Quantitative measurement of finger usage in stroke hemiplegia using ring-shaped wearable devices

Abstract

Abstract Background In post-stroke rehabilitation, positive use of affected limbs in daily life is important to improve affected upper-limb function. Several studies have quantitatively evaluated the amount of upper-limb activity, but few have measured finger usage. In this study, we used a ring-shaped wearable device to measure upper-limb and finger usage simultaneously in hospitalized patients with hemiplegic stroke and investigated the association between finger usage and general clinical evaluation. Methods Twenty patients with hemiplegic stroke in an inpatient hospital participated in this study. All patients wore a ring-shaped wearable device on both hands for 9 h on the day of the intervention, and their finger and upper-limb usage were recorded. For the rehabilitation outcome assessments, the Fugl-Meyer Assessment of the Upper Extremity (FMA-UE), Simple Test for Evaluating Hand Function (STEF), Action Research Arm Test (ARAT), Motor Activity Log-14 (MAL), and Functional Independence Measure Motor (FIM-m) were performed and evaluated on the same day as the intervention. Results Finger usage of the affected hand was moderately correlated with STEF ( $$r=0.48$$ r = 0.48 , $$p<0.05$$ p < 0.05 ) and STEF ratio ( $$r=0.47$$ r = 0.47 , $$p<0.05$$ p < 0.05 ). The finger-usage ratio was moderately correlated with FMA-UE ( $$r=0.56$$ r = 0.56 , $$p<0.05$$ p < 0.05 ) and ARAT ( $$r=0.53$$ r = 0.53 , $$p<0.05$$ p < 0.05 ), and strongly correlated with STEF ( $$r=0.80$$ r = 0.80 , $$p<0.01$$ p < 0.01 ) and STEF ratio ( $$r=0.80$$ r = 0.80 , $$p<0.01$$ p < 0.01 ). The upper-limb usage of the affected side was moderately correlated with FMA-UE ( $$r=0.46$$ r = 0.46 , $$p<0.05$$ p < 0.05 ), STEF ( $$r=0.55$$ r = 0.55 , $$p<0.05$$ p < 0.05 ) and STEF ratio ( $$r=0.54$$ r = 0.54 , $$p<0.05$$ p < 0.05 ), and strongly correlated with ARAT ( $$r=0.57$$ r = 0.57 , $$p<0.01$$ p < 0.01 ). The upper-limb usage ratio was moderately correlated with ARAT ( $$r=0.48$$ r = 0.48 , $$p<0.05$$ p < 0.05 ) and STEF ( $$r=0.55$$ r = 0.55 , $$p<0.05$$ p < 0.05 ), and strongly correlated with the STEF ratio ( $$r=0.61$$ r = 0.61 , $$p<0.01$$ p < 0.01 ). By contrast, there was no correlation between MAL and any of the measurements. Conclusions This measurement technique provided useful information that was not biased by the subjectivity of the patients and therapists.

Keywords

• Physical activity
• Activities of daily living
• Finger
• Upper limb
• Rehabilitation
• Stroke