A Wearable Bracelet Device for Promoting Arm Use in Stroke Patients

Belén Rubio Ballester, Alica Lathe, Esther Duarte, Armin Duff, Paul F. M. J. Verschure

2015

Abstract

After stroke, many patients experience hemiparesis or weakness on one side of the body. In order to compensate for this lack of motor function, they tend to overuse their non-affected limb. This so called learned non-use may be one of the most relevant contributors to functional loss after post-stroke hospital discharge. We hypothesize that frequent exposure to movement related feedback through a wearable bracelet device may 1) increase the patient’s intrinsic motivation for using the paretic limb, and 2) counteract learned non-use, therefore inducing motor recovery. First, to validate the accelerometers-based measurement of arm use, we recruited 10 right-handed volunteers without neurological impairments. Second, we explored the acceptability and clinical impact of a low-cost wearable system on 4 chronic stroke patients with hemiparesis. Our results suggest that frequent exposure to direct feedback about arm use promotes the integration of the paretic limb in the performance of instrumental activities of daily living (iADLs). In addition, results from questionnaires revealed that the use of wearable devices may influence positively the patient’s intrinsic motivation for using the affected arm. To the best of our knowledge, this is the first study suggesting the benefits of wearable-based feedback as an intervention tool for counteracting learned non-use.

References

  1. Ballester, B. R., Maier, M., Duff, A., San Segundo, R., Casta n˜eda, V., and Verschure, P. (2015a). Reinforcement-Induced Movement Therapy: A novel approach for overcoming learned non-use in chronic stroke patients. In Proceedings of the International Conference on Virtual Rehabilitation. In press., pages 1-6.
  2. Ballester, B. R., Nirme, J., Duarte, E., Cuxart, A., Rodriguez, S., Verschure, P., and Duff, A. (2015b). The visual amplification of goal-oriented movements counteracts acquired non-use in hemiparetic stroke patients. Journal of neuroengineering and rehabilitation, 12(1):50.
  3. Gubbi, J., Rao, A. S., Fang, K., Yan, B., and Palaniswami, M. (2013). Motor recovery monitoring using acceleration measurements in post acute stroke patients. Biomedical engineering online, 12:33.
  4. Han, C. E., Arbib, M. A., and Schweighofer, N. (2008). Stroke rehabilitation reaches a threshold. PLoS computational biology, 4(8):e1000133.
  5. Hidaka, Y., Han, C. E., Wolf, S. L., Winstein, C. J., and Schweighofer, N. (2012). Use it and improve it or lose it: interactions between arm function and use in humans post-stroke. PLoS computational biology, 8(2):e1002343.
  6. Lai, S.-M., Studenski, S., Duncan, P. W., and Perera, S. (2002). Persisting consequences of stroke measured by the Stroke Impact Scale. Stroke, 33(7):1840-1844.
  7. Markopoulos, P., Timmermans, A. A. A., Beursgens, L., Van Donselaar, R., and Seelen, H. A. M. (2011). Us' em: The user-centered design of a device for motivating stroke patients to use their impaired arm-hand in daily life activities. In Engineering in Medicine and Biology Society, EMBC, 2011 Annual International Conference of the IEEE, pages 5182-5187. IEEE.
  8. Noork o˜iv, M., Rodgers, H., and Price, C. I. (2014). Accelerometer measurement of upper extremity movement after stroke: a systematic review of clinical studies. Journal of neuroengineering and rehabilitation, 11(1):144.
  9. Ryan, R. M., Patrick, H., Deci, E. L., and Williams, G. C. (2008). Facilitating health behaviour change and its maintenance: Interventions based on selfdetermination theory. European Health Psychologist, 10(1):2-5.
  10. Taub, E. and Uswatte, G. (2003). Constraint-induced movement therapy: bridging from the primate laboratory to the stroke rehabilitation laboratory. Journal of Rehabilitation Medicine, 35:34-40.
  11. Tsurumi, K., Itani, T., Tachi, N., Takanishi, T., Suzumura, H., and Takeyama, H. (2002). Estimation of Energy Expenditure during Sedentary Work with Upper Limb Movement. Journal of occupational health, 44(6):408-413.
  12. Uswatte, G., Foo, W. L., Olmstead, H., Lopez, K., Holand, A., and Simms, L. B. (2005). Ambulatory monitoring of arm movement using accelerometry: an objective measure of upper-extremity rehabilitation in persons with chronic stroke. Archives of physical medicine and rehabilitation, 86(7):1498-1501.
  13. Uswatte, G., Taub, E., Morris, D., Light, K., and Thompson, P. A. (2006). The Motor Activity Log-28 assessing daily use of the hemiparetic arm after stroke. Neurology, 67(7):1189-1194.
  14. van der Pas, S. C., Verbunt, J. A., Breukelaar, D. E., van Woerden, R., and Seelen, H. A. (2011). Assessment of arm activity using triaxial accelerometry in patients with a stroke. Archives of physical medicine and rehabilitation, 92(9):1437-1442.
  15. Wang, Q., Chen, W., and Markopoulos, P. (2014). Literature review on wearable systems in upper extremity rehabilitation. In IEEE-EMBS International Conference on Biomedical and Health Informatics (BHI), pages 551-555. IEEE.
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Paper Citation


in Harvard Style

Rubio Ballester B., Lathe A., Duarte E., Duff A. and F. M. J. Verschure P. (2015). A Wearable Bracelet Device for Promoting Arm Use in Stroke Patients . In Proceedings of the 3rd International Congress on Neurotechnology, Electronics and Informatics - Volume 1: NEUROTECHNIX, ISBN 978-989-758-161-8, pages 24-31. DOI: 10.5220/0005662300240031


in Bibtex Style

@conference{neurotechnix15,
author={Belén Rubio Ballester and Alica Lathe and Esther Duarte and Armin Duff and Paul F. M. J. Verschure},
title={A Wearable Bracelet Device for Promoting Arm Use in Stroke Patients},
booktitle={Proceedings of the 3rd International Congress on Neurotechnology, Electronics and Informatics - Volume 1: NEUROTECHNIX,},
year={2015},
pages={24-31},
publisher={SciTePress},
organization={INSTICC},
doi={10.5220/0005662300240031},
isbn={978-989-758-161-8},
}


in EndNote Style

TY - CONF
JO - Proceedings of the 3rd International Congress on Neurotechnology, Electronics and Informatics - Volume 1: NEUROTECHNIX,
TI - A Wearable Bracelet Device for Promoting Arm Use in Stroke Patients
SN - 978-989-758-161-8
AU - Rubio Ballester B.
AU - Lathe A.
AU - Duarte E.
AU - Duff A.
AU - F. M. J. Verschure P.
PY - 2015
SP - 24
EP - 31
DO - 10.5220/0005662300240031