scholarly journals Portable Sensors Add Reliable Kinematic Measures to the Assessment of Upper Extremity Function

Sensors ◽  
2019 ◽  
Vol 19 (5) ◽  
pp. 1241 ◽  
Author(s):  
Fredrik Öhberg ◽  
Tomas Bäcklund ◽  
Nina Sundström ◽  
Helena Grip
Keyword(s):  
Cycle Time ◽  
Inertial Sensors ◽  
Axial Rotation ◽  
Time Range ◽  
Good Reliability ◽  
Rater Reliability ◽  
Flexion Extension ◽  
Arm Function ◽  
Kinematic Measures ◽  
Overall Reliability

Ordinal scales with low resolution are used to assess arm function in clinic. These scales may be improved by adding objective kinematic measures. The aim was to analyze within-subject, inter-rater and overall reliability (i.e., including within-subject and inter-rater reliability) and check the system’s validity of kinematic measures from inertial sensors for two such protocols on one person. Twenty healthy volunteers repeatedly performed two tasks, finger-to-nose and drinking, during two test sessions with two different raters. Five inertial sensors, on the forearms, upper arms and xiphoid process were used. Comparisons against an optical camera system evaluated the measurement validity. Cycle time, range of motion (ROM) in shoulder and elbow were calculated. Bland–Altman plots and linear mixed models including the generalizability (G) coefficient evaluated the reliability of the measures. Within-subject reliability was good to excellent in both tests (G = 0.80–0.97) and may serve as a baseline when assessing upper extremities in future patient groups. Overall reliability was acceptable to excellent (G = 0.77–0.94) for all parameters except elbow axial rotation in finger-to-nose task and both elbow axial rotation and flexion/extension in drinking task, mainly due to poor inter-rater reliability in these parameters. The low to good reliability for elbow ROM probably relates to high within-subject variability. The sensors provided good to excellent measures of cycle time and shoulder ROM in non-disabled individuals and thus have the potential to improve today’s assessment of arm function.

Feasibility of an iPhone-based application for knee joint goniometry during gait in a stroke patient (Preprint)

2018 ◽  
Author(s):  
Claudia Nava ◽  
Patrizio Sale ◽  
Vittorio Leggero ◽  
Simona Ferrante ◽  
Cira Fundaro' ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Stroke Patient ◽  
Reference Method ◽  
Flexion Angle ◽  
Good Reliability ◽  
Rater Reliability ◽  
Maximum Extension ◽  
Angle Measurements ◽  
Hemiparetic Gait ◽  
Flexion Extension

BACKGROUND In recent years, different smartphone apps have been validated for joint goniometry, but none for goniometric assessment of gait after stroke. OBJECTIVE The aims of our work were to assess:1) to assess intra-rater reliability of an image-based goniometric app – DrGoniometer- in the measurement of the extension, flexion angles and range of motion of the knee during the hemiparetic gait of a stroke patient; (2) its validity comparing to the reference method (electrogoniometer) for flexion-extension excursion measurements; and the intra-rater agreement in the choice of the video frames. METHODS An left-hemiparetic inpatient following haemorrhagic stroke was filmed using the app while walking on a linear path. An electrogoniometer was fixed on the medial face of the affected knee in order to record the dynamic goniometry during gait. Twenty-one raters, blinded to measurements, were recruited to rate knee angle measurements from video acquired with DrGoniometer. Each rater repeated the same procedure twice, the second one at least one day after the first measure. RESULTS Results showed that flexion angle measurements are reliable (ICC95%=0.66, 0.34;0.85; SEM=4°), and adequately precise (CV=14%). Extension angles measurements demonstrated moderate reliability and higher degree of variation (ICC=0.51, 0.09;0.77; SEM 4°; CV=53%). ROM values were: ICC=0.23 (-0.21;0.60); CV=20%. Accuracy of DrGoniometer compared to the electrogoniometer was 7.3±4.7°. The selection of maximum extension frame revealed an accordance of 58% and 72% within a range of ±5 or ±10 frames, respectively; while the best flexion frame reported 86% of agreement for both range of 5 and 10 frames. CONCLUSIONS The results demonstrated moderate to good reliability concerning the maximum extension and flexion angles, while assessing ROM DrGoniometer showed poor intra-rater reliability. Flexion angle measurements seemed to be reliable according to ICC and SEM values and more precise with a limited dispersion of results DrGoniometer revealed a good accuracy in the measurement of range of motion. The agreement of the maximal extension frame was anyway adequate within 5 frames (59%) and noticeably increased within 10 frames (72%). In conclusion, DrGoniometer was found to be a valid and reliable method for assessing knee angles during hemiparetic gait. Further studies are necessary to investigate inter-rater reliability and confirm our results.

