.nlm.nih.gov/pubmed/36146287
http://dx.doi.org/10.3390/s22186938
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author Schwerz de Lucena, Diogo
Rowe, Justin B.
Okita, Shusuke
Chan, Vicky
Cramer, Steven C.
Reinkensmeyer, David J.
author_facet Schwerz de Lucena, Diogo
Rowe, Justin B.
Okita, Shusuke
Chan, Vicky
Cramer, Steven C.
Reinkensmeyer, David J.
author_sort Schwerz de Lucena, Diogo
collection PubMed
description After stroke, many people substantially reduce use of their impaired hand in daily life, even if they retain even a moderate level of functional hand ability. Here, we tested whether providing real-time, wearable feedback on the number of achieved hand movements, along with a daily goal, can help people increase hand use intensity. Twenty participants with chronic stroke wore the Manumeter, a novel magnetic wristwatch/ring system that counts finger and wrist movements. We randomized them to wear the device for three weeks with (feedback group) or without (control group) real-time hand count feedback and a daily goal. Participants in the control group used the device as a wristwatch, but it still counted hand movements. We found that the feedback group wore the Manumeter significantly longer (11.2 ± 1.3 h/day) compared to the control group (10.1 ± 1.1 h/day). The feedback group also significantly increased their hand counts over time (p = 0.012, slope = 9.0 hand counts/hour per day, which amounted to ~2000 additional counts per day by study end), while the control group did not (p-value = 0.059; slope = 4.87 hand counts/hour per day). There were no significant differences between groups in any clinical measures of hand movement ability that we measured before and after the feedback period, although several of these measures improved over time. Finally, we confirmed that the previously reported threshold relationship between hand functional capacity and daily use was stable over three weeks, even in the presence of feedback, and established the minimal detectable change for hand count intensity, which is about 30% of average daily intensity. These results suggest that disuse of the hand after stroke is temporarily modifiable with wearable feedback, but do not support that a 3-week intervention of wearable hand count feedback provides enduring therapeutic gains.
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spelling pubmed-95050542022-09-24 Providing Real-Time Wearable Feedback to Increase Hand Use after Stroke: A Randomized, Controlled Trial Schwerz de Lucena, Diogo Rowe, Justin B. Okita, Shusuke Chan, Vicky Cramer, Steven C. Reinkensmeyer, David J. Sensors (Basel) Article After stroke, many people substantially reduce use of their impaired hand in daily life, even if they retain even a moderate level of functional hand ability. Here, we tested whether providing real-time, wearable feedback on the number of achieved hand movements, along with a daily goal, can help people increase hand use intensity. Twenty participants with chronic stroke wore the Manumeter, a novel magnetic wristwatch/ring system that counts finger and wrist movements. We randomized them to wear the device for three weeks with (feedback group) or without (control group) real-time hand count feedback and a daily goal. Participants in the control group used the device as a wristwatch, but it still counted hand movements. We found that the feedback group wore the Manumeter significantly longer (11.2 ± 1.3 h/day) compared to the control group (10.1 ± 1.1 h/day). The feedback group also significantly increased their hand counts over time (p = 0.012, slope = 9.0 hand counts/hour per day, which amounted to ~2000 additional counts per day by study end), while the control group did not (p-value = 0.059; slope = 4.87 hand counts/hour per day). There were no significant differences between groups in any clinical measures of hand movement ability that we measured before and after the feedback period, although several of these measures improved over time. Finally, we confirmed that the previously reported threshold relationship between hand functional capacity and daily use was stable over three weeks, even in the presence of feedback, and established the minimal detectable change for hand count intensity, which is about 30% of average daily intensity. These results suggest that disuse of the hand after stroke is temporarily modifiable with wearable feedback, but do not support that a 3-week intervention of wearable hand count feedback provides enduring therapeutic gains. MDPI 2022-09-14 /pmc/articles/PMC9505054/ /pubmed/36146287 http://dx.doi.org/10.3390/s22186938 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/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 (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Schwerz de Lucena, Diogo
Rowe, Justin B.
Okita, Shusuke
Chan, Vicky
Cramer, Steven C.
Reinkensmeyer, David J.
Providing Real-Time Wearable Feedback to Increase Hand Use after Stroke: A Randomized, Controlled Trial
title Providing Real-Time Wearable Feedback to Increase Hand Use after Stroke: A Randomized, Controlled Trial
title_full Providing Real-Time Wearable Feedback to Increase Hand Use after Stroke: A Randomized, Controlled Trial
title_fullStr Providing Real-Time Wearable Feedback to Increase Hand Use after Stroke: A Randomized, Controlled Trial
title_full_unstemmed Providing Real-Time Wearable Feedback to Increase Hand Use after Stroke: A Randomized, Controlled Trial
title_short Providing Real-Time Wearable Feedback to Increase Hand Use after Stroke: A Randomized, Controlled Trial
title_sort providing real-time wearable feedback to increase hand use after stroke: a randomized, controlled trial
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9505054/
https://www.ncbi.nlm.nih.gov/pubmed/36146287
http://dx.doi.org/10.3390/s22186938
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