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Antonacci C, Longo UG, Nazarian A, Schena E, Carnevale A. Monitoring Scapular Kinematics through Wearable Magneto-Inertial Measurement Units: State of the Art and New Frontiers. SENSORS (BASEL, SWITZERLAND) 2023; 23:6940. [PMID: 37571723 PMCID: PMC10422625 DOI: 10.3390/s23156940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 07/31/2023] [Accepted: 08/02/2023] [Indexed: 08/13/2023]
Abstract
Monitoring shoulder kinematics, including the scapular segment, is of great relevance in the orthopaedic field. Among wearable systems, magneto-inertial measurement units (M-IMUs) represent a valid alternative for applications in unstructured environments. The aim of this systematic literature review is to report and describe the existing methods to estimate 3D scapular movements through wearable systems integrating M-IMUs. A comprehensive search of PubMed, IEEE Xplore, and Web of Science was performed, and results were included up to May 2023. A total of 14 articles was included. The results showed high heterogeneity among studies regarding calibration procedures, tasks executed, and the population. Two different techniques were described, i.e., with the x-axis aligned with the cranial edge of the scapular spine or positioned on the flat surface of the acromion with the x-axis perpendicular to the scapular spine. Sensor placement affected the scapular motion and, also, the kinematic output. Further studies should be conducted to establish a universal protocol that reduces the variability among studies. Establishing a protocol that can be carried out without difficulty or pain by patients with shoulder musculoskeletal disorders could be of great clinical relevance for patients and clinicians to monitor 3D scapular kinematics in unstructured settings or during common clinical practice.
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Affiliation(s)
- Carla Antonacci
- Fondazione Policlinico Universitario Campus Bio-Medico, Via Álvaro del Portillo, 200, 00128 Roma, Italy; (C.A.); (A.C.)
- Unit of Measurements and Biomedical Instrumentation, Università Campus Bio-Medico di Roma, Via Álvaro del Portillo, 21, 00128 Roma, Italy;
| | - Umile Giuseppe Longo
- Fondazione Policlinico Universitario Campus Bio-Medico, Via Álvaro del Portillo, 200, 00128 Roma, Italy; (C.A.); (A.C.)
- Research Unit of Orthopaedic and Trauma Surgery, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Álvaro del Portillo, 21, 00128 Roma, Italy
| | - Ara Nazarian
- Carl J. Shapiro Department of Orthopaedic Surgery and Center for Advanced Orthopaedic Studies, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 20115, USA;
| | - Emiliano Schena
- Unit of Measurements and Biomedical Instrumentation, Università Campus Bio-Medico di Roma, Via Álvaro del Portillo, 21, 00128 Roma, Italy;
| | - Arianna Carnevale
- Fondazione Policlinico Universitario Campus Bio-Medico, Via Álvaro del Portillo, 200, 00128 Roma, Italy; (C.A.); (A.C.)
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Fang Z, Woodford S, Senanayake D, Ackland D. Conversion of Upper-Limb Inertial Measurement Unit Data to Joint Angles: A Systematic Review. SENSORS (BASEL, SWITZERLAND) 2023; 23:6535. [PMID: 37514829 PMCID: PMC10386307 DOI: 10.3390/s23146535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 07/11/2023] [Accepted: 07/17/2023] [Indexed: 07/30/2023]
Abstract
Inertial measurement units (IMUs) have become the mainstay in human motion evaluation outside of the laboratory; however, quantification of 3-dimensional upper limb motion using IMUs remains challenging. The objective of this systematic review is twofold. Firstly, to evaluate computational methods used to convert IMU data to joint angles in the upper limb, including for the scapulothoracic, humerothoracic, glenohumeral, and elbow joints; and secondly, to quantify the accuracy of these approaches when compared to optoelectronic motion analysis. Fifty-two studies were included. Maximum joint motion measurement accuracy from IMUs was achieved using Euler angle decomposition and Kalman-based filters. This resulted in differences between IMU and optoelectronic motion analysis of 4° across all degrees of freedom of humerothoracic movement. Higher accuracy has been achieved at the elbow joint with functional joint axis calibration tasks and the use of kinematic constraints on gyroscope data, resulting in RMS errors between IMU and optoelectronic motion for flexion-extension as low as 2°. For the glenohumeral joint, 3D joint motion has been described with RMS errors of 6° and higher. In contrast, scapulothoracic joint motion tracking yielded RMS errors in excess of 10° in the protraction-retraction and anterior-posterior tilt direction. The findings of this study demonstrate high-quality 3D humerothoracic and elbow joint motion measurement capability using IMUs and underscore the challenges of skin motion artifacts in scapulothoracic and glenohumeral joint motion analysis. Future studies ought to implement functional joint axis calibrations, and IMU-based scapula locators to address skin motion artifacts at the scapula, and explore the use of artificial neural networks and data-driven approaches to directly convert IMU data to joint angles.