Validity and reliability of a wearable-controlled serious game and goniometer for telemonitoring of wrist fracture rehabilitation

2021 ◽  
Author(s):  
Henriëtte A. W. Meijer ◽  
Maurits Graafland ◽  
Miryam C. Obdeijn ◽  
Marlies P. Schijven ◽  
J. Carel Goslings
Keyword(s):  
Range Of Motion ◽  
Intraclass Correlation ◽  
Internal Validity ◽  
Wrist Fracture ◽  
Serious Game ◽  
Reference Standard ◽  
Validity And Reliability ◽  
Good Reliability ◽  
Rater Reliability ◽  
Flexion Extension

Abstract Purpose To determine the validity of wrist range of motion (ROM) measurements by the wearable-controlled ReValidate! wrist-rehabilitation game, which simultaneously acts as a digital goniometer. Furthermore, to establish the reliability of the game by contrasting ROM measurements to those found by medical experts using a universal goniometer. Methods As the universal goniometer is considered the reference standard, inter-rater reliability between surgeons was first determined. Internal validity of the game ROM measurements was determined in a test–retest setting with healthy volunteers. The reliability of the game was tested in 34 patients with a restricted range of motion, in whom the ROM was measured by experts as well as digitally. Intraclass-correlation coefficients (ICCs) were determined and outcomes were analyzed using Bland–Altman plots. Results Inter-rater reliability between experts using a universal goniometer was poor, with ICCs of 0.002, 0.160 and 0.520. Internal validity testing of the game found ICCs of − 0.693, 0.376 and 0.863, thus ranging from poor to good. Reliability testing of the game compared to medical expert measurements, found that mean differences were small for the flexion–extension arc and the radial deviation-ulnar deviation arc. Conclusion The ReValidate! game is a reliable home-monitoring device digitally measuring ROM in the wrist. Interestingly, the test–retest reliability of the serious game was found to be considerably higher than the inter-rater reliability of the reference standard, being healthcare professionals using a universal goniometer. Trial registration number (internal hospital registration only) MEC-AMC W17_003 #17.015.

scholarly journals Validity and reliability of inertial sensors for elbow and wrist range of motion assessment

PeerJ ◽  
2020 ◽  
Vol 8 ◽  
pp. e9687
Author(s):  
Vanina Costa ◽  
Óscar Ramírez ◽  
Abraham Otero ◽  
Daniel Muñoz-García ◽  
Sandra Uribarri ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Inertial Sensors ◽  
High Reliability ◽  
Intraclass Correlation ◽  
Active Movement ◽  
Neutral Position ◽  
Maximum Difference ◽  
Validity And Reliability ◽  
Rater Reliability ◽  
Flexion Extension

