Background: The aim of clinical trials for spinal cord injury (SCI) is to improve everyday-life activity outcomes, which requires reliable methods for monitoring patient activity. This study evaluates sensor-derived activity metrics in comparison to established clinical assessment methods. Methods: Wearable inertial sensors collected data from 69 individuals with acute, traumatic cervical SCI participating in the Nogo-A Inhibition in Spinal Cord Injury trial (NCT03935321), a phase 2b, multicenter, randomized, placebo-controlled trial. During inpatient rehabilitation, participants wore up to 5 inertial sensors for up to 3 consecutive days each week. An estimation of average daily energy expenditure (EE) was used as an indicator of physical activity and compared to the recovery of Upper Extremity Motor Scores (UEMS) and Spinal Cord Independence Measures (SCIM). Results: Participants in the verum (n = 41; 59.4%) and placebo (n = 28; 40.6%) groups showed similar initial activity levels, however, the verum group exhibited a significantly greater weekly increase in average daily EE (ΔEE = 11.6 kcal/day/week, 95% CI [1.5, 21.8], P = .025). In contrast, no significant group differences were observed in changes in UEMS (ΔUEMS = 0.1/week, 95% CI [−0.2, 0.3], P = .603) or SCIM (ΔSCIM = 0.2, per week 95% CI [−0.7, 1.1], P = .644). Conclusion: Continuous sensor-based activity monitoring offers objective and sensitive insights into changes in physical capabilities, effectively complementing periodic clinical assessments. Thus, sensor-derived outcome measures offer potential for improving the evaluation of clinical studies in individuals with SCI. Clinical Trail Registration: https://clinicaltrials.gov ; NCT03935321.

Spinal cord injuries (SCI) often result in impaired motor functions. To quantify these impairments, swimming patterns were analyzed in individuals with SCI. Water provides a unique rehabilitation environment where buoyancy supports weight-bearing activities and can reveal deficits that might otherwise go unnoticed. Data were collected of 30 individuals with chronic, motor-incomplete SCI and 20 healthy controls during breaststroke swimming on a kickboard. Using eight wearable inertial sensors attached to the lower limbs, we captured detailed kinematic data. Spatiotemporal parameters were then calculated and compared between the two groups to assess differences in swimming patterns. An analysis of the parameters revealed significant differences in velocity (p < 0.001, ε² = 0.476) and distance per stroke (p < 0.001, ε² = 0.516), indicating decreased swimming speeds in individuals with SCI compared to controls. Furthermore, individuals with SCI demonstrated a reduced range of motion (RoM) in the ankle (p = 0.003, ε² = 0.516) and knee joints (p = 0.041, ε² = 0.142). The limited RoM likely contributes to the shorter distance covered per stroke. These observations underscore the impact of SCI on functional capabilities. The developed algorithm holds promise for enhancing the assessment of motor deficits after neurological injuries.

Wearable cameras provide a means to assess hand function in individuals with spinal cord injury (SCI) beyond clinical settings. Previous studies have found