Upper Extremity Functional Evaluation by Fugl-Meyer Assessment Scoring Using Depth-Sensing Camera in Hemiplegic Stroke Patients

Abstract

Virtual home-based rehabilitation is an emerging area in stroke rehabilitation. Functional assessment tools are essential to monitor recovery and provide current function-based rehabilitation. We developed the Fugl-Meyer Assessment (FMA) tool using Kinect (Microsoft, USA) and validated it for hemiplegic stroke patients. Forty-one patients with hemiplegic stroke were enrolled. Thirteen of 33 items were selected for upper extremity motor FMA. One occupational therapist assessed the motor FMA while recording upper extremity motion with Kinect. FMA score was calculated using principal component analysis and artificial neural network learning from the saved motion data. The degree of jerky motion was also transformed to jerky scores. Prediction accuracy for each of the 13 items and correlations between real FMA scores and scores using Kinect were analyzed. Prediction accuracies ranged from 65% to 87% in each item and exceeded 70% for 9 items. Correlations were high for the summed score for the 13 items between real FMA scores and scores obtained using Kinect (Pearson’s correlation coefficient = 0.873, P<0.0001) and those between total upper extremity scores (66 in full score) and scores using Kinect (26 in full score) (Pearson’s correlation coefficient = 0.799, P<0.0001). Log transformed jerky scores were significantly higher in the hemiplegic side (1.81 ± 0.76) compared to non-hemiplegic side (1.21 ± 0.43) and showed significant negative correlations with Brunnstrom stage (3 to 6; Spearman correlation coefficient = -0.387, P = 0.046). FMA using Kinect is a valid way to assess upper extremity function and can provide additional results for movement quality in stroke patients. This may be useful in the setting of unsupervised home-based rehabilitation.

The Impact of Rehabilitation-oriented Virtual Reality Device in Patients With Ischemic Stroke in the Early Subacute Recovery Phase: Study Protocol for a Phase III, Single-Blinded, Randomized, Controlled Clinical Trial

“…Fugl-Meyer Assessment (FMA) scale is a validated tool widely used for motor function assessment in patients with stroke. 33 As a continuous outcome measure, it has good correlation with the changes in motor impairment. 34 The motor score in this scale ranges from 0 (hemiplegia) to 100 points (normal motor performance), divided into 66 points for upper extremity and 34 points for the lower extremity.…”

Design and Analysis of Cloud Upper Limb Rehabilitation System Based on Motion Tracking for Post-Stroke Patients

“…By comparing the assessment method with references [30] and [37], it could be seen that the TCNN method is more appropriate and convenient than the evaluation method in reference [30], which found a strong linear relationship between qualitative scores and quantitative scores derived from both standard and low-cost motion capture. The TCNN model accuracy is higher than the PCA-ANN (Principal Component Analysis-Artificial Neural Networks) model accuracy in reference [37], which ranged from 65% to 87% [37].…”

Automation of motor dexterity assessment

“…Several efforts have been made towards providing an automatic solution to this problem [12], [20], [21] but thus far the reported success rates (maximum reported accuracy: 87.3%) [30], translating into 44.65 correspondence with clinician opinion) are insufficient to guarantee wide clinical acceptance. Our hypothesis in this regard is that if we can increase classification rates of motor dexterity exercises by capitalizing on information shared among classes, then the technology will come closer to acceptance by clinicians.…”