###### Abstract  
The Brunnstrom recovery stage (BRS) assessment is a frequently used clinical instrument, but does not allow temporal or spatial analysis owing to its use of binary assessments. We developed a kinematic analysis system (_Fahrenheit_) that employs three-dimensional motor analysis using the Leap Motion Controller as an infrared camera to assess hand motor function in patients post-cerebrovascular disease (CeVD)/stroke, according to the BRS assessment criteria. We investigated whether _Fahrenheit_ could predict the outcome of the BRS assessment of hand motor function in post-CeVD patients with hemiplegia. Thirty-two inpatients with CeVD were recruited in this pilot study. Participants' hand motor function after CeVD was assessed through their performance of nine tasks according to the BRS assessment. We constructed a receiver operating characteristic (ROC) curve based on each participants' performance, and compared the results of the BRS assessment and computed the area under the curve (AUC) for each ROC curve. All task values showed significant differences between sufficient and insufficient movements. AUC analyses showed that the nine tasks assessed using _Fahrenheit_ had high predictability (all AUC values \(\geq\) 0.7), which were comparable to those of the therapists' assessment. Measurements with _Fahrenheit_ showed high predictability with respect to the BRS criteria, indicating that _Fahrenheit_ may have clinical application for assessing post-CeVD finger movement and motor functions. Further verification involving more patients is required to ensure that Fahrenheit becomes a more reliable evaluation tool. hand function; kinematic analysis; Brunnstrom recovery stage; leap motion controller; stroke assessment +
Footnote †: journal: Medical  
voluntary individual joint movements in stage VI [3]. The BRS assessment of UE function was moderately correlated with neurophysiological measures using the Hoffmann/Muscle (H/M) slope ratio and the H/M max ratio, and was highly correlated with the Modified Ashworth Scale score for the evaluation of motor recovery in CeVD patients [4]. However, BRS scores are influenced by therapists' abilities to conduct this assessment. Moreover, the BRS assessment does not allow for the identification of finer changes in UE and hand impairment within each stage, given that it is an observer-based ordinal scale that utilizes binary assessments that are either \"sufficient\" or \"insufficient\". The Fugl-Meyer assessment (FMA) is a clinical instrument that uses the BRS criteria [5] and provides a cluster analysis of UE function in patients with chronic CeVD, enabling the classification of 3 or 4 levels of impairment [6]. The FMA-UE measures motor recovery in terms of the degree of impairment, but this does not accurately describe a patient's actual ability to accomplish a task. This is because compensatory movements develop in response to abnormal muscle synergies, and these compensatory movements provide an alternative functional form of recovery. Hence, the FMA-UE score does not always predict functional recovery because of the ceiling effect, given that it relies on discrete scoring criteria rather than continuous measurement [7]. Microsoft Kinect, which utilizes infrared (IR) sensors to obtain highly accurate 3D motor analyses of limb motion, without markers, has been used to assess progress during rehabilitation [8]. However, the Kinect skeleton model, with its total of 25 anatomical landmarks, is insufficient for analyzing fine hand movements, as it only analyzes four landmarks in the hand: the tips of the hand and thumb, which are the only two distal points, the midpoint of the hand, and the wrist. Therefore, there is a need for a numeric scale that can be used to assess the specific arm or hand movements that patients can or cannot perform following a CeVD.