scholarly journals Concurrent Validity and Reliability of an Inertial Measurement Unit for the Assessment of Craniocervical Range of Motion in Subjects with Cerebral Palsy

Diagnostics ◽  
2020 ◽  
Vol 10 (2) ◽  
pp. 80 ◽  
Author(s):  
Cristina Carmona-Pérez ◽  
Juan Luis Garrido-Castro ◽  
Francisco Torres Vidal ◽  
Sandra Alcaraz-Clariana ◽  
Lourdes García-Luque ◽  
...  

Objective: This study aimed to determine the validity and reliability of Inertial Measurement Units (IMUs) for the assessment of craniocervical range of motion (ROM) in patients with cerebral palsy (CP). Methods: twenty-three subjects with CP and 23 controls, aged between 4 and 14 years, were evaluated on two occasions, separated by 3 to 5 days. An IMU and a Cervical Range of Motion device (CROM) were used to assess craniocervical ROM in the three spatial planes. Validity was assessed by comparing IMU and CROM data using the Pearson correlation coefficient, the paired t-test and Bland–Altman plots. Intra-day and inter-day relative reliability were determined using the Intraclass Correlation Coefficient (ICC). The Standard Error of Measurement (SEM) and the Minimum Detectable Change at a 90% confidence level (MDC90) were obtained for absolute reliability. Results: High correlations were detected between methods in both groups on the sagittal and frontal planes (r > 0.9), although this was reduced in the case of the transverse plane. Bland–Altman plots indicated bias below 5º, although for the range of cervical rotation in the CP group, this was 8.2º. The distance between the limits of agreement was over 23.5º in both groups, except for the range of flexion-extension in the control group. ICCs were higher than 0.8 for both comparisons and groups, except for inter-day comparisons of rotational range in the CP group. Absolute reliability showed high variability, with most SEM below 8.5º, although with worse inter-day results, mainly in CP subjects, with the MDC90 of rotational range achieving more than 20º. Conclusions: IMU application is highly correlated with CROM for the assessment of craniocervical movement in CP and healthy subjects; however, both methods are not interchangeable. The IMU error of measurement can be considered clinically acceptable; however, caution should be taken when this is used as a reference measure for interventions.

Diagnostics ◽  
2020 ◽  
Vol 10 (9) ◽  
pp. 661
Author(s):  
Cristina Carmona-Pérez ◽  
Alberto Pérez-Ruiz ◽  
Juan L. Garrido-Castro ◽  
Francisco Torres Vidal ◽  
Sandra Alcaraz-Clariana ◽  
...  

Objective: The aim of this study was to design and propose a new test based on inertial measurement unit (IMU) technology, for measuring cervical posture and motor control in children with cerebral palsy (CP) and to evaluate its validity and reliability. Methods: Twenty-four individuals with CP (4–14 years) and 24 gender- and age-matched controls were evaluated with a new test based on IMU technology to identify and measure any movement in the three spatial planes while the individual is seated watching a two-minute video. An ellipse was obtained encompassing 95% of the flexion/extension and rotation movements in the sagittal and transversal planes. The protocol was repeated on two occasions separated by 3 to 5 days. Construct and concurrent validity were assessed by determining the discriminant capacity of the new test and by identifying associations between functional measures and the new test outcomes. Relative reliability was determined using the intraclass correlation coefficient (ICC) for test–retest data. Absolute reliability was obtained by the standard error of measurement (SEM) and the Minimum Detectable Change at a 90% confidence level (MDC90). Results: The discriminant capacity of the area and both dimensions of the new test was high (Area Under the Curve ≈ 0.8), and consistent multiple regression models were identified to explain functional measures with new test results and sociodemographic data. A consistent trend of ICCs higher than 0.8 was identified for CP individuals. Finally, the SEM can be considered low in both groups, although the high variability among individuals determined some high MDC90 values, mainly in the CP group. Conclusions: The new test, based on IMU data, is valid and reliable for evaluating posture and motor control in children with CP.


