Abstract

Objective: Upper limb (UL) impairment impacts quality of life, but is common after stroke. UL function evaluated in the clinic may not reflect use in activities of daily living (ADLs) after stroke, and current approaches for assessment at home rely on self-report and lack details about hand function. Wrist-worn accelerometers have been applied to capture UL use, but also fail to reveal details of hand function. In response, a wearable system is proposed consisting of egocentric cameras combined with computer vision approaches, in order to identify hand use (hand-object interactions) and the role of the more-affected hand (as stabilizer or manipulator) in unconstrained environments. Methods: Nine stroke survivors recorded their performance of ADLs in a home simulation laboratory using an egocentric camera. Motion, hand shape, colour, and hand size change features were generated and fed into random forest classifiers to detect hand use and classify hand roles. Leave-one-subject-out cross-validation (LOSOCV) and leave-one-task-out cross-validation (LOTOCV) were used to evaluate the robustness of the algorithms. Results: LOSOCV and LOTOCV F1-scores for more-affected hand use were 0.64 ± 0.24 and 0.76 ± 0.23, respectively. For less-affected hands, LOSOCV and LOTOCV F1-scores were 0.72 ± 0.20 and 0.82 ± 0.22. F1-scores for hand role classification were 0.70 ± 0.19 and 0.68 ± 0.23 in the more-affected hand for LOSOCV and LOTOCV, respectively, and 0.59 ± 0.23 and 0.65 ± 0.28 in the less-affected hand. Conclusion: The results demonstrate the feasibility of predicting hand use and the hand roles of stroke survivors from egocentric videos.

Highlights

  • Hemiplegia or hemiparesis is commonly experienced after stroke

  • Rand and Eng reported that even when upper limb function was improved after rehabilitation, stroke survivors were still prone to predominantly use their less-affected sides [10]. These results demonstrate that hand function evaluated in the clinic, does not reflect hand use in daily life

  • The results showed that the algorithm was robust for identifying the hand-object interactions of stroke survivors, without considering whether the hand was more-affected or less-affected

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Summary

Introduction

Hemiplegia or hemiparesis is commonly experienced after stroke. Unilateral motor deficit on the contralateral side of the brain lesion leads to decreased quality of life. Upper limb function is one of the determinants of quality of life and independence after stroke [1]. An estimated 65% of stroke survivors experience difficulties in their activities of daily living (ADLs) as a result of upper limb impairment, despite medication and rehabilitation [2]–[4]. Measuring the upper limb function of stroke survivors in their daily life is vital to quantifying the impact of new interventions and to designing personalized rehabilitation plans. Clinical upper limb function assessments for stroke survivors can measure different domains within the International Classification of Functioning, Disability and Health (ICF) developed by the World Health Organization. The activity domain can be subdivided into capacity and performance [5]. Performance is defined as what a person does in

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