Every year, around 270,000 people in Germany suffer from a stroke. The most visible consequences are sensorimotor consequences such as paresis, i.e., paralysis. Such limitations by a disease that primarily affects older people can reduce independence in everyday life.
When treating with medication or rehabilitation, it is important to check which functional limitations are present and, ultimately, whether the desired effect of the treatment has been achieved. This is usually done using standardized tests, such as grip strength measurements or achievable walking speeds. The extent to which such capacity tests can be transferred to everyday behaviour, which is generally submaximal, has yet to be sufficiently tested.
Dr. Philipp Gulde, Research Associate at the Chair of Human Movement Science, investigated this phenomenon in the study "Outside the laboratory assessment of upper-limb laterality in patients with stroke: A cross-sectional study" using wearables (smartwatches). The results of the study were published in the journal "Stroke". The journal is one of the most important in clinical neurology and has an impact factor of 10.17.
In the study, 50 people with stroke were examined to see how different the performance of the upper extremities was in clinical tests and whether this laterality was reflected in everyday behaviour. Daily behaviour was analyzed in terms of three dimensions: volume ("How much?"), intensity ("How strong/fast?") and quality ("How smooth/coordinated?"). Recruitment occurred at the Center for Clinical Neuroplasticity, Medical Park Loipl, a long-standing scientific cooperation partner. It was found that everyday behaviour and the laboratory tests were clearly and reliably associated and that the sensorimotor limitations affected all the dimensions investigated, but that insity metrics measured the most sensitive.
"In the article, we show that data from activity sensors, such as those built into a smartwatch, can provide meaningful data on everyday behaviour in stroke patients. In doing so, we go far beyond previously researched methods and determine different dimensions of behaviour. Our measurements show how the differences between the hands determined in the clinical tests carry over into everyday life," explains Prof. Dr. Joachim Hermsdörfer, head of the Chair of Human Movement Science and Head of the Department Health and Sport Sciences.
Dr. Gulde sees several advantages over clinical tests in the ease of use and availability of wearables: "Monitoring using smartwatches offers the possibility of continuous observation - every hour, every day, all year round. This would be expensive with clinical tests and beyond human resources." The travelling involved for people, some of whom have limited mobility, should also be taken into account because "with the help of the smartwatch on my wrist, I can take measurements in the most remote places and I can do this for any number of people at the same time," adds the Research Associate.
Ultimately, the kinematic analyses of the sensor data make it possible to differentiate between the various factors that influence behaviour: "A person may move little because he or she is suffering from post-stroke depression. If the person suffers from sensorimotor impairments, we can quantify these using intensity measures independent from physically activity levels. And for us as scientists, it is nice to see that our clinical tests, some very abstract, actually have something to do with the everyday behaviour of the people affected. Until now, we have only claimed this," concludes Gulde.
The study is part of the eXprt innovation network at the Technical University of Munich and was funded by the Federal Ministry of Education and Research (BMBF) and the Free State of Bavaria as part of the Excellence Strategy of the German federal and state governments.
To the publication "Outside the laboratory assessment of upper-limb laterality in patients with stroke: A cross-sectional study"
To the homepage of the Chair of Human Movement Science
Contact:
Prof. Dr. Joachim Hermsdörfer
Head Department Health and Sport Sciences
Chair of Human Movement Science
Georg-Brauchle Ring 60/62
80992 Munich
phone: 089 289 24550
e-mail: joachim.hermsdoerfer(at)tum.de
Dr. Philipp Gulde
Chair of Human Movement Science
Georg-Brauchle Ring 60/62
80992 Munich
E-Mail: philipp.gulde(at)tum.de
Text: Bastian Daneyko
Photos: Private