Background. While wrist-worn accelerometers have been used to measure upper extremity use in the past, they primarily measure arm motion and lack the ability to capture functional hand opening and grasping activities which are essential for activities of daily living. Objectives. To characterize real-world functional hand opening and grasping activities captured over multiple days in adults with stroke and in matched controls using a novel wrist-worn device. Methods. Twenty-eight individuals (fourteen individuals with stroke and 14 healthy controls) wore the devices on both wrists for 3 days. Functional hand activity was characterized by daily hand counts, hourly hand counts, and asymmetry between hands. The Mann–Whitney U test was used to evaluate differences in functional hand activities between the two groups. Results. The stroke group had 1480 and 4691 daily hand counts in their affected and nonaffected hands, respectively. The control group had 3559 and 5021 daily hand counts in their nondominant and dominant hands, respectively. Significantly fewer daily hand counts (P = .019), fewer hourly hand counts (P = .024), and a larger asymmetry index (P = .01) of the affected hand in the stroke group were found compared to that of the nondominant hand in the control group. Conclusions. Real-world functional upper extremity activity can be measured using this novel wrist-worn device. Unlike wrist-worn accelerometers, this wrist-worn device can provide a measurement of functional grasping activity. The findings have implications for clinicians and researchers to monitor and assess real-world hand activity, as well as to apply specific doses of repetitions to improve neural recovery after stroke.

背景。虽然腕戴式加速度计过去曾被用于测量上肢使用情况，但它们主要测量手臂运动，缺乏捕捉日常生活活动必不可少的功能性手张开和抓握活动的能力。目标。使用一种新颖的腕戴式设备来描述成人中风和匹配控制中在多天内捕获的真实世界功能性手张开和抓握活动。方法. 28 人（14 名中风患者和 14 名健康对照者）在两个手腕上佩戴了该设备 3 天。功能性手部活动的特点是每日手数、每小时手数和手之间的不对称。Mann-Whitney U 检验用于评估两组之间功能性手部活动的差异。结果. 中风组受影响和未受影响的手分别有 1480 和 4691 次每日手数。对照组的非惯用手和惯用手分别有 3559 和 5021 次每日手数。与非优势组相比，卒中组患手的每日手数显着减少 (P = .019)、每小时手数减少 (P = .024) 和更大的不对称指数 (P = .01)交到对照组。结论. 可以使用这种新颖的腕戴式设备测量真实世界的功能性上肢活动。与腕戴式加速度计不同，这种腕戴式设备可以提供功能性抓握活动的测量。这些发现对临床医生和研究人员监测和评估现实世界的手部活动以及应用特定剂量的重复以改善中风后的神经恢复具有重要意义。