Use of wrist worn accelerometers to quantify bilateral upper limb activity and asymmetry under free living conditions in people with multiple sclerosis.
BACKGROUND Although upper limb (UL) dysfunctions are quite common among people with Multiple Sclerosis (pwMS) there is a scarcity of information about actual UL usage under free living conditions. The aim of the present study is to quantitatively assess 'real world' activity time, intensity and possible asymmetry of use among dominant and non dominant ULs in pwMS. METHODS Twenty eight pwMS (20 women, 8 men, average EDSS 4.3) and 28 age and sex matched unaffected individuals were required to wear a tri axial accelerometer on each wrist 24h/day for 2 weekdays. Raw accelerations were processed to calculate parameters associated with time and intensity of use of UL both when engaged in uni or bilateral activities. RESULTS During the 2 day monitoring period, pwMS were characterized by significantly lower overall activity, they used their dominant limb for a significantly longer time and, while performing bilateral activities, their dominant limb expressed movements of superior intensity in a proportion higher than what was observed in unaffected individuals. CONCLUSION The instrumental monitoring of UL activity with two wrist worn sensors may represent an effective tool for assessing the contribution of each limb to uni and bilateral movements. Such data can be employed to monitor the progression of UL dysfunctions and the effectiveness of pharmacologic and rehabilitative treatments.
Multiple sclerosis and related disorders