Abstract
Monitoring upper-limb activity in a free-living environment is important for the evaluation of rehabilitation. This study is a validation of the Strathclyde Upper-Limb Activity Monitor (SULAM) which records the vertical movement and position of each wrist, and assesses bimanual movement. Agreement between the SULAM and two independent video observers was assessed using interclass correlation coefficients (ICC) and the Bland and Altman method. Concurrent validity was very good for movement of each upper-limb (ICC > 0.9), and good for the vertical position of the wrist (ICC > 0.8 for wrist positions below the shoulder, ICC > 0.6 otherwise). The ICC was good (>0.8) for bimanual movement, however the SULAM systematically underreported this by approximately 15%. The SULAM could be a useful tool to assess upper-limb activity of clinical populations in their usual environment.




Similar content being viewed by others
Notes
Presented in the 25th Annual International Conference of the IEEE EMBC 2003 [http://ieeexplore.ieee.org].
References
Aminian K, Robert P, Buchser EE et al (1999) Physical activity monitoring based on accelerometry: validation and comparison with video observation. Med Biol Eng Comp 37:304–308
Bernhardt J, Hill K (2005) We only treat what it occurs to us to assess: the importance of knowledge based assessment. In: Refshauge K, Ada L, Ellis E (eds) Science-based rehabilitation theories into practice. Elsevier Butterworth Heinemann, Edinburgh
Bernmark E, Wiktorin C (2002) A triaxial accelerometer for measuring arm movements. Appl Ergon 33:541–547
Bland JM, Altman DG (1986) Statistical methods for assessing agreement between two methods of clinical measurement. Lancet 327:307–310
Bland JM, Altman DG (2003) Applying the right statistics: analyses of measurement studies. Ultrasound Obstet Gynecol 22:85–93
Busser HJ, Ott J, van Lummel RC et al (1997) Ambulatory monitoring of children’s activity. Med Eng Phys 19:440–445
Cauraugh JH, Summers JJ (2005) Neural plasticity and bilateral movements: a rehabilitation approach for chronic stroke. Prog Neurobiol 75:309–320
Estill C, MacDonald L, Wenzl T et al (2000) Use of accelerometers as an ergonomic assessment method for arm acceleration a large-scale field trial. Ergonomics 43:1430–1445
Fleiss JL (1986) The design and analysis of clinical experiments. Wiley, New York
Foerster F, Smeja M, Fahrenberg J (1999) Detection of posture and motion by accelerometry: a validation study in ambulatory monitoring. Comput Hum Behav 15:571–583
Kemp B, Janssen AJMW, van der Kamp B (1998) Body position can be monitored in 3D using miniature accelerometers and earth-magnetic field sensors. Electroencephalogr Clin Neurophysiol 109:484–488
Kopp B, Kunkel A, Flor H et al (1997) The arm motor ability test: reliability, validity, and sensitivity to change of an instrument for assessing disabilities in activities of daily living. Arch Phys Med Rehabil 78:615–620
Page SJ, Sisto SA, Levine P (2002) Modified constraint-induced therapy in chronic stroke. Am J Phys Med Rehabil 81:870–875
Pomeroy VM, Pramanik A, Sykes L et al (2003) Agreement between physiotherapists on quality of movement rated via videotape. Clin Rehabil 17:264–272
Rankin G, Stokes M (1998) Reliability of assessment tools in rehabilitation: an illustration of appropriate statistical analyses. Clin Rehabil 12:187–199
Rau G, Disselhorst-Klug C, Schmidt R (2000) Movement biomechanics goes upwards: from the leg to the arm. J Biomech 33:1207–1216
Rice MS, Newell KM (2004) Upper-extremity interlimb coupling in persons with left hemiplegia due to stroke. Arch Phys Med Rehabil 85:629–634
Schasfoort FC, Bussman JB, Stam HJ (2002) Ambulatory measurement of upper-limb usage and mobility-related activities during normal daily life with an upper-limb-activity monitor: a feasibility study. Med Biol Eng Comput 40:173–182
Schasfoort FC, Bussmann JB, Stam HJ (2004) Impairments and activity limitations in subjects with chronic upper-limb complex regional pain syndrome type I. Arch Phys Med Rehabil 85:557–566
Sporrong H, Sandsjö L, Kadefors R et al (1999) Assessment of workload and arm position during different work sequences: a study with portable devices on construction workers. Appl Ergon 30:495–503
Uswatte G, Miltner WH, Foo B et al (2000) Objective measurement of functional upper-extremity movement using accelerometer recordings transformed with a threshold filter. Stroke 31:662–667
Uswatte G, Foo WL, Olmstead H et al (2005) Ambulatory monitoring of arm movement using accelerometry: an objective measure of upper extremity rehabilitation in persons with chronic stroke. Arch Phys Med Rehabil 86:1498–1501
VanSwearingen JM, Brach JS (2001) Making geriatric assessment work: selecting useful measures. Phys Ther 81:1233–1252
Vega-González A, Granat MH (2005) Continuous monitoring upper-limb activity in a free-living-environment. Arch Phys Med Rehabil 86:541–548
Wade TD (1992) Measurement in neurological rehabilitation. Oxford Medical Publications, Oxford
Waters PM, Zurakowski D, Patterson P et al (2004) Interobserver and intraobserver reliability of therapist-assisted videotaped evaluations of upper-limb hemiplegia. J Hand Surg 29A:328–334
Wiles CM, Newcombe RG, Fuller KJ et al (2003) Use of videotape to assess mobility in a controlled randomized crossover trial of physiotherapy in chronic multiple sclerosis. Clin Rehabil 17:256–263
Winter D (1990) Biomechanics and motor control of human movement. Wiley, New York
Acknowledgments
The work for this study was conducted at the University of Strathclyde, Glasgow, UK. The authors would like to thank Mr Ian Tullis for his technical help and CONACyT for their financial support of Arturo’s Ph.D. studies at the University of Strathclyde, Glasgow.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Vega-Gonzalez, A., Bain, B.J., Dall, P.M. et al. Continuous monitoring of upper-limb activity in a free-living environment: a validation study. Med Bio Eng Comput 45, 947–956 (2007). https://doi.org/10.1007/s11517-007-0233-7
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11517-007-0233-7