Multi-touch-based assessment of hand mobility, dexterity and function. Preliminary study of validity, reliability and sensitivity to upper limb impairment severity in individuals with stroke

Impairments of the upper limb function are among the most common and disabling sequelae after stroke, and their rehabilitation poses a major challenge for current physical and occupational therapy interventions. While restoration of certain degree of proximal and global movements and function is expected, the recovery of premorbid hand mobility and dexterity is less likely to occur. Although great efforts are usually made to rehabilitate these skills, with customized particular and analytic exercises, their assessment is rarely made with the same level of specificity. In general, hand and finger mobility and functionality are indirectly assessed in the clinic with standardized clinical scales and tests that require the use of these skills to perform some tasks. Although these scales are easy to administer, they can present poor accuracy, be biased, and do not allow for isolated assessment of joints and movements. Multi-touch technology enables interaction with electronic devices, such as smartphones and tablets, with on-screen finger touches. Although there is a very limited number of studies that investigate the potential of this technology to rehabilitate hand mobility and dexterity, the use of this technology for assessment of these skills remains unexplored. This study evaluates the feasibility of a multi-touch-based assessment tool (app) of hand mobility and dexterity in a sample of post-stroke survivors. Our results provide preliminary evidence that this technology can be used to design valid and reliable instruments for assessing hand mobility and dexterity that, in addition, are sensitive to the severity of the motor impairment of the upper limb after stroke, which could complement conventional clinical assessment.