A Hierarchical Bayesian Model for Cyber-Human Assessment of Movement in Upper Extremity Stroke Rehabilitation.

Abstract

The evidence-based quantification of the relation between changes in movement quality and functionality can assist clinicians in achieving more effective structuring or adapting of therapy. In this paper, clinicians rated task, segment, and composite movement feature performance for 478 videos of stroke survivors executing upper extremity therapy tasks. We used the clinician ratings to develop a Hierarchical Bayesian Model (HBM) with task, segment, and composite layers for computing the statistical relation of movement quality changes to function. The model was enhanced through a detailed correlation graph (ΔHBM) that links computationally extracted kinematics with clinician-rated composite features for different task-segment combinations. Utilizing the weights and correlation graphs, we finally derive reverse cascading probabilities of the proposed HBM from kinematics to composite features, segments, and tasks. In a test involving 98 cases where clinician ratings differed, the HBM resolved 95% of these discrepancies. The model effectively aligned kinematic data with specific task-segment combinations in over 90% of cases. Once the HBM is expanded and refined through additional data it can be used for the automated calculation of statistical relations between changes in kinematics and performance of functional tasks and the generation of therapy assessment recommendations for clinicians. While our work primarily focuses on the upper extremities of stroke survivors, the HBM can be adapted to many other neurorehabilitation contexts.