Visualisation of upper limb activity using spirals: A new approach to the assessment of daily prosthesis usage

Background: Current outcome measures used in upper limb myoelectric prosthesis studies include clinical tests of function and self-report questionnaires on real-world prosthesis use. Research in other cohorts has questioned both the validity of self-report as an activity assessment tool and the relationship between clinical functionality and real-world upper limb activity. Previously,(1) we reported the first results of monitoring upper limb prosthesis use. However, the data visualisation technique used was limited in scope. Study Design: Methodology development. Objectives: To introduce two new methods for the analysis and display of upper limb activity monitoring data and to demonstrate the potential value of the approach with example real-world data. Methods: Upper limb activity monitors, worn on each wrist, recorded data on two anatomically intact participants and two prosthesis users over 1week. Participants also filled in a diary to record upper limb activity. Data visualisation was carried out using histograms, and Archimedean spirals to illustrate temporal patterns of upper limb activity. Results: Anatomically intact participants' activity was largely bilateral in nature, interspersed with frequent bursts of unilateral activity of each arm. At times when the prosthesis was worn prosthesis users showed very little unilateral use of the prosthesis (approximate to 20-40min/week compared to approximate to 350min/week unilateral activity on each arm for anatomically intact participants), with consistent bias towards the intact arm throughout. The Archimedean spiral plots illustrated participant-specific patterns of non-use in prosthesis users. Conclusion: The data visualisation techniques allow detailed and objective assessment of temporal patterns in the upper limb activity of prosthesis users.