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Affiliation(s)
- Zhou Fang
- Department of Biomedical Engineering, The University of Melbourne, Melbourne 3052, Australia; (Z.F.); (S.W.); (D.S.)
| | - Sarah Woodford
- Department of Biomedical Engineering, The University of Melbourne, Melbourne 3052, Australia; (Z.F.); (S.W.); (D.S.)
| | - Damith Senanayake
- Department of Biomedical Engineering, The University of Melbourne, Melbourne 3052, Australia; (Z.F.); (S.W.); (D.S.)
- Department of Mechanical Engineering, The University of Melbourne, Melbourne 3052, Australia
| | - David Ackland
- Department of Biomedical Engineering, The University of Melbourne, Melbourne 3052, Australia; (Z.F.); (S.W.); (D.S.)
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Friesen KB, Sigurdson A, Lang AE. Comparison of scapular kinematics from optical motion capture and inertial measurement units during a work-related and functional task protocol. Med Biol Eng Comput 2023; 61:1521-1531. [PMID: 36781544 DOI: 10.1007/s11517-023-02794-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 01/29/2023] [Indexed: 02/15/2023]
Abstract
Understanding scapular motion during everyday tasks is essential for adequate return-to-work and intervention programming, yet most scapular assessments involve restricted motion analysis within a laboratory setting. Inertial measurement units (IMUs) have been used to track scapular motion, but their validity compared to "gold standard" optical motion capture is not well defined. Further, it is unclear how different IMU sensor placements could affect scapular kinematic outcomes during a functional task protocol. To assess the reliability of scapular motion measurements with the use of the "gold standard" optical motion capture and IMUs, and to compare scapular IMU placement to assess which location (acromion or spine) was best for reliability of scapular motion, participants completed two testing sessions. During each lab visit, participant torso, humeri, and scapulae motion was tracked during 3 trials of 8 dynamic tasks and two elevation movements. Scapular angles were extracted during each task. To assess intra-session reliability, intra-class correlation coefficients (ICCs), and root mean square errors (RMSEs) were calculated. Results showed ICCs and RMSEs were acceptable. Although there appeared offsets between the two motion capture system scapular kinematics outcomes based on the plotted waveforms, the movement patterns appeared consistent between both motion capture methods. Data also showed that acromion IMU placement produced slightly more reliable outcomes than placement on the spine. Two placements of scapular tracking IMUs were tested with identical procedures.
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Affiliation(s)
- Kenzie B Friesen
- College of Medicine, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK, S7N 2Z4, Canada
| | - Anya Sigurdson
- College of Medicine, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK, S7N 2Z4, Canada
| | - Angelica E Lang
- College of Medicine, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK, S7N 2Z4, Canada.
