Can Generative Video Address the Clinical Video Data Gap? Evaluation of Synthetic Parkinsonian Hand Motions

Computer vision approaches to disease motor assessment are limited by clinical video dataset scarcity and distributional imbalance, motivating interest in generative video models as a potential source of training data. We introduce a three-component framework for evaluating the clinical fidelity of synthetic medical motion data, assessing visual fidelity, biomechanical stability, and pathophysiological accuracy, and apply it to videos generated by the text-to-video model Sora 2 depicting Parkinsonian hand-fisting motions across MDS-UPDRS severity levels 0–2 (normal to mild–moderate motor impairment). We further use real-versus-real bootstrapping to compare synthetic-real differences against the natural variability of real clinical videos. Although generated videos appear visually realistic, quantitative analysis shows substantial divergence from real clinical recordings, including weaker severity-dependent patterns of bradykinesia and hypokinesia, less realistic tremor rhythms, and substantial temporal instability. These findings reveal a motion-domain gap between Sora-2-generated and real clinical motor behavior in this Parkinsonian hand-motion setting and demonstrate that visual realism alone is insufficient to establish the clinical utility of synthetic video data for training or evaluating medical computer vision systems.