A Novel, Wearable Inertial Measurement Unit for Stroke Survivors: Validity, Acceptability, and Usability

Lauri Bishop; Marika Demers; Justin Rowe; Daniel Zondervan; Carolee J Winstein

doi:10.1016/j.apmr.2024.01.020

A Novel, Wearable Inertial Measurement Unit for Stroke Survivors: Validity, Acceptability, and Usability

Arch Phys Med Rehabil. 2024 Mar 5:S0003-9993(24)00094-7. doi: 10.1016/j.apmr.2024.01.020. Online ahead of print.

Authors

Lauri Bishop¹, Marika Demers², Justin Rowe³, Daniel Zondervan³, Carolee J Winstein⁴

Affiliations

¹ Division of Biokinesiology and Physical Therapy, Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, CA; Department of Physical Therapy, Miller School of Medicine, University of Miami, Coral Gables, FL. Electronic address: Lauri.Bishop@med.miami.edu.
² Division of Biokinesiology and Physical Therapy, Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, CA; Center for Interdisciplinary Research, University of Montreal, Montreal, Quebec, Canada.
³ Flint Rehabilitation Devices, Irvine, CA.
⁴ Division of Biokinesiology and Physical Therapy, Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, CA; Department of Neurology, Keck School of Medicine, University of Southern California, Los Angeles, CA.

PMID: 38441511
DOI: 10.1016/j.apmr.2024.01.020

Abstract

Objective: To establish the concurrent validity, acceptability, and sensor optimization of a consumer-grade, wearable, multi-sensor system to capture quantity and quality metrics of mobility and upper limb movements in stroke survivors.

Design: Single-session, cross-sectional.

Setting: Clinical research laboratory.

Participants: Thirty chronic stroke survivors (age 57 (10) years; 33% female) with mild to severe motor impairments participated.

Interventions: Not Applicable.

Main outcome measures: Participants donned 5 sensors and performed standardized assessments of mobility and upper limb (UL) movement. True/false, positive/negative time in active movement for the UL were calculated and compared to criterion-standards using an accuracy rate. Bland-Altman plots and linear regression models were used to establish concurrent validity of UL movement counts, step counts, and stance time symmetry of MiGo against established criterion-standard measures. Acceptability and sensor optimization were assessed through an end-user survey and decision matrix.

Results: Mobility metrics showed excellent association with criterion-standards for step counts (video: r=0.988, P<.001, IMU: r=0.921, P<.001) and stance-time symmetry (r=0.722, P<.001). In the UL, movement counts showed excellent to good agreement (paretic: r=0.849, P<.001, nonparetic: r=0.672, P<.001). Accuracy of active movement time was 85.2% (paretic) and 88.0% (nonparetic) UL. Most participants (63.3%) had difficulty donning/doffing the sensors. Acceptability was high (4.2/5).

Conclusions: The sensors demonstrated excellent concurrent validity for mobility metrics and UL movements of stroke survivors. Acceptability of the system was high, but alternative wristbands should be considered.

Keywords: Gait; IMU; Stroke; Upper limb; Wearables.