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Jafarian Tangrood Z, Sole G, Cury Ribeiro D. Association between changes in pain or function scores and changes in scapular rotations in patients with subacromial shoulder pain: a prospective cohort study. Arch Physiother 2022; 12:18. [PMID: 35965342 PMCID: PMC9377126 DOI: 10.1186/s40945-022-00143-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Accepted: 06/04/2022] [Indexed: 11/24/2022] Open
Abstract
Background Scapular dyskinesis is reported as one of the potential factors contributing to the presentation of pain in subacromial shoulder pain. In clinical practice, the evaluation and control of scapular dyskinesis is considered important for managing the subacromial shoulder pain. The aim is to determine the association between changes in pain or function and changes in scapular rotations in participants with subacromial shoulder pain. Method Pain, function and scapular rotations were measured in 25 participants with subacromial shoulder pain at baseline and after 8 weeks. Pain was measured with Numeric Pain Rating Scale (NPRS) and function was measured with Patient Specific Functional Scale (PSFS). Scapular rotations were measured with a scapular locator at 60°, 90° and 120° of scapular arm elevation. Spearman rank correlations (rs) were used to assess the association between variables. Findings No association was observed between changes in pain or function scores with changes in scapular upward/downward rotations (rs = 0.03 to 0.27 for pain and − 0.13 to 0.23 for function) and scapular anterior/posterior tilt (rs = − 0.01 to 0.23 for pain and − 0.13 to 0.08 for function) of arm at 60°, 90° and 120° elevation. Data associated with scapular internal/external rotation was not reported due to low reliability. Conclusion These findings reject associations between changes in pain or function scores and scapular rotations. Future observational study is warranted using a multifactorial approach to understand potential factors that contribute to the presentation of subacromial shoulder pain.
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Senanayake D, Halgamuge S, Ackland DC. Real-time conversion of inertial measurement unit data to ankle joint angles using deep neural networks. J Biomech 2021; 125:110552. [PMID: 34237661 DOI: 10.1016/j.jbiomech.2021.110552] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 05/12/2021] [Accepted: 05/31/2021] [Indexed: 10/21/2022]
Abstract
Joint angle quantification from inertial measurement units (IMUs) is commonly performed using kinematic modelling, which depends on anatomical sensor placement and/or functional joint calibration; however, accurate three-dimensional joint motion measurement remains challenging to achieve. The aims of this study were firstly to employ deep neural networks to convert IMU data to ankle joint angles that are indistinguishable from those derived from motion capture-based inverse kinematics (IK) - the reference standard; and secondly, to validate the robustness of this approach across contrasting walking speeds in healthy individuals. Kinematics data were simultaneously calculated using IMUs and IK from 9 subjects during walking on a treadmill at 0.5 m/s, 1.0 m/s and 1.5 m/s. A generative adversarial network was trained using gait data at two of the walking speeds to predict ankle kinematics from IMU data alone for the third walking speed. There were significant differences between IK and IMU joint angle predictions for ankle eversion and internal rotation during walking at 0.5 m/s and 1.0 m/s (p < 0.001); however, no significant differences in joint angles were observed between the generative adversarial network prediction and IK at any speed or plane of joint motion (p < 0.05). The RMS difference in ankle joint kinematics between the generative adversarial network and IK for walking at 1.0 m/s was 3.8°, 2.1° and 3.5° for dorsiflexion, inversion and axial rotation, respectively. The modeling approach presented for real-time IMU to ankle joint angle conversion, which can be readily expanded to other joints, may provide enhanced IMU capability in applications such as telemedicine, remote monitoring and rehabilitation.
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Affiliation(s)
- Damith Senanayake
- Department of Mechanical Engineering, University of Melbourne, Parkville, Victoria 3010, Australia; Department of Biomedical Engineering, University of Melbourne, Parkville, Victoria 3010, Australia
| | - Saman Halgamuge
- Department of Mechanical Engineering, University of Melbourne, Parkville, Victoria 3010, Australia
| | - David C Ackland
- Department of Biomedical Engineering, University of Melbourne, Parkville, Victoria 3010, Australia.
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Between-Day Reliability of Scapular Locator for Measuring Scapular Position During Arm Elevation in Asymptomatic Participants. J Manipulative Physiol Ther 2020; 43:276-283. [PMID: 32723666 DOI: 10.1016/j.jmpt.2019.03.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Revised: 03/07/2019] [Accepted: 03/08/2019] [Indexed: 11/20/2022]
Abstract
OBJECTIVE The aim of this study was to assess the between-day reliability of the scapular locator for measuring scapular rotations during arm elevation in patients without shoulder pain/conditions/disorders. METHODS Twenty-three asymptomatic individuals were measured during 2 sessions separated by 24 hours. One observer measured scapular position with a scapular locator while participants held their arms at 30°, 60°, 90°, and 120° elevation in the scapular plane. Three trials were performed for each arm position. RESULTS At 30°, between-day intraclass correlation coefficients (ICCs) for all scapular rotations were poor (ICC 0.10-0.40). At higher arm elevations (60°, 90°, and 120°), ICCs ranged from 0.73 to 0.93 for scapular upward rotation, 0.80 to 0.87 for posterior tilt, and 0.37 to 0.62 for scapular internal rotation. For all scapular rotations, the standard error of measurement was less than 6°, and the smallest detectable difference ranged from 11° to 18°. CONCLUSION The findings indicate good to excellent reliability for measuring scapular upward/downward rotation and anterior/posterior tilt between 60° and 120° of shoulder elevation in the scapular plane. However, low reliability was found for all scapular rotations at 30° elevation, and for scapular internal rotation at higher arm elevation.
