Automated ARAT Scoring Using Multimodal Video Analysis, Multi-View Fusion, and Hierarchical Bayesian Models: A Clinician Study

Abstract

Manual scoring of the Action Research Arm Test (ARAT) for upper extremity assessment in stroke rehabilitation is time-intensive and variable. We propose an automated ARAT scoring system integrating multimodal video analysis with SlowFast, I3D, and Transformer-based models using OpenPose keypoints and object locations. Our approach employs multi-view data (ipsilateral, contralateral, and top perspectives), applying early and late fusion to combine features across views and models. Hierarchical Bayesian Models (HBMs) infer movement quality components, enhancing interpretability. A clinician dashboard displays task scores, execution times, and quality assessments. We conducted a study with five clinicians who reviewed 500 video ratings generated by our system, providing feedback on its accuracy and usability. Evaluated on a stroke rehabilitation dataset, our framework achieves 89.0% validation accuracy with late fusion, with HBMs aligning closely with manual assessments. This work advances automated rehabilitation by offering a scalable, interpretable solution with clinical validation.