Although neuromuscular specialist Jay Han is pleased that promising drugs are being developed to treat muscular dystrophy, he is dismayed when he thinks about the clinical trials. As a physician and researcher focusing on the progressive neuromuscular and genetic diseases that often strike multiple family members, he finds it heartbreaking that a young boy with early symptoms can participate in a drug trial, while his older wheelchair-dependent brother is denied access.

“There are many ways to objectively monitor gait and assess lower extremity function to see if a new therapy is working but none that effectively quantify efficacy on the upper extremities,” says Han. “The fact that better outcome measures for arm function have not been developed means that researchers aren’t doing their job.”

The standard way of measuring and monitoring upper extremity range of motion is with a goniometer, explains Han, a kind of large plastic protractor invented some 300 years ago. Using it to measure a patient’s complete range of motion takes a lot of time, and the results are presented as a series of joint angles that are less than intuitively obvious.

“A report of goniometer measurements consists of a lengthy list of numbers and angles that is not easy to decipher. It’s difficult to glean an overall sense of what a patient can do functionally, and trying to determine disease progression from one clinical appointment to another is challenging.”

Han, who has always been drawn to technology, turned to the Center for Information Technology Research in the Interest of Society (CITRIS), a collaboration of engineers, clinical researchers and social scientists from UC campuses at Davis, Berkeley, Merced and Santa Cruz committed to finding solutions to real-world problems. Together, they are developing ingenious new ways to quantify upper extremity function that promise to revolutionize how doctors monitor patient progress.

Han and his CITRIS colleagues homed in on Microsoft’s Kinect technology, which uses cameras and depth sensors that precisely detect 3-D motion, allowing a gamer to enter into imaginary worlds. Real-time motion of the user is translated to a personal avatar on a monitor – who might be playing golf at Pismo Beach or wielding a light saber to fight off an Imperial Stormtrooper.

To Han, the applications of this technology are more down-to-earth but much more exciting; applying the technology toward a medical need. A patient can sit on a chair and systematically move his arms through his complete range of motion – over the head, out to the side, across and even behind the body. The application they are developing measures the patient’s “reachable workspace,” then translates it to a visual image with colored hemispheres around the patient.

Han’s application – currently under patent development – can allow immediate and intuitive understanding of a patient’s upper limb function. A large hemisphere around and above a patient’s body shows that he has good upper extremity function and can likely perform all tasks needed for daily living. In contrast, a small colored area of reachable workspace low down below the shoulder level shows that a patient no longer has the strength to lift his arms, and will have difficulty with overhead tasks.

“Using our application, a patient’s upper extremity function can be measured in minutes and presented in a quantifiable as well as intuitive format for both patients and clinicians,” says Han. “This is a huge improvement for assessing and monitoring patient progress.”

With a relatively low-cost scalable system comprised of a Kinect sensor, an Internet connection, and Han’s program – which he hopes will soon be commercially available – patients can be monitored frequently and remotely, saving them the often considerable trouble of a trip to their specialist’s clinic, especially for those who are mobility-impaired and in wheelchairs. Han has another patent application in the works based on the same technology that allows therapists to remotely provide and monitor physical therapy.

Most importantly to Han, he has created a system he anticipates will allow all his patients – even those who can no longer walk – to participate in clinical trials for promising new drugs.

“My goal is that we will no longer offer one child the hope of a cure and not his brother,” says Han. “This is now within reach.”