Estimating Upper Extremity Fugl-Meyer Assessment Scores From Reaching Motions Using Wearable Sensors

The Fugl Meyer Assessment (FMA) is a widelyused assessment for tracking motor function recovery post-stroke. Due to the limited access to rehabilitation, there exists a need for remote and automated assessment solutions. Wearable sensors and data-driven methods have shown promise for enabling automatic upper extremity FMA (FMA-UE) estimation, but minimizing user input motion and aligning with current clinical activities will aid the adoption of sensor-based assessments. In this work, we present an FMA-UE estimator which can make score predictions for a key subset of the assessment (70% of all items) using data from inertial measurement units (IMUs) placed on the arms and the trunk from three volitional reaching motions representative of functional daily activities. We collected a dataset of eleven stroke participants performing a subset of FMA-UE, and three reaching motions. The FMA-UE of each participant was assessed by an occupational therapist providing the labeled score for the training data. The estimator was trained on windowed data during FMA-UE motions and was able to make score estimates from reaching motions. Through leave-one-subjectout cross validation, the estimator achieved a normalized RMSE of 7%, which is comparable to or below the established minimal clinically important difference and minimal detectable change of FMA-UE of post-stroke individuals. Comparison experiments of various model designs also revealed the importance of trunk-based features inspired by compensation strategies common post stroke and features