Fully-automated test of upper-extremity function

With the advent of new approaches to upper extremity recovery after stroke and spinal cord injury, the quantitative evaluation of hand function has become a crucial component of outcome evaluation. Recently we developed a workstation, the ReJoyce (Rehabilitation Joystick for Computer Exercise) on which subjects perform a variety of movement tasks while playing computer games. An important feature of the system is the ReJoyce Automated Hand Function Test (RAHFT). In this study we compared and validated the RAHFT against two widely-used clinical tests, the Action Research Arm Test (ARAT) [1][2] and the Fugl-Meyer Assessment (FMA) [3]. All three tests were performed in 34 separate sessions in 13 tetraplegic individuals. Principal component and regression analyses revealed that both the ARAT and the RAHFT correlated well with the first principle component fitted to the scores of the three tests. The FMA was less well correlated. These data help validate the RAHFT as a quantitative, automated alternative to the ARAT and FMA. The RAHFT is the first comprehensive test of hand function that does not depend on human judgment.