Automatic assessment of upper limb function during play of the action video game, circus challenge: validity and sensitivity to change

Serradilla, J; Shi, JQ; Cheng, Y; Morgan, G; Lambden, C; Eyre, JA

doi:10.1109/SeGAH.2014.7067073

Automatic assessment of upper limb function during play of the action video game, circus challenge: validity and sensitivity to change

Lookup NU author(s): Dr Javier Serradilla, Dr Jian Shi, Yafeng Cheng, Professor Graham Morgan ORCiD, Charlotte Lambden, Professor Janet Eyre

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Abstract

We present an evaluation of the cross-sectional and longitudinal validity (sensitivity to change) of a new algorithm to assess upper limb function generated automatically during play of a bespoke, professionally-written action video game (Circus Challenge Assessment Game, CCAG). The subjects were 33 patients with hemiplegia after stroke (aged 33-81 years), who played the CCAG on 8 separate occasions over a 12 week period; 19 in the chronic phase after stroke, with stable function; 14 in the acute phase during recovery of function. A convergent construct validation process was used by correlating the scores of the CCAG with a validated, clinically assessed reference, the Chedoke Arm and Hand Assessment Inventory (CAHAI). Cross- sectional validity was demonstrated using the between-subjects correlation coefficient (r = .998, p???value < .001); longitudinal validity by the within-subjects correlation coefficient (overall, r = .54, p???value < .001; chronic, r = .33, p???value < .001; acute, r = .63, p ??? value < .001). There was no difference between the CCAG and CAHAI in the classification of pa- tients to acute and chronic groups (comparing ROC curves, p ??? value = .50), demonstrating similar sensitivity to change. This is the first time a serious game can achieve automatic in- game assessment to a clinical standard, solely using low cost, commodity hardware and professionally written action video games and demonstrates the potential for remote monitoring of patients during home based rehabilitation programs.