Using a Webcam to Assess Upper Extremity Proprioception: Experimental Validation and Application to Persons Post Stroke

Many medical conditions impair proprioception but there are few easy-to-deploy technologies for assessing proprioceptive deficits. Here, we developed a method-called "OpenPoint"-to quantify upper extremity (UE) proprioception using only a webcam as the sensor. OpenPoint automates a classic neurological test: the ability of a person to use one hand to point to a finger on their other hand with vision obscured. Proprioception ability is quantified with pointing error in the frontal plane measured by a deep-learning-based, computer vision library (MediaPipe). In a first experiment with 40 unimpaired adults, pointing error significantly increased when we replaced the target hand with a fake hand, verifying that this task depends on the availability of proprioceptive information from the target hand, and that we can reliably detect this dependence with computer vision. In a second experiment, we quantified UE proprioceptive ability in 16 post-stroke participants. Individuals post stroke exhibited increased pointing error (<i>p</i> < 0.001) that was correlated with finger proprioceptive error measured with an independent, robotic assessment (r = 0.62, <i>p</i> = 0.02). These results validate a novel method to assess UE proprioception ability using affordable computer technology, which provides a potential means to democratize quantitative proprioception testing in clinical and telemedicine environments.