• Hao-Ling Chen, Keh-Chung Lin, Yu-Wei Hsieh, Ching-Yi Wu, Rong-Jiuan Liing, and Chia-Ling Chen.
• 1 School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan.
• Clin Rehabil. 2018 Jan 1; 32 (1): 75-83.

ObjectiveTo investigate the predictive validity, responsiveness, and minimal clinically important difference of arm accelerometer in real-world activity of patients with chronic stroke.DesignValidation and psychometric study.SettingThree medical centers.SubjectsPatients with chronic stroke came from three separated randomized controlled trials.InterventionsPatients with stroke received upper extremity rehabilitation programs for four weeks.Main MeasuresReal-world arm movements were measured by an arm accelerometer and three clinical measurement tools-the Motor Activity Log, Stroke Impact Scale, and Nottingham Extended Activities of Daily Living-administered before and after treatment.ResultsA total of 82 subjects were recruited in the study (mean age: 55.32 years; mean score of Fugl-Meyer Assessment: 39.91). Correlations between the arm accelerometer and three clinical measurement tools were fair to moderate (Pearson's r = 0.47, 0.42, and 0.34, respectively). The correlation between the arm accelerometer and the quality of use of Motor Activity Log subscale was moderate to good (Pearson's r = 0.57). The responsiveness of the arm accelerometer from pretreatment to posttreatment was medium (standardized response mean = 0.72). The minimal clinically important difference range for the arm accelerometer was 547-751 mean counts.ConclusionThe arm accelerometer demonstrated acceptable predictive validity and responsiveness in patients with chronic stroke. The affected arm activity measured by the arm accelerometer was sensitive to change. The change score of a patient with chronic stroke on the arm accelerometer should reach 574-751 mean counts to be regarded as a minimal clinically important difference.

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