Funded Grants

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Grantee: University of Alabama, Birmingham, USA

Researcher: Gitendra Uswatteand Edward Taub

Grant Title: Accelerometry: A new approach to real-world outcome measures in rehabilitation

Program Area: Cognitive Rehabilitation

Grant Type: Research Award

Amount: $59,439

Year Awarded: 1997

Accelerometry: A new approach to real-world outcome measures in rehabilitation

Constraint-Induced (CI) Movement Therapy'," is a new treatment for chronic upper extremity hemiparesis. It has been cited by the Chair of a committee convened by NIH to assess the effectiveness of treatments in physical neurorehabilitation as one of the few modalities for which there is sound evidence of successful transfer of therapeutic effect from the clinic to the life situation." Traditional instruments in physical rehabilitation, however, do not provide a direct measure of motor function in the home. Therefore, it was necessary that this laboratory, which develops and evaluates new CI Therapy techniques, develop new methods for assessing "real-world" motor outcomes.

The development of cognitive rehabilitation techniques also demand innovations in measurement, since treatment adherence and effect are best evaluated by direct, continuous, and objective measures of cognitive function in the home. Current neuropsychological instruments measure cognitive function by assessing performance on laboratory tests' and obtaining self- and caregiver reports of cognitive function."' The work proposed herein might provide a model for the creation of appropriate real-world outcome measures in the field of cognitive rehabilitation.

The general purpose of this Pilot Project is to assess the validity of accelerometry as a measure of real-world motor rehabilitation outcome. The specific aims of this application are to validate accelerometry as a direct, objective, and continuous measure of the amount of stroke-affected arm movement in CI Therapy patients and age- and gender- matched controls in the laboratory (Experiment 1) and in CI Therapy patients in the home (Experiment 2).

In Experiment 1, we will evaluate the relationship the among accelerometer recordings taken from the arm and observer counts of arm movements and judgements of the duration of task-related arm movement when 10 CI Therapy patients and 10 age-matched controls are performing a series of Activities of Daily Living (ADL) tasks and resting in the laboratory.

In Experiment 2, we will evaluate the relationship among accelerometer recordings, patient and caregiver diaries of arm use, and observer counts of arm movement in 33 CI-Therapy patients over 5 weeks in the home.

A high positive correlation between the accelerometer recordings and observational measures and the recordings and self-report measures will suggest that the accelerometers are valid measures of real-world arm use.