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.

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.

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.

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.

Scaphoid Excision and Bicolumnar Carpal Fusion with Retrograde Headless Screws

2021 ◽  
Author(s):  
Sebastian Undurraga ◽  
Kendrick Au ◽  
Johanna Dobransky ◽  
Braden Gammon
Keyword(s):  
Range Of Motion ◽  
Articular Surface ◽  
Statistical Significance ◽  
Pinch Strength ◽  
Neutral Position ◽  
Level Of Evidence ◽  
Wrist Extension ◽  
Flexion Extension ◽  
Patient Reported

Abstract Background/Purpose Scaphoid excision and partial wrist fusion is used for the treatment of scapholunate advanced collapse/scaphoid nonunion advanced collapse wrist arthritis. The purpose of this study was to report midterm functional and radiographic outcomes in a series of patients who underwent bicolumnar fusion of the lunocapitate and triquetrohamate joints using retrograde headless screws. Methods Twenty-three consecutive patients (25 wrists) underwent surgery with this technique from January 2014 to May 2017 with a minimum follow-up of 1 year. Assessment consisted of range of motion, grip, and pinch strength. Patient-reported outcome measures included disabilities of the arm, shoulder, and hand (DASH) and patient-rated wrist evaluation (PRWE) scores. Fusion rates and the radiolunate joint were evaluated radiographically. The relationship between wrist range of motion and midcarpal fusion angle (neutral position vs. extended capitolunate fusion angle > 20 degrees) was analyzed. Results Average follow-up was 18 months. Mean wrist extension was 41 degrees, flexion 36 degrees, and radial-ulnar deviation arc was 43 degrees. Grip strength was 39 kg and pinch 9 kg. Residual pain for activities of daily living was 1.6 (visual analog scale). The mean DASH and PRWE scores were 19 ± 16 and 28 ± 18, respectively. Patients with an extended capitolunate fusion angle trended toward more wrist extension but this did not reach statistical significance (p = 0.17). Conclusions With retrograde headless compression screws, the proximal articular surface of the lunate is not violated, preserving the residual load-bearing articulation. Patients maintained a functional flexion–extension arc of motion with grip-pinch strength close to normal. Capitolunate fusion angle greater than 20 degrees may provide more wrist extension but further studies are needed to demonstrate this. Level of Evidence This is a Level IV study.

scholarly journals Smartphone Application with Virtual Reality Goggles for the Reliable and Valid Measurement of Active Craniocervical Range of Motion

Diagnostics ◽  
2019 ◽  
Vol 9 (3) ◽  
pp. 71 ◽  
Author(s):  
Ke-Vin Chang ◽  
Wei-Ting Wu ◽  
Mei-Chu Chen ◽  
Yi-Chi Chiu ◽  
Der-Sheng Han ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Range Of Motion ◽  
Correlation Coefficient ◽  
Pearson Correlation ◽  
Random Effect Model ◽  
Altman Plot ◽  
Rater Reliability ◽  
Hybrid Device ◽  
Flexion Extension ◽  
The Right

Objective: This study aimed to determine the intra-rater and inter-rater reliability and validity of a hybrid device, combining virtual reality goggles, a magnetometer and an inclinometer application for smartphones, to measure craniocervical range. Summary of Background Data: Accurate evaluation of craniocervical range of motion is important for early detection of certain diseased conditions and monitoring the progress of interventions. The universal goniometer is widely used for the measurement but it requires experienced practitioners. Whether a combination of virtual reality goggles and smartphone applications can provide the same or better performance compared with the goniometer is still unknown. Methods: Forty-one healthy adults from the department of physical medicine and rehabilitation were recruited for craniocervical range examination (flexion, extension, side-bending to the right or left and rotating to the right or left) by using the hybrid device and universal goniometer. Using the hybrid device, repeated measurements were performed twice by a primary rater and once by a second rater. The primary rater also conducted a measurement using the universal goniometer in the same cohort. The intra-rater and inter-rater reliability (intra-class correlation coefficient (ICC)) were calculated using the two-way random effect model, whereas the validity was examined by the Pearson correlation coefficient and Bland-and-Altman plot. The interval between the first and second sessions of the measurement for intra-rater reliability was set at 30 min. Results: Excellent intra-rater (ICC ≥ 0.925) and inter-rater (ICC ≥ 0.880) reliability was noted for the hybrid device. The minimal detectable changes from intra-observer and inter-observer comparisons ranged between 4.12° and 7.42° in all six directions. The Bland-and-Altman plot revealed small mean differences (≤1.68°) between the hybrid device and universal goniometer. Both instruments had highly correlated measurements of craniocervical motion (r values ≥ 0.918). Conclusion: For healthy participants, excellent intra-rater and inter-rater reliability was noted for the hybrid device, and the measurements were consistent with the universal goniometer measurements. Future studies are needed to examine whether the device can perform similarly for patients with neck disorders.

