Augmented Reality-based Physical Assessment (ARPA) for Remote Assessment of Patients with Prior Stroke: A Feasibility Study
Jose Eduardo Espindola Lima1, Yuri Cho2, Julie Muccini3, Edward Kim2, Alan David Anaya Gallegos4, Alton Sturgis2, James Hu2, Cathy Zhang2, Erik Nelson2, Nicholas Perlich5, Sophie Rengarajan1, Sanjit A. Seshia 2, Maarten Lansberg6
1Stanford Neurology, 2Department of Electrical Engineering and Computer Sciences, University of California, Berkeley, 3Human Performance Lab, Stanford Medicine, 4Stanford University School of Medicine, 5California Polytechnic State University, 6Stanford Stroke Center
Objective:
Assess the feasibility of the ARPA use for patients with a history of stroke affecting the upper extremity.
Background:
Over 700,000 patients in the US suffer from stroke yearly and about 70% of patients with stroke will experience some degree of arm weakness. Despite the importance of rehabilitation, access to outpatient rehabilitation is often limited by long waitlists and by the need for appointments in person. Home-based rehabilitation is an alternative to increase access. However, methods to accurately track patient progress at home are needed by clinicians to create the plan of care.
Design/Methods:
Based on the original Upper Extremity Fugl-Meyer (FMA-UE) assessment, we developed a virtual version of the FMA-UE (vFMA-UE) with 21 tasks excluding reflexes, implemented using our customized assessment software and an augmented reality headset. The primary outcome of the study was to assess patient tolerance and experience. Two patients with prior stroke underwent an ARPA followed by a standard FMA-UE evaluation by an occupational therapist or physician. Software calibration was allowed between each patient.
Results:
Two patients participated in the initial evaluation. Both patients completed the augmented-reality assessment and reported a positive experience. The first patient scored 37/57 on vFMA-UE and 39/60 on FMA-UE, while the second patient scored 40/57 and 41/60, respectively. Both patients indicated that breaks during the assessment are required. One patient required assistance from another person to adjust the headset, but neither patient required assistance to start the application or complete the assessments.
Conclusions:
In conclusion, based on our preliminary results, our ARPA system successfully delivered a virtual assessment of upper-extremity deficits in patients with stroke, suggesting its feasibility. In the next phases, we plan to assess the correlation between vFMA-UE and FMA-UE with a larger group of patients, demonstrate the accuracy of the system and deliver rehabilitation remotely.