Envisioning the use of in-situ arm movement data in stroke rehabilitation: Stroke survivors' and occupational therapists' perspectives

Trends and Innovations in Wearable Technology for Motor Rehabilitation, Prediction, and Monitoring: A Comprehensive Review

(1) Background: Continuous health promotion systems are increasingly important, enabling decentralized patient care, providing comfort, and reducing congestion in healthcare facilities. These systems allow for treatment beyond clinical settings and support preventive monitoring. Wearable systems have become essential tools for health monitoring, but they focus mainly on physiological data, overlooking motor data evaluation. The World Health Organization reports that 1.71 billion people globally suffer from musculoskeletal conditions, marked by pain and limited mobility. (2) Methods: To gain a deeper understanding of wearables for the motor rehabilitation, monitoring, and prediction of the progression and/or degradation of symptoms directly associated with upper-limb pathologies, this study was conducted. Thus, all articles indexed in the Web of Science database containing the terms "wearable", "upper limb", and ("rehabilitation" or "monitor" or "predict") between 2019 and 2023 were flagged for analysis. (3) Results: Out of 391 papers identified, 148 were included and analyzed, exploring pathologies, technologies, and their interrelationships. Technologies were categorized by typology and primary purpose. (4) Conclusions: The study identified essential sensory units and actuators in wearable systems for upper-limb physiotherapy and analyzed them based on treatment methods and targeted pathologies.

Enhancing Activity Recognition After Stroke: Generative Adversarial Networks for Kinematic Data Augmentation

The generalizability of machine learning (ML) models for wearable monitoring in stroke rehabilitation is often constrained by the limited scale and heterogeneity of available data. Data augmentation addresses this challenge by adding computationally derived data to real data to enrich the variability represented in the training set. Traditional augmentation methods, such as rotation, permutation, and time-warping, have shown some benefits in improving classifier performance, but often fail to produce realistic training examples. This study employs Conditional Generative Adversarial Networks (cGANs) to create synthetic kinematic data from a publicly available dataset, closely mimicking the experimentally measured reaching movements of stroke survivors. This approach not only captures the complex temporal dynamics and common movement patterns after stroke, but also significantly enhances the training dataset. By training deep learning models on both synthetic and experimental data, we enhanced task classification accuracy: models incorporating synthetic data attained an overall accuracy of 80.0%, significantly higher than the 66.1% seen in models trained solely with real data. These improvements allow for more precise task classification, offering clinicians the potential to monitor patient progress more accurately and tailor rehabilitation interventions more effectively.

Wearable-Based Kinematic Analysis of Upper-Limb Movements During Daily Activities Could Provide Insights into Stroke Survivors' Motor Ability

BACKGROUND

Frequent and objective monitoring of motor recovery progression holds significant importance in stroke rehabilitation. Despite extensive studies on wearable solutions in this context, the focus has been predominantly on evaluating limb activity. This study aims to address this limitation by delving into a novel measure of wrist kinematics more intricately related to patients' motor capacity.

OBJECTIVE

To explore a new wearable-based approach for objectively and reliably assessing upper-limb motor ability in stroke survivors using a single inertial sensor placed on the stroke-affected wrist.

METHODS

Seventeen stroke survivors performed a series of daily activities within a simulated home setting while wearing a six-axis inertial measurement unit on the wrist affected by stroke. Inertial data during point-to-point upper-limb movements were decomposed into movement segments, from which various kinematic variables were derived. A data-driven approach was then employed to identify a kinematic variable demonstrating robust internal reliability, construct validity, and convergent validity.

RESULTS

We have identified a key kinematic variable, namely the 90th percentile of movement segment distance during point-to-point movements. This variable exhibited robust reliability (intra-class correlation coefficient of .93) and strong correlations with established clinical measures of motor capacity (Pearson's correlation coefficients of .81 with the Fugl-Meyer Assessment for Upper-Extremity; .77 with the Functional Ability component of the Wolf Motor Function Test; and -.68 with the Performance Time component of the Wolf Motor Function Test).

CONCLUSIONS

The findings underscore the potential for continuous, objective, and convenient monitoring of stroke survivors' motor progression throughout rehabilitation.