A novel taxonomy to assess dressing activity in chronic stroke

Upper-body dressing (UBD) is a key aspect of motor rehabilitation after stroke, but most individuals with stroke require long-term dressing assistance. Having a measurement approach that captures the quantity and quality of dressing movements during training could support more targeted strategies. As the basis of an approach, we modified our previously developed motion taxonomy, which categorizes elemental motions into classes of functional primitives (e.g. reaches, transports, stabilizations ). Three expert coders examined videos of two healthy subjects performing dressing tasks, and expanded the taxonomy to account for the unique arm and trunk motions of UBD. An expert and a trained coder then applied the expanded taxonomy to dressing videos of five chronic stroke subjects. We examined the interrater reliability (IRR) for classifying primitives. Using the expanded taxonomy, IRR for identifying primitives in UBD was overall low (k = 0.52) but varied by primitive class: IRR was moderate for reach (k = 0.75), transport (k = 0.63), and idle (k = 0.68), lower for reposition (k = 0.58), and negligible for stabilization (k = -0.02). IRR increased with increasing UE-FMA score (ρ=1, p<0.0001), indicating that the reliability of primitive classification improved with less impaired movement. With additional modification, the expanded taxonomy could support the measurement of training doses and impaired motion during dressing activities. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement This study was funded by the AHA 19AMTG35210398 (AP), NLM R01 LM013316 (HS), and NINDS K02 NS104207 (HS). ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: Institutional Review Board of New York University Langone Health gave ethical approval for this work. I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes All data produced in the present study are available upon reasonable request to the authors.