Novel clinically-relevant assessment of upper extremity movement using depth sensors.

backgroundFor individuals post-stroke, home-based programs are necessary to deliver additional hours of therapy outside of the limited time in the clinic. Virtual reality (VR)-based approaches show modest outcomes in improving client function when delivered in the home. The movement sensors used in these VR-based approaches, such as the Microsoft Kinect® have been validated against gold standards tools but have not been used as an assessment of upper extremity movement quality in the stroke population.

objectivesThe purpose of this study was to explore the use of a movement sensor paired with a VR-based intervention to assess upper extremity movement for individuals post-stroke.

methodsMovement data captured with the Microsoft Kinect® from four separate studies were aggregated for analysis (n = 8 individuals post-stroke, n = 30 individuals without disabilities). For all participants, the skeletal data (x, y, z coordinates for 15 tracked joints) for each game play session were processed in MatLab and movement variables (normalized jerk, movement path ratio, average path sway) were calculated using an OPTICS density-based cluster algorithm.

resultsData from the 30 healthy individuals created a normative baseline for the three kinematic variables. Individuals post-stroke were less efficient and had more jerky movements in both upper extremities as compared to healthy individuals.

conclusionIt is feasible to use a movement sensor paired with a VR-based intervention to quantify and qualify upper extremity movement for individuals post-stroke. Further research with a larger cohort is necessary to establish clinical sensitivity and specificity.