Background Elbow and wrist chronic conditions are very common among musculoskeletal problems. These painful conditions affect muscle function, which ultimately leads to a decrease in the joint’s Range Of Motion (ROM). Due to their portability and ease of use, goniometers are still the most widespread tool for measuring ROM. Inertial sensors are emerging as a digital, low-cost and accurate alternative. However, whereas inertial sensors are commonly used in research studies, due to the lack of information about their validity and reliability, they are not widely used in the clinical practice. The goal of this study is to assess the validity and intra-inter-rater reliability of inertial sensors for measuring active ROM of the elbow and wrist. Materials and Methods Measures were taken simultaneously with inertial sensors (Werium™ system) and a universal goniometer. The process involved two physiotherapists (“rater A” and “rater B”) and an engineer responsible for the technical issues. Twenty-nine asymptomatic subjects were assessed individually in two sessions separated by 48 h. The procedure was repeated by rater A followed by rater B with random order. Three repetitions of each active movement (elbow flexion, pronation, and supination; and wrist flexion, extension, radial deviation and ulnar deviation) were executed starting from the neutral position until the ROM end-feel; that is, until ROM reached its maximum due to be stopped by the anatomy. The coefficient of determination (r2) and the Intraclass Correlation Coefficient (ICC) were calculated to assess the intra-rater and inter-rater reliability. The Standard Error of the Measurement and the Minimum Detectable Change and a Bland–Altman plots were also calculated. Results Similar ROM values when measured with both instruments were obtained for the elbow (maximum difference of 3° for all the movements) and wrist (maximum difference of 1° for all the movements). These values were within the normal range when compared to literature studies. The concurrent validity analysis for all the movements yielded ICC values ≥0.78 for the elbow and ≥0.95 for the wrist. Concerning reliability, the ICC values denoted a high reliability of inertial sensors for all the different movements. In the case of the elbow, intra-rater and inter-rater reliability ICC values range from 0.83 to 0.96 and from 0.94 to 0.97, respectively. Intra-rater analysis of the wrist yielded ICC values between 0.81 and 0.93, while the ICC values for the inter-rater analysis range from 0.93 to 0.99. Conclusions Inertial sensors are a valid and reliable tool for measuring elbow and wrist active ROM. Particularly noteworthy is their high inter-rater reliability, often questioned in measurement tools. The lowest reliability is observed in elbow prono-supination, probably due to skin artifacts. Based on these results and their advantages, inertial sensors can be considered a valid assessment tool for wrist and elbow ROM.

Evaluation of spinal posture during gait with inertial measurement units

2020 ◽  
Vol 234 (10) ◽  
pp. 1094-1105
Author(s):  
Elisa Digo ◽  
Giuseppina Pierro ◽  
Stefano Pastorelli ◽  
Laura Gastaldi
Keyword(s):  
Inertial Sensors ◽  
Axial Rotation ◽  
Rehabilitation Program ◽  
Inertial Measurement Units ◽  
Inertial Measurement ◽  
Spinal Posture ◽  
Non Invasive ◽  
Flexion Extension ◽  
Invasive Method ◽  
Measurement Units

The increasing number of postural disorders emphasizes the central role of the vertebral spine during gait. Indeed, clinicians need an accurate and non-invasive method to evaluate the effectiveness of a rehabilitation program on spinal kinematics. Accordingly, the aim of this work was the use of inertial sensors for the assessment of angles among vertebral segments during gait. The spine was partitioned into five segments and correspondingly five inertial measurement units were positioned. Articulations between two adjacent spine segments were modeled with spherical joints, and the tilt–twist method was adopted to evaluate flexion–extension, lateral bending and axial rotation. In total, 18 young healthy subjects (9 males and 9 females) walked barefoot in three different conditions. The spinal posture during gait was efficiently evaluated considering the patterns of planar angles of each spine segment. Some statistically significant differences highlighted the influence of gender, speed and imposed cadence. The proposed methodology proved the usability of inertial sensors for the assessment of spinal posture and it is expected to efficiently point out trunk compensatory pattern during gait in a clinical context.

