Depth Sensor-Based Assessment of Reachable Work Space for Visualizing and Quantifying Paretic Upper Extremity Motor Function in People With Stroke.

Abstract

Quantitative evaluation of upper extremity (UE) motor function is important in people with hemiparetic stroke. A depth sensor-based assessment of reachable work space (RWS) was applied to visualize and quantify paretic UE motor function. The objectives of this study were to examine the characteristics of RWS and to assess its validity, reliability, measurement error, and responsiveness in people with hemiparetic stroke. This was a descriptive, repeated-measures, observational study. Fifty-eight people with stroke participated. RWS was assessed on both paretic and nonparetic UEs, and the RWS ratio was determined by dividing the RWS of the paretic UE by that of the nonparetic UE. The concurrent validity of the RWS was determined by examining the relationship with the Fugl-Meyer Assessment UE motor score. Test-retest reproducibility was examined in 40 participants. Responsiveness was determined by examining the RWS results before and after 3weeks of intensive training of the paretic UE in 32 participants. The lower area of RWS bordering shoulder was significantly larger than the upper area, and the medial-lower area of RWS bordering shoulder was significantly larger than the lateral-lower area. The RWS ratio was highly correlated with the Fugl-Meyer Assessment UE motor score (r=0.81). The RWS ratio showed good intrarater relative reliability (intraclass correlation coefficient =0.94) and no fixed or proportional bias. The minimal detectable change of the RWS ratio was 16.6. The responsiveness of the RWS ratio was large (standardized response mean=0.83). Interexaminer reliability was not assessed. The RWS assessment showed sufficient validity, reliability, and responsiveness in people with hemiparetic stroke. A depth sensor-based RWS evaluation is useful for visualizing and quantifying paretic UE motor function in the clinical setting.