Validity of Novel Outcome Measures for Hand Function Performance After Stroke Using Egocentric Video

Abstract

Background: Evaluating upper limb (UL) interventions after stroke calls for outcome measures that describe impact on daily life in the community. UL use ratio has been used to quantify the performance domain of UL function, but generally focuses on arm use only. A hand use ratio could provide additional information about UL function after stroke. Additionally, a ratio based on the role of the more-affected hand in bilateral activities (stabilizer or manipulator) may also reflect hand function recovery. Egocentric video is a novel modality that can record both dynamic and static hand use and hand roles at home after stroke. Objective: To validate hand use and hand role ratios from egocentric video against standardized clinical UL assessments. Methods: Twenty-four stroke survivors recorded daily tasks in a home simulation laboratory and their daily routines at home using egocentric cameras. Spearman’s correlation was used to compare the ratios with the Fugl-Meyer Assessment-Upper Extremity (FMA-UE), Action Research Arm Test (ARAT), and Motor Activity Log-30 (MAL, Amount of Use (AoU), and Quality of Movement (QoM)). Results: Hand use ratio significantly correlated with the FMA-UE (0.60, 95% CI: 0.26, 0.81), ARAT (0.44, CI: 0.04, 0.72), MAL-AoU (0.80, CI: 0.59, 0.91), and MAL-QoM (0.79, CI: 0.57, 0.91). Hand role ratio had no significant correlations with the assessments. Conclusion: Hand use ratio automatically extracted from egocentric video, but not hand role ratio, was found to be a valid measure of hand function performance in our sample. Further investigation is necessary to interpret hand role information.