2020 ◽  
Vol 68 (11) ◽  
pp. 967-977
Author(s):  
Christina Mittag ◽  
Regina Leiss ◽  
Katharina Lorenz ◽  
Thomas Seel

AbstractThis paper presents the proof-of-concept of a home-based gamified wrist rehabilitation training system for children with cerebral palsy (CCP). We describe the user-centered design process of this system, which is composed of a wrist-worn inertial measurement unit (IMU) and a tangible device with an embedded IMU. The system employs a quaternion-based algorithm for automatic real-time estimation of the range of motion (RoM) covered by adduction/abduction and flexion/extension motions of the wrist. Experimental validation shows that the RoM can be determined with sufficient accuracy to control a game and that the algorithm is applicable in CCP. A serious game, which uses the presented algorithm and enables feedback as well as motivating stimuli, is implemented and evaluated by physiotherapists.


Sensors ◽  
2019 ◽  
Vol 19 (23) ◽  
pp. 5297 ◽  
Author(s):  
Michael Alexander Wirth ◽  
Gabriella Fischer ◽  
Jorge Verdú ◽  
Lisa Reissner ◽  
Simone Balocco ◽  
...  

This study aims to compare a new inertial measurement unit based system with the highly accurate but complex laboratory gold standard, an optoelectronic motion capture system. Inertial measurement units are sensors based on accelerometers, gyroscopes, and/or magnetometers. Ten healthy subjects were recorded while performing flexion-extension and radial-ulnar deviation movements of their right wrist using inertial sensors and skin markers. Maximum range of motion during these trials and mean absolute difference between the systems were calculated. A difference of 10° ± 5° for flexion-extension and 2° ± 1° for radial-ulnar deviation was found between the two systems with absolute range of motion values of 126° and 50° in the respective axes. A Wilcoxon rank sum test resulted in a no statistical differences between the systems with p-values of 0.24 and 0.62. The observed results are even more precise than reports from previous studies, where differences between 14° and 27° for flexion-extension and differences between 6° and 17° for radial-ulnar deviation were found. Effortless and fast applicability, good precision, and low inter-observer variability make inertial measurement unit based systems applicable to clinical settings.


2021 ◽  
pp. 1-6
Author(s):  
Young Jin Jo ◽  
Young Kyun Kim

BACKGROUND: Dynamic knee valgus (DKV) is a known risk factor for acute and chronic knee injuries and is more frequently diagnosed in females. A real-time single-leg squat test (SLST) could screen for DKV to prevent injuries. OBJECTIVE: To compare the differences in lower extremity strength and range of motion (ROM) in female soccer athletes with and without DKV during an SLST. METHODS: Eighteen subjects with DKV (DKV group) and 18 subjects without DKV (control group) during a single-leg squat were included. Hip strength (flexion, extension, abduction, adduction, internal rotation, and external rotation) was measured with a hand-held dynamometer. Hip ROM (internal and external rotation), and ankle ROM (dorsiflexion with the knee flexed and extended) were measured. Independent t-test was used to compare the averages of the groups. RESULTS: There were significant differences in hip abduction to adduction strength ratio (DKV: 1.48 ± 0.3, control: 1.22 ± 0.26, p< 0.01) and ankle dorsiflexion with knee flexed (DKV: 17.22 ± 6.82, control: 21.22 ± 4.55, p< 0.05) and extended (DKV: 10.14 ± 4.23, control: 14.75 ± 3.40, p< 0.001) between the groups. CONCLUSION: The hip abduction to adduction strength ratio and gastrocnemius and soleus flexibility may be associated factors in dynamic knee valgus and therefore should be assessed and treated, if indicated, as a possible preventive measure in female athletes with this variation.


Author(s):  
Henriëtte A. W. Meijer ◽  
Maurits Graafland ◽  
Miryam C. Obdeijn ◽  
Marlies P. Schijven ◽  
J. Carel Goslings

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.


2020 ◽  
pp. 1-4
Author(s):  
Hannah W. Tucker ◽  
Emily R. Tobin ◽  
Matthew F. Moran