scholarly journals The Reliability and Validity of Wearable Inertial Sensors Coupled with the Microsoft Kinect to Measure Shoulder Range-of-Motion

Sensors ◽  
2020 ◽  
Vol 20 (24) ◽  
pp. 7238
Author(s):  
Peter Beshara ◽  
Judy F. Chen ◽  
Andrew C. Read ◽  
Pierre Lagadec ◽  
Tian Wang ◽  
...  
Keyword(s):  
Construct Validity ◽  
Range Of Motion ◽  
Inertial Sensors ◽  
Objective Assessment ◽  
Reliability And Validity ◽  
Human Movement ◽  
Microsoft Kinect ◽  
Rater Reliability ◽  
Shoulder Range Of Motion ◽  
Shoulder Flexion

Background: Objective assessment of shoulder joint active range of motion (AROM) is critical to monitor patient progress after conservative or surgical intervention. Advancements in miniature devices have led researchers to validate inertial sensors to capture human movement. This study investigated the construct validity as well as intra- and inter-rater reliability of active shoulder mobility measurements using a coupled system of inertial sensors and the Microsoft Kinect (HumanTrak). Methods: 50 healthy participants with no history of shoulder pathology were tested bilaterally for fixed and free ROM: (1) shoulder flexion, and (2) abduction using HumanTrak and goniometry. The repeat testing of the standardised protocol was completed after seven days by two physiotherapists. Results: All HumanTrak shoulder movements demonstrated adequate reliability (intra-class correlation (ICC) ≥ 0.70). HumanTrak demonstrated higher intra-rater reliability (ICCs: 0.93 and 0.85) than goniometry (ICCs: 0.75 and 0.53) for measuring free shoulder flexion and abduction AROM, respectively. Similarly, HumanTrak demonstrated higher intra-rater reliability (ICCs: 0.81 and 0.94) than goniometry (ICCs: 0.70 and 0.93) for fixed flexion and abduction AROM, respectively. Construct validity between HumanTrak and goniometry was adequate except for free abduction. The differences between raters were predominately acceptable and below ±10°. Conclusions: These results indicated that the HumanTrak system is an objective, valid and reliable way to assess and track shoulder ROM.

scholarly journals Validity and reliability of assessing diaphragmatic mobility by area on X-rays of healthy subjects

2018 ◽  
Vol 44 (3) ◽  
pp. 220-226 ◽  
Author(s):  
Aline Pedrini ◽  
Márcia Aparecida Gonçalves ◽  
Bruna Estima Leal ◽  
Michelle Gonçalves de Souza Tavares ◽  
Wellington Pereira Yamaguti ◽  
...  
Keyword(s):  
Correlation Coefficient ◽  
Intraclass Correlation ◽  
X Rays ◽  
Altman Analysis ◽  
Validity And Reliability ◽  
Anthropometric Parameters ◽  
Rater Reliability ◽  
Bland Altman Analysis ◽  
Left Hemidiaphragm ◽  
The Right

ABSTRACT Objective: To investigate the concurrent validity, as well as the intra- and inter-rater reliability, of assessing diaphragmatic mobility by area (DMarea) on chest X-rays of healthy adults. Methods: We evaluated anthropometric parameters, pulmonary function, and diaphragmatic mobility in 43 participants. Two observers (rater A and rater B) determined diaphragmatic mobility at two time points. We used Pearson’s correlation coefficient to evaluate the correlation between DMarea and the assessment of diaphragmatic mobility by distance (DMdist). To evaluate intra- and inter-rater reliability, we used the intraclass correlation coefficient (ICC [2,1]), 95% CI, and Bland-Altman analysis. Results: A significant correlation was found between the DMarea and DMdist methods (r = 0.743; p < 0.0001). For DMarea, the intra-rater reliability was found to be quite high for the right hemidiaphragm (RHD)-ICC (2,1) = 0.92 (95% CI: 0.86-0.95) for rater A and ICC (2,1) = 0.90 (95% CI: 0.84-0.94) for rater B-and the left hemidiaphragm (LHD)-ICC (2,1) = 0.96 (95% CI: 0.93-0.97) for rater A and ICC (2,1) = 0.91 (95% CI: 0.81-0.95) for rater B-(p < 0.0001 for all). Also for DMarea, the inter-rater reliability was found to be quite high for the first and second evaluations of the RHD-ICC (2,1) = 0.99 (95% CI: 0.98-0.99) and ICC (2,1) = 0.95 (95% CI: 0.86-0.97), respectively-and the LHD-ICC (2,1) = 0.99 (95% CI: 0.98-0.99) and ICC (2,1) = 0.94 (95% CI: 0.87-0.97)-(p < 0.0001 for both). The Bland-Altman analysis showed good agreement between the mobility of the RHD and that of the LHD. Conclusions: The DMarea method proved to be a valid, reliable measure of diaphragmatic mobility.

