P30: Remote and In-Clinic Teletracking and Analysis for Enhanced Rheumatologic Examination

Abstract

Purpose: Rheumatoid arthritis and related arthritides associated with chronic joint inflammation of the hands significantly affects range of motion and daily living functionality due to stiffness, pain, and swelling. It is vital to closely monitor changes in joint flexibility across the progression of this disease state to assess treatment efficacy and provide informed quantitative analysis. Our group previously developed and reported on a video-based motion analysis system with a wide range of utility. Using this system, we evaluated the range of motion of radiocarpal and phalangeal joints in arthritic versus normal subjects. We hypothesized that use of this system in clinic and at home would provide accurate and quantitative data on joint flexibility and also allow assessment of progression of flexibility of affected joints in patients experiencing joint inflammation across their treatment timelines. Methods: Healthy volunteers and those experiencing self-reported, clinically-diagnosed arthritis were instructed via a telehealth remote platform to place small brightly-colored visual markers (1cm2) on their hands. Using our video motion analysis system, video recordings were captured as subjects performed: 1) wrist flexion and extension, 2) finger flexion and extension, and 3) finger adduction and abduction. The digital recordings were imaged as a motion signature and the data was analyzed to obtain the angle (degrees) of rotation about the joints by correcting full extension/adduction to a “zero degrees” baseline and calculating the degrees of flexion/abduction at the peak point. This protocol allowed for versatility of analysis based on the treatment course providing novel access to patient monitoring outside of the clinic setting. Results: Range of motion of the radiocarpal and phalangeal joints measured in degrees was successfully recorded on both healthy (n=14, 9F 5M) and arthritic subjects (n=8, 4M 4F) in a virtual setting via the video motion analysis system. In all cases the system offered the resolution required to determine overall joint flexibility. A clear quantitative distinction was detected between arthritic patients versus health subjects. Conclusion: A video motion analysis system utilizing small markers can characterize, track, and compare joint flexibility in at-home settings for rheumatoid arthritis and related joint diseases. With face-to-face clinic time being an increasingly limited commodity, this system offers a valuable, digital tool to not only assess patients remotely but it adds a quantitative dimension previously absent in the Rheumatologic exam. As this project continues, arthritis subjects will be monitored over time to assess functionality of disease-state tracking across a treatment time course. Digital assessment of joint flexibility is a useful addition to the diagnostic armamentarium of the Rheumatologist, Orthopedist and related Health Care providers enhancing the precision of diagnosis and therapy.