Using Accelerometers in the Neurological ICU to Monitor Unilaterally Motor Impaired Patients

Objective: explore the feasibility of automating motor function scoring by using continuous accelerometer measurements to identify characteristics present in both accelerometer recordings and motor exam scores. Background: neurological motor exam provides important information about a patient’s clinical status in the ICU, but the frequency at which it needs to be performed often makes it arduous for both healthcare providers and patients. Methods: Patients with unilateral motor impairment (defined as a score of 0-2 on “weak” side compared with 3-5 on “normal” side) in the neurological ICU were considered for this study. The Axivity AX3 accelerometer was used to measure three-dimensional accelerations for up to 14 days in each patient. These unobtrusive devices were placed on all 4 limbs using standard hospital bands, and required no active maintenance. Acceleration signals were processed to identify movement events that lasted ≥0.5msec. Movement events per hour were summated and compared between “weak” and “normal” limbs, and average movement count per hour was compared against motor strength score. Results: Three subjects were recruited; mean age 44years, 67[percnt] male. Two patients were diagnosed with ischemic strokes, and one with hemorrhagic stroke. One subject was impaired on the left hemibody; two were right-side impaired. The mean recording duration was 10 days (range 6-14 days). We found that there were significantly more movements in each of the normal upper and lower extremities as compared to their respective weak upper and lower extremities for all 3 subjects (P u003c 0.05, one-tail, two sample Kolmogorov-Smirnov test). Moreover, mean movement counts per hour appeared to correlate with objective provider motor scoring. Conclusions: Continuous monitoring of limb activity with accelerometers is feasible and can be used to identify motor asymmetry after neurological injury. It is unclear if accelerometer monitoring can be used to assess nuanced motor function. Disclosure: Dr. LaBuzetta has nothing to disclose. Dr. Hermiz has nothing to disclose. Dr. Gilja has nothing to disclose. Dr. Karanjia has nothing to disclose.