Performing the Action Research Arm Test in immersive virtual reality to assess post-stroke upper limb activity

Burton, Quentin [UCL] Lejeune, Thierry [UCL] Dehem, Stéphanie [UCL] Lebrun, Noémie [UCL] Ajana, Khawla [UCL] Edwards, Martin [UCL] Everard, Gauthier [UCL]

Introduction: To plan treatment and measure post-stroke recovery, frequent and time-bounded functional assessments are recommended. With increasing needs for neurorehabilitation, new technological methods such as virtual reality (VR) have emerged. Here, we developed an immersive VR version of the Action Research Arm Test (ARAT-VR) to complement VR neurorehabilitation. This study aimed to assess the validity, test-retest reliability and usability of the ARAT-VR among individuals with stroke, healthcare professionals and healthy control subjects (HCS). Methods: Eleven healthcare professionals, 30 individuals with stroke, and 25 HCS were recruited. Concurrent validity was measured through correlation between the ARAT-VR and ARAT scores for the individuals with stroke and through scores comparison for the HCS. A third of individuals with stroke and HCS were reseen in a convenient delay to measure testretest reliability. Usability was measured using the System Usability Scale. Results: When assessing paretic hands, the ARAT-VR and classical ARAT were strongly correlated (r=0.84). Test-retest reliability (ICC=0.99; p<0.001) and usability (SUS=82.5[75- 90]) were excellent. Conclusion: The ARAT-VR is a valid, reliable and usable tool to assess hand action among individuals with stroke, providing potential to increase assessment frequency and remote evaluation, particularly for use with VR based neurorehabilitation