An inertial sensor-based protocol for spinal range of motion measurements

2021 ◽  
Author(s):  
PJ Mulcahey ◽  
PT Knott ◽  
A Madiraju ◽  
N Haque ◽  
DS Haoson ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Healthy Subjects ◽  
Inertial Sensors ◽  
Inertial Sensor ◽  
Rater Reliability ◽  
Spinal Motion ◽  
Flexion Extension ◽  
Motion Measurements ◽  
Baseline Error ◽  
Bicycle Wheel

To develop a protocol for assessing spinal range of motion using an inertial sensor device. The baseline error of an inertial sensor was assessed using a bicycle wheel. Nineteen healthy subjects (12 females and 7 males, average age 18.2 ± 0.6 years) were then prospectively enrolled in a study to assess the reliability of an inertial sensor-based method for assessing spinal motion. Three raters each took three measurements of subjects’ flexion/extension, right and left bending, and right and left rotation. Afterwards, one trial from each set of measurements was excluded. Correlations and the ICC (3,1) were used to assess intra-rater reliability, and ICC (3,2) was used to assess inter-rater reliability of the protocol. The baseline error of the sensor was 1.45°. Correlation and ICC (3,1) values for the protocol all exceeded 0.888, indicating high intra-rater reliability. ICC (3,2) values for the protocol exceed 0.87, indicating high inter-rater reliability. Our study presents both a paradigm for assessing the baseline error of inertial sensors and a protocol for assessing motion of the spine using an inertial sensing device.

scholarly journals Piloting the Play Cycle Observation Method in ‘real time’: Recording children’s Play Cycles in pre-school provision

2020 ◽  
pp. 1476718X2096985
Author(s):  
Pete King ◽  
LaDonna Atkins ◽  
Brandon Burr
Keyword(s):  
Pilot Study ◽  
Real Time ◽  
School Setting ◽  
Early Years ◽  
Good Reliability ◽  
Rater Reliability ◽  
Children's Play ◽  
Observational Tool ◽  
Observation Method ◽  
And Training

The Play Cycle Observation Method (PCOM) is an observational tool developed to focus on the process of play and has shown good reliability when watching videos of children playing. This study piloted use of the PCOM in ‘real time’ in a pre-school setting where 3-year-old children play. The results from two independent observers not familiar with the concept of the Play Cycle or the PCOM found good inter-rater reliability using Cohen Kappa (k) when observing play cues to form play cycles, as well as observing play cues within established play cycles. In addition, the recording of the nature of the play cues and play returns, the play frame and how the play cycle finishes (annihilation) were shown to be consistent between the two inter-rater observers. The results of this pilot study indicate the PCOM can be used as an observational tool to record the process of play by both students and practitioners working in a range of contexts including playwork, childcare, early years and statutory education. The PCOM can also be used as a teaching and training aid for trainers and lecturers.

scholarly journals Accuracy and repeatability of wrist joint angles in boxing using an electromagnetic tracking system

2019 ◽  
Vol 23 (1) ◽  
Author(s):  
Ian T. Gatt ◽  
Tom Allen ◽  
Jon Wheat
Keyword(s):  
Wrist Joint ◽  
Tracking System ◽  
Testing Procedure ◽  
Electromagnetic Tracking ◽  
Good Reliability ◽  
Flexion Extension ◽  
In Vivo Testing ◽  
Accuracy And Repeatability ◽  
Electromagnetic Tracking System

AbstractThe hand-wrist region is reported as the most common injury site in boxing. Boxers are at risk due to the amount of wrist motions when impacting training equipment or their opponents, yet we know relatively little about these motions. This paper describes a new method for quantifying wrist motion in boxing using an electromagnetic tracking system. Surrogate testing procedure utilising a polyamide hand and forearm shape, and in vivo testing procedure utilising 29 elite boxers, were used to assess the accuracy and repeatability of the system. 2D kinematic analysis was used to calculate wrist angles using photogrammetry, whilst the data from the electromagnetic tracking system was processed with visual 3D software. The electromagnetic tracking system agreed with the video-based system (paired t tests) in both the surrogate (< 0.2°) and quasi-static testing (< 6°). Both systems showed a good intraclass coefficient of reliability (ICCs > 0.9). In the punch testing, for both repeated jab and hook shots, the electromagnetic tracking system showed good reliability (ICCs > 0.8) and substantial reliability (ICCs > 0.6) for flexion–extension and radial-ulnar deviation angles, respectively. The results indicate that wrist kinematics during punching activities can be measured using an electromagnetic tracking system.

