Wearable Monitor Could Bring Real-time Tracking To Stroke Rehabilitation

A wristband device could allow doctors to monitor stroke recovery continuously and in real-world settings rather than through occasional clinic assessments. Results published today in Science Translational Medicine show promise for the technology to support personalized rehabilitation programs with clear progress tracking.

“We are the first group to actually show that, using wearable data, we can extract information about patients’ motor severity, which clinicians can actually use to determine whether their intervention is effective or not,” said Sunghoon Ivan Lee, PhD, associate professor at the Manning College of Information and Computer Sciences of the University of Massachusetts Amherst.

As many as 77% of people who suffer a stroke experience difficulties with upper-limb mobility immediately after. About 40% of them continue to present chronic issues, which can interfere with everyday activities and independent living.

While physical therapy can improve mobility, clinicians commonly rely on time-consuming observational assessments that are generally conducted before and after rehabilitation, providing only limited snapshots of a patient’s recovery.

“During the therapy process, neither the patient nor the therapist has a clear idea of how patients are responding to the treatments that they’re receiving,” said Lee. “Currently, clinicians aren’t able to see if patients are responding to the prescribed exercises, and patients have no way of knowing how they are progressing.”

Lee’s team developed a digital arm performance scale (DAPS) using 23,000 hours of data collected by wristband accelerometers. A machine-learning model then breaks movement data into segments and extracts features that can be used to generate a digital measure of motor recovery.

Results showed the algorithm was up to 50% more accurate in reflecting patients’ underlying condition when compared to a standard clinician evaluation. Independent testing in a group of 79 people with chronic stroke found that DAPS broadly agreed with conventional scores assigned by physicians.

Continuous monitoring could offer several advantages over assessments performed solely in a clinical setting. Because a wristband device can record movement throughout the day and in real-world environments, it could potentially capture behaviors that controlled clinical tests would otherwise miss. The data could also help therapists identify changes in performance sooner and adjust treatment strategies accordingly.

Beyond patient care, the technology could have implications for stroke research. A simulation of a previous clinical study showed that replacing conventional clinician observations with DAPS could produce statistically significant results while reducing required enrollment by as much as 73%.

Lee and colleagues are currently recruiting stroke patients for further research at Spaulding Rehabilitation Hospital in Boston. The researchers have already filed a provisional patent and are pursuing commercialization through the startup Lumid Health.

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