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Vitali RV, Perkins NC. Determining anatomical frames via inertial motion capture: A survey of methods. J Biomech 2020; 106:109832. [PMID: 32517995 DOI: 10.1016/j.jbiomech.2020.109832] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 04/28/2020] [Accepted: 05/05/2020] [Indexed: 11/26/2022]
Abstract
Despite the exponential growth in using inertial measurement units (IMUs) for biomechanical studies, future growth in "inertial motion capture" is stymied by a fundamental challenge - how to estimate the orientation of underlying bony anatomy using skin-mounted IMUs. This challenge is of paramount importance given the need to deduce the orientation of the bony anatomy to estimate joint angles. This paper systematically surveys a large number (N = 112) of studies from 2000 to 2018 that employ four broad categories of methods to address this challenge across a range of body segments and joints. We categorize these methods as: (1) Assumed Alignment methods, (2) Functional Alignment methods, (3) Model Based methods, and (4) Augmented Data methods. Assumed Alignment methods, which are simple and commonly used, require the researcher to visually align the IMU sense axes with the underlying anatomical axes. Functional Alignment methods, also commonly used, relax the need for visual alignment but require the subject to complete prescribed movements. Model Based methods further relax the need for prescribed movements but instead assume a model for the joint. Finally, Augmented Data methods shed all of the above assumptions, but require data from additional sensors. Significantly different estimates of the underlying anatomical axes arise both across and within these categories, and to a degree that renders it difficult, if not impossible, to compare results across studies. Consequently, a significant future need remains for creating and adopting a standard for defining anatomical axes via inertial motion capture to fully realize this technology's potential for biomechanical studies.
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Affiliation(s)
- Rachel V Vitali
- Department of Mechanical Engineering, University of Michigan, Ann Arbor, MI, USA.
| | - Noel C Perkins
- Department of Mechanical Engineering, University of Michigan, Ann Arbor, MI, USA
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Giuseppe LU, Laura RA, Berton A, Candela V, Massaroni C, Carnevale A, Stelitano G, Schena E, Nazarian A, DeAngelis J, Denaro V. Scapular Dyskinesis: From Basic Science to Ultimate Treatment. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17082974. [PMID: 32344746 PMCID: PMC7215460 DOI: 10.3390/ijerph17082974] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/07/2020] [Revised: 04/16/2020] [Accepted: 04/22/2020] [Indexed: 01/05/2023]
Abstract
Background: This study intends to summarize the causes, clinical examination, and treatments of scapular dyskinesis (SD) and to briefly investigate whether alteration can be managed by a precision rehabilitation protocol planned on the basis of features derived from clinical tests. Methods: We performed a comprehensive search of PubMed, Cochrane, CINAHL and EMBASE databases using various combinations of the keywords “Rotator cuff”, “Scapula”, “Scapular Dyskinesis”, “Shoulder”, “Biomechanics” and “Arthroscopy”. Results: SD incidence is growing in patients with shoulder pathologies, even if it is not a specific injury or directly related to a particular injury. SD can be caused by multiple factors or can be the trigger of shoulder-degenerative pathologies. In both cases, SD results in a protracted scapula with the arm at rest or in motion. Conclusions: A clinical evaluation of altered shoulder kinematics is still complicated. Limitations in observing scapular motion are mainly related to the anatomical position and function of the scapula itself and the absence of a tool for quantitative SD clinical assessment. High-quality clinical trials are needed to establish whether there is a possible correlation between SD patterns and the specific findings of shoulder pathologies with altered scapular kinematics.
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Affiliation(s)
- Longo Umile Giuseppe
- Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University, Via Alvaro del Portillo, Trigoria 200, 00128 Rome, Italy; (R.A.L.); (A.B.); (V.C.); (A.C.); (G.S.)