Between-Day Reliability of a Cluster-Based Method for Multisegment Kinematic Analysis of the Foot-Ankle Complex

2014 ◽  
Vol 104 (6) ◽  
pp. 601-609 ◽  
Author(s):  
Thales R. Souza ◽  
Haroldo L. Fonseca ◽  
Ana Carolina A. Vaz ◽  
Juliana S. Antero ◽  
Cristiano S. Marinho ◽  
...  
Keyword(s):  
Subtalar Joint ◽  
High Reliability ◽  
Intraclass Correlation ◽  
Correlation Coefficients ◽  
Neutral Position ◽  
Multiple Correlation ◽  
Noninvasive Methods ◽  
Intraclass Correlation Coefficients ◽  
Ankle Complex ◽  
Kinematic Evaluation

Background Detailed description of foot pronation-supination requires multisegment evaluation of the kinematics of the foot-ankle complex. There are noninvasive methods with independent (single) tracking markers attached directly to the skin. However, these methods are inconsistent with the usual rigid segments assumption. In contrast, using clustered markers is compatible with this assumption and is necessary for analyses that need tracking markers to be distant from the foot (eg, shod walking). This study investigated the between-day reliability of a cluster-based method for multisegment analysis of foot-ankle angles related to pronation-supination. Methods Ten healthy adults participated in the study. An anatomically based, three-dimensional model comprising the shank, calcaneus, and forefoot was created. Rigid clusters of tracking markers were used to determine the relative positions and motions of the segments. Mean positions were measured with the subtalar joint in neutral position during standing. Furthermore, mean angles, peaks, and timings of peaks were measured during the stance phase of walking. All of the variables were measured twice, with a 1-week interval. To evaluate reliability, intraclass correlation coefficients were calculated for discrete variables and coefficients of multiple correlation for entire gait curves. Results Intraclass correlation coefficients varied from 0.8 to 0.93 for the angles obtained when the subtalar joint was in neutral and from 0.76 to 0.9 for walking variables. Coefficients of multiple correlation varied from 0.93 to 0.97 for walking curves. Conclusions The method described has good to high reliability and provides a systematic method for multisegment kinematic evaluation of foot-ankle pronation-supination.

scholarly journals Cervical Vertebral Maturation Method: Reproducibility and Efficiency of Chronological Age Estimation

2021 ◽  
Vol 11 (7) ◽  
pp. 3160
Author(s):  
Lydia Schoretsaniti ◽  
Anastasia Mitsea ◽  
Kety Karayianni ◽  
Iosif Sifakakis
Keyword(s):  
Age Estimation ◽  
High Reliability ◽  
Intraclass Correlation ◽  
Growth Spurt ◽  
Chronological Age ◽  
Maturation Stage ◽  
Rater Reliability ◽  
Absolute Agreement ◽  
Cervical Vertebral Maturation ◽  
Cervical Maturation

The aim of this study was to investigate the reproducibility of the Cervical Vertebral Maturation (CVM) method and the potential for chronological age estimation using this method. The sample consisted of 474 lateral cephalometric radiographs, from orthodontic patients aged 6.4–22.4 years. Six raters were trained to the CVM method (Baccetti). All images were assessed twice. Intra- and inter-rater agreements were assessed by Cohen’s weighted kappa and intraclass correlation coefficient, respectively. Analysis of variance was performed to investigate the correlation between cervical maturation stages and chronological age. The age prediction potential of the method was tested by general linear model regression analysis. Intra-rater reliability ranged from 0.857 to 0.931. Intra-rater absolute agreement ranged from 77% to 87% however inter-rater absolute agreement was lower than 50%. Inter-rater reliability was higher than 0.9. The 3rd Cervical Maturation Stage (CS3) showed the lowest reproducibility. The mean age differences among the 6 CS stages were statistically significant and increased as the CS increased. CS and gender could roughly explain the 60% (adjusted R2 = 0.61) of the age variance of the sample. This CVM method proved able to show high reliability; however, it cannot predict accurately the pubertal growth spurt. A direct correlation was found between cervical stages and chronological age. This method provides a broad estimation of chronological age.

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