Development of a Post-stroke Upper Limb Rehabilitation Wearable Sensor for Use in Sub-Saharan Africa: A Pilot Validation Study

Abstract

The development of context-appropriate sensor technologies could alleviate the significant burden of stroke in Sub-Saharan African rehabilitation clinicians and health care facilities. However, many commercially available wearable sensors are beyond the financial capabilities of the majority of African persons. In this study, we evaluated the concurrent validity of a low-cost wearable sensor (i.e., the outREACH sensor) to measure upper limb movement kinematics of 31 healthy persons, using an 8-camera Vicon motion capture system as the reference standard. The outREACH sensor showed high correlation (r range: 0.808–0.990) and agreement (mean difference range: −1.60 to 1.10) with the reference system regardless of task or kinematic parameter. Moreover, Bland-Altman analyses indicated that there were no significant systematic errors present. This study indicates that upper limb movement kinematics can be accurately measured using the outREACH sensor, and have the potential to enhance stroke evaluation and rehabilitation in sub-Saharan Africa.

Quantitative Assessment of Upper Limb Motor Function in Ethiopian Acquired Brain Injured Patients Using a Low-Cost Wearable Sensor

“…With this in mind, future work will employ a user-centered approach to design a simple, clear, and culturally relevant mobile application available in both English and Amharic (official language of Ethiopia). In addition, we will work to refine the algorithms and integrate them with the outREACH mobile application (15,(29)(30)(31) so that upper limb kinematics can be characterized on-line. Despite the numerous barriers for individuals with acquired brain injury, participants provided overall positive feedback regarding the possibility to continue post-acquired brain injury care in their home environment with the outREACH sensor.…”

“…The issues surrounding traditional upper limb physical rehabilitation has stimulated particular interest in using wearable sensors for the evaluation post-acquired brain injured upper limb dysfunction (15)(16)(17)(18). For example, 12 examined the relationship between stroke impairment level (as measured by the Fugl-Meyer assessment for upper extremity [uFMA] scores) and upper limb kinematics using a 17-sensor system (MVN, Xsens Technologies).…”

“…To bridge this gap, San Francisco State University (USA), and the University of Gondar (Ethiopia) have collaborated in order to design a low-cost wearable sensor specifically for use in geographical areas such as Ethiopia, that struggle with a shortage of healthcare professionals and technical resources crucial to the evaluation and rehabilitation of post-acquired brain injured upper limb dysfunction. The validity of the outREACH sensor was recently compared to a Vicon motion capture system (15), with results indicating strong positive correlations (r = 0.808-0.990) and agreement (mean difference range: −1.60-1.10) with the reference system. Given that the upper limb movement kinematics of neurologically and physically healthy individuals can be accurately measured, the aim of the present study is to evaluate the extent to which the outREACH sensor is sensitive to the hand performing the task (unimpaired, impaired) and level of impairment (mild impairment, moderate impairment) in 14 Ethiopian acquired brain injury patients with upper limb dysfunction.…”

Accuracy and Validity of a Single Inertial Measurement Unit-Based System to Determine Upper Limb Kinematics for Medically Underserved Populations

“…Another enabling technology are inertial measurement units (IMUs) that exhibit great potential as a low-cost, portable means to evaluate and monitor patient progress during decentralized rehabilitation protocols ( Parrington et al, 2021 ). IMUs have been shown to accurately measure motor function and provide information regarding the different motor components that contribute to task performance, (e.g., movement accuracy, efficiency, precision, smoothness) ( Hughes et al, 2019a ; Schwarz et al, 2019 ), with kinematic variables obtained by IMU-based system correlating with standard clinical assessments ( Hughes et al, 2019b ; Oubre et al, 2020 ; Chen et al, 2021 ). For example, Hughes et al (2019a) , Hughes et al (2019b) developed a low-cost IMU-based wearable sensor specifically designed for medically underserved populations.…”

Biomechanical Assessment of Post-Stroke Patients’ Upper Limb before and after Rehabilitation Therapy Based on FES and VR

“…Using FES, they observed that there is an increase in shoulder flexion and elbow extension. Hughes et al [ 37 ] examined the total movement time, maximum velocity, and spectral spectrum in post-stroke patients (in the ARAT block, drink, and pour water tasks) and found a very high correlation and concordance. Finally, the importance of movement analysis measures for post-stroke patients was highlighted by Lane et al [ 33 ] as objective information on the performance and progress of therapy.…”