Context: Performance on single-leg hopping (SLH) assessments is commonly included within return-to-sport criteria for rehabilitating athletes. Triaxial accelerometers have been used to quantify impact loading in a variety of movements, including hopping; however, they have never been attached to the tibia during SLH, and their method of fixation has not been investigated. Objective: The purpose of this study was to quantify triaxial accelerations and evaluate the influence of the fixation method of a lightweight inertial measurement unit (Blue Trident) mounted to the tibia during SLH performance. Design: Single cohort, repeated-measures experimental design. Participants: Sixteen healthy participants (10 females and 6 males; 20 [0.9] y; 1.67 [0.08] m; 66.0 [8.5] kg) met the inclusion criteria, volunteered, and completed this study. Interventions: Participants performed 2 sets of 3 SLH trials with an inertial measurement unit (1500 Hz) fixated to the tibia, each set with 1 of 2 attachment methods (double-sided tape [DST] with athletic tape and silicon strap [SS] with Velcro adhesion). Main Outcome Measures: Hop distance, peak tibial acceleration (PTA), time to PTA, and the acceleration slope were assessed during each hop landing. Results: Repeated-measures analysis of variance determined no significant effect of the attachment method on hop metrics (P = .252). Across 3 trials, both fixation methods (DST and SS) had excellent reliability values (intraclass correlation coefficient: .868–.941) for PTA and acceleration slope but not for time to PTA (intraclass correlation coefficient: .397–.768). The PTA for DST (27.22 [7.94] g) and SS (26.21 [10.48] g) was comparable and had a moderate, positive relationship (DST: r = .72, P < .01; SS: r = .77, P < .01) to SLH distance. Conclusions: Tibial inertial measurement units with triaxial accelerometers can reliably assess PTA during performance of the SLH, and SS is a viable alternative tibial attachment to DST.


Author(s):  
Steffen Held ◽  
Ludwig Rappelt ◽  
Jan-Philip Deutsch ◽  
Lars Donath

The accurate assessment of the mean concentric barbell velocity (MCV) and its displacement are crucial aspects of resistance training. Therefore, the validity and reliability indicators of an easy-to-use inertial measurement unit (VmaxPro®) were examined. Nineteen trained males (23.1 ± 3.2 years, 1.78 ± 0.08 m, 75.8 ± 9.8 kg; Squat 1-Repetition maximum (1RM): 114.8 ± 24.5 kg) performed squats and hip thrusts (3–5 sets, 30 repetitions total, 75% 1RM) on two separate days. The MCV and displacement were simultaneously measured using VmaxPro® and a linear position transducer (Speed4Lift®). Good to excellent intraclass correlation coefficients (0.91 < ICC < 0.96) with a small systematic bias (p < 0.001; ηp2 < 0.50) for squats (0.01 ± 0.04 m·s−1) and hip thrusts (0.01 ± 0.05 m·s−1) and a low limit of agreement (LoA < 0.12 m·s−1) indicated an acceptable validity. The within- and between-day reliability of the MCV revealed good ICCs (0.55 < ICC < 0.91) and a low LoA (<0.16 m·s−1). Although the displacement revealed a systematic bias during squats (p < 0.001; ηp2 < 0.10; 3.4 ± 3.4 cm), no bias was detectable during hip thrusts (p = 0.784; ηp2 < 0.001; 0.3 ± 3.3 cm). The displacement showed moderate to good ICCs (0.43 to 0.95) but a high LoA (7.8 to 10.7 cm) for the validity and (within- and between-day) reliability of squats and hip thrusts. The VmaxPro® is considered to be a valid and reliable tool for the MCV assessment.


Author(s):  
Arūnė Dūdaitė ◽  
Vilma Juodžbalienė

Research background. Virtual reality and visual feedback improve motor performance, motor function and balance, so we want to fnd if it affects the function of legs and balance of children with spastic hemiplegia. Research aim was to establish if the use of virtual reality and visual feedback with traditional physiotherapy improve the function of legs and balance of children with cerebral palsy. Methods. Nine children with cerebral palsy participated in the research. Participants were randomly divided into two groups – virtual reality group (n = 6) and control (n = 3). Virtual reality group practised exergaming and stretching exercises for 10 weeks, twice a week. Control group practiced conventional physiotherapy and stretching exercises for 6 weeks, twice a week. We measured the range of motion of the lower limb, spasticity of the lower limb using Modifed Ashworth’o Scale, static, dynamic balance, trunk coordination using Trunk Impairment Scale at the start and the end of the research, and balance using Pediatric Balance Scale. Results. Virtual reality and visual feedback reduced the spasticity of the lower limb, improved balance and postural control for children with cerebral palsy, but it did not improve the range of motion of the lower limb of children with cerebral palsy. Conclusions. Virtual reality and visual feedback did not improve the range of motion of the lower limb of children with cerebral palsy. Virtual reality and visual feedback reduced spasticity of the lower limb, improved balance and postural control for children with cerebral palsy.Keywords. Cerebral palsy, virtual reality, visual feedback, postural control, muscle architecture.


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