Is intervertebral disc degeneration related to segmental instability? An evaluation with two different grading systems based on clinical imaging

2017 ◽  
Vol 59 (3) ◽  
pp. 327-335 ◽  
Author(s):  
David Volkheimer ◽  
Fabio Galbusera ◽  
Christian Liebsch ◽  
Sabine Schlegel ◽  
Friederike Rohlmann ◽  
...  
Keyword(s):  
Intervertebral Disc Degeneration ◽  
Statistical Significance ◽  
Axial Rotation ◽  
Spinal Motion ◽  
X Ray ◽  
Grading Systems ◽  
Flexion Extension ◽  
The Difference ◽  
Magnetic Resonance Imaging Mri

Background Several in vitro studies investigated how degeneration affects spinal motion. However, no consensus has emerged from these studies. Purpose To investigate how degeneration grading systems influence the kinematic output of spinal specimens. Material and Methods Flexibility testing was performed with ten human T12-S1 specimens. Degeneration was graded using two different classifications, one based on X-ray and the other one on magnetic resonance imaging (MRI). Intersegmental rotation (expressed by range of motion [ROM] and neutral zone [NZ]) was determined in all principal motion directions. Further, shear translation was measured during flexion/extension motion. Results The X-ray grading system yielded systematically lesser degeneration. In flexion/extension, only small differences in ROM and NZ were found between moderately degenerated motion segments, with only NZ for the MRI grading reaching statistical significance. In axial rotation, a significant increase in NZ for moderately degenerated segments was found for both grading systems, whereas the difference in ROM was significant only for the MRI scheme. Generally, the relative increases were more pronounced for the MRI classification compared to the X-ray grading scheme. In lateral bending, only relatively small differences between the degeneration groups were found. When evaluating shear translations, a non-significant increase was found for moderately degenerated segments. Motion segment segments tended to regain stability as degeneration progressed without reaching the level of statistical significance. Conclusion We found a fair agreement between the grading schemes which, nonetheless, yielded similar degeneration-related effects on intersegmental kinematics. However, as the trends were more pronounced using the Pfirrmann classification, this grading scheme appears superior for degeneration assessment.

Comparing Reliability Between 3D Imaging And 2D Photography For External Nasal Anthropometry

2021 ◽  
Author(s):  
Yoon-Soo Seo ◽  
Ki-Hun Jo ◽  
Jun-Sang CHA ◽  
Joo-Yeon Kim ◽  
Jae-Hwan Kwon
Keyword(s):  
3D Imaging ◽  
Intraclass Correlation ◽  
Digital Camera ◽  
Angular Parameter ◽  
Good Reliability ◽  
Rater Reliability ◽  
3D Images ◽  
Imaging Result ◽  
External Nose ◽  
2D And 3D

Abstract Background: This study investigates and compare the reliability and reproducibility of two facial anthropometric methods about external nasal angles, 3D imaging and conventional 2D photography. Methods: 2D photograph images and 3D images about external nose of 30 volunteers were taken using digital camera and Morpheus 3D scanner. To evaluate intra-rater reliability, each images were taken over two different days for each subject by the same researcher. To evaluate inter-rater reliability, another researcher took each images for each subject on the first day. The reliability of each method for measuring 4 external nasal angle is obtained using intraclass correlation coefficient (ICC) and compared.Results: Inter-rater and intra-rater reliability of both 3D imaging and 2D photography had excellent agreement in all 4 nasal angles. In the nasofacial angular parameter, Inter-rater ICC, 2D photography was significantly higher than 3D imaging. Result of intra-rater ICC also showed both 3D imaging and 2D photography had good reliability in all 4 nasal angles. Similar to those of inter-rater ICC, nasofacial angular parameter showed statistically significant differences between 3D imaging and 2D photography.Conclusion: In terms of reliability, both 2D and 3D showed appropriate anthropometric results and considering its own advantage, each methods can be used complementarily.

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