Abstract TMP38: Web Based Testing of Upper Extremity Movement for Patients Recovering After Stroke

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Background: Studies of movement of the upper extremity for stroke patients currently require assessments with special equipment and trained assessors, limiting the accessibility. Hevelius is an experimental online platform designed to study human interaction with technology at a large scale. Our aim was to demonstrate the feasibility of using Hevelius for testing arm kinematics in stroke patients. Methods: Stroke patients (time from stroke 6 weeks to 1 year) with upper extremity weakness with an NIH Stroke Scale contralesional arm motor (5A or 5B) score of 2 or less were tested on Hevelius. Participants engaged in a Point-And-Click task. Thirty-two kinematic features of movement from continuous, target-driven mouse movement were collected in the arms contralesional and ipsilesional to stroke and compared to data from with health controls. Upper extremity Fugl-Meyer (UE-FM), NIH Stroke Scale (NIHSS), 9-Hole-Peg as well as patient reported outcomes (via Stroke Impact Scale) were collected during the same research visits. Results: In a total sample of N = 19 patients with upper extremity weakness after stroke who performed Hevelius testing, the median age was 66 (range 47 - 81) with 70% male participants. Nine participants had strokes affecting their dominant arm. LASSO method was used for regression to simultaneously performs feature selection and fitting of a linear model. Score estimates on Hevelius platform correlated strongly on linear regression modeling with clinical scores (from r=0.675 for arm portion of NIHSS ). There was also correlation with 9-Hole-Peg (r=0.581) and no clear correlation with UE-FM, modified Rankin score and Stroke Impact Scale. Five of the 9 patients with dominant arm affected by stroke had NIHSS of 0 and UE-FM of 66. Abnormal movement kinematics were detected in both the contralesional and ipsilesional arms when compared to healthy controls. Conclusions: Characteristics of arm movement are essential to the understanding of motor recovery after stroke. Our study demonstrates subtle deficits of arm movement in task-directed testing that were not captured with traditional measures of stroke recovery.