Publications

After a stroke, a great number of patients experience persistent motor impairments such as hemiparesis or weakness in one entire side of the body. As a result, the lack of use of the paretic limb might be one of the main contributors to functional loss after clinical discharge. We aim to reverse this cycle by promoting the use of the paretic limb during activities of daily living (ADLs). To do so, we describe the key components of a system composed of a wearable bracelet (i.e., a smartwatch) and a mobile phone, designed to bring a set of neurorehabilitation principles that promote acquisition, retention and generalization of skills to the home of the patient. A fundamental question is whether the loss in motor function derived from learned–non–use may emerge as a consequence of decision–making processes for motor optimization. Our system is based on well-established rehabilitation strategies that aim to reverse this behaviour by increasing the reward associated with action execution and implicitly reducing the expected cost of using the paretic limb, following the notion of reinforcement–induced movement therapy (RIMT). Here we validate an accelerometer-based measure of arm use and its capacity to discriminate different activities that require increasing movement of the arm. The usability and acceptance of the device as a rehabilitation tool is tested using a battery of self–reported and objective measurements obtained from acute/subacute patients and healthy controls. We believe that an extension of these technologies will allow for the deployment of unsupervised rehabilitation paradigms during and beyond hospitalization time. © 2021, Springer Nature Switzerland AG.

JTD Keywords: adls, hemiparesis, learned non-use, wearables, Activities of daily living, Adls, Functional loss, Generalisation, Hemiparesis, Learned non-use, Motor impairments, Neurorehabilitation [], Patient experiences, Stroke, Wearable devices, Wearable technology, Wearables