Objective: To develop and validate objective functional assessment tools that will accurately mirror real-life functional improvements following spasticity interventions, as well as provide new information over traditional outcome measures. Hypotheses: New assessment devices can quantify functional performance. We are currently evaluating the StepWatch activity monitor (ambulation), Shadow Glove (hand function), and the Pedar-X System (foot pressure). StepWatch pilot studies were performed prereversible and postreversible nerve blockade and with chemoneurolytic intervention. Improvements in ambulation parameters were assessed. Subjects: Individuals at least 18 years of age with acquired brain injury-related spasticity were recruited for participation in multiple pilot studies in quantitative outcome assessment. Methods: In 2 StepWatch studies, subjects undergoing open label clinical intervention with chemoneurolysis or reversible nerve block with marcaine were evaluated prior to and after intervention. Data included a 6-minute walk, stride length, total strides, and distance traveled over 1 week. Other pilot studies included subjects with acquired brain injury who received no intervention. Results: StepWatch studies produced objective measures of ambulation with step count error measured at 2.4%. Following marcaine nerve block, subjects walked 43% further in the 6MTW test. Following botulinum toxin injection, subjects improved distanced walked in the 6MTW test by an average 61.3%. All 4 subjects increased stride length (39%), while 75% increased distance walked per day (47%). Discussion: Advances in technology (eg, miniaturization, wireless) make it possible to objectively measure functional performance outside the clinic before and after spasticity interventions. Pre-stepWatch and post-StepWatch evaluations effectively capture improvements in function as a result of intervention. Use of wearable technology can provide more relevant functional information than traditional methods.

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