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

PLoS One. 2016 Jul 1;11(7):e0158640. doi: 10.1371/journal.pone.0158640. eCollection 2016.

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.

MeSH terms

  • Disability Evaluation
  • Female
  • Hemiplegia / complications*
  • Humans
  • Male
  • Middle Aged
  • Movement*
  • Recovery of Function*
  • Stroke / complications*
  • Stroke / physiopathology*
  • Stroke Rehabilitation
  • Upper Extremity / physiopathology*

Grants and funding

This research was supported by the The Ministry of Science, ICT and Future Planning (MSIP), Korea and Microsoft Research, under ICT/SW Creative research program supervised by the National ICT Industry Promotion Agency (NIPA)[NIPA-2014-(H0510-14-1014)] and [NIPA-2013-(H0503-13-1018)], which were received by N-J.P. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.