A Framework for Sensor-based Assessment of Upper-limb Functioning

A bstract The ultimate goal of any upper-limb neurorehabilitation procedure is to improve upper-limb functioning in daily life. While clinic-based assessments provide an assessment of what a patient can do, they do not completely reflect what a patient does in his/her daily life. The compensatory use of the less affected upper-limb (e.g. “learned non-use”) in daily life is a common behavioral pattern seen in patients with hemiparesis. To this end, there has been an increasing interest in the use of wearable sensors to objectively assess upper-limb functioning. This paper presents a framework for assessing upper-limb functioning using sensors by providing: (a) a set of definitions of important construct associated with upper-limb functioning; (b) presenting different visualization methods for evaluating upper-limb functioning, along ways to qualitatively analyze different visualization methods; and (c) two new measures for quantifying how much an upper-limb is used and the relative bias in the use of the two upper-limbs. The demonstration of some of these components is presented using data collected from inertial measurement units from a previous study. The proposed framework can help guide the future technical and clinical work in this area to realize a valid, objective, and robust tool for assessing upper-limb functioning. This will in turn drive the refinement and standardization of the assessment of upper-limb functioning.