- Correspondence: ; Tel.: +39-062-2541-1613; Fax: +39-0622-5411
| | - Risi Ambrogioni Laura
- Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University, Via Alvaro del Portillo, Trigoria 200, 00128 Rome, Italy; (R.A.L.); (A.B.); (V.C.); (A.C.); (G.S.)
| | - Alessandra Berton
- Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University, Via Alvaro del Portillo, Trigoria 200, 00128 Rome, Italy; (R.A.L.); (A.B.); (V.C.); (A.C.); (G.S.)
| | - Vincenzo Candela
- Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University, Via Alvaro del Portillo, Trigoria 200, 00128 Rome, Italy; (R.A.L.); (A.B.); (V.C.); (A.C.); (G.S.)
| | - Carlo Massaroni
- Laboratory of Measurement and Biomedical Instrumentation, Campus Bio-Medico University, Via Alvaro del Portillo 200, 00128 Rome, Italy; (C.M.); (E.S.)
| | - Arianna Carnevale
- Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University, Via Alvaro del Portillo, Trigoria 200, 00128 Rome, Italy; (R.A.L.); (A.B.); (V.C.); (A.C.); (G.S.)
- Laboratory of Measurement and Biomedical Instrumentation, Campus Bio-Medico University, Via Alvaro del Portillo 200, 00128 Rome, Italy; (C.M.); (E.S.)
| | - Giovanna Stelitano
- Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University, Via Alvaro del Portillo, Trigoria 200, 00128 Rome, Italy; (R.A.L.); (A.B.); (V.C.); (A.C.); (G.S.)
| | - Emiliano Schena
- Laboratory of Measurement and Biomedical Instrumentation, Campus Bio-Medico University, Via Alvaro del Portillo 200, 00128 Rome, Italy; (C.M.); (E.S.)
| | - Ara Nazarian
- Carl J. Shapiro Department of Orthopaedic Surgery and Center for Advanced Orthopaedic Studies, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 20115, USA; (A.N.); (J.D.)
| | - Joseph DeAngelis
- Carl J. Shapiro Department of Orthopaedic Surgery and Center for Advanced Orthopaedic Studies, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 20115, USA; (A.N.); (J.D.)
| | - Vincenzo Denaro
- Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University, Via Alvaro del Portillo, Trigoria 200, 00128 Rome, Italy; (R.A.L.); (A.B.); (V.C.); (A.C.); (G.S.)
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De Baets L, Vanbrabant S, Dierickx C, van der Straaten R, Timmermans A. Assessment of Scapulothoracic, Glenohumeral, and Elbow Motion in Adhesive Capsulitis by Means of Inertial Sensor Technology: A Within-Session, Intra-Operator and Inter-Operator Reliability and Agreement Study. SENSORS 2020; 20:s20030876. [PMID: 32041375 PMCID: PMC7038682 DOI: 10.3390/s20030876] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Revised: 01/22/2020] [Accepted: 02/05/2020] [Indexed: 11/24/2022]
Abstract
Adhesive capsulitis (AC) is a glenohumeral (GH) joint condition, characterized by decreased GH joint range of motion (ROM) and compensatory ROM in the elbow and scapulothoracic (ST) joint. To evaluate AC progression in clinical settings, objective movement analysis by available systems would be valuable. This study aimed to assess within-session and intra- and inter-operator reliability/agreement of such a motion capture system. The MVN-Awinda® system from Xsens Technologies (Enschede, The Netherlands) was used to assess ST, GH, and elbow ROM during four tasks (GH external rotation, combing hair, grasping a seatbelt, placing a cup on a shelf) in 10 AC patients (mean age = 54 (±6), 7 females), on two test occasions (accompanied by different operators on second occasion). Standard error of measurements (SEMs) were below 1.5° for ST pro-retraction and 4.6° for GH in-external rotation during GH external rotation; below 6.6° for ST tilt, 6.4° for GH flexion-extension, 7.1° for elbow flexion-extension during combing hair; below 4.4° for GH ab-adduction, 13° for GH in-external rotation, 6.8° for elbow flexion-extension during grasping the seatbelt; below 11° for all ST and GH joint rotations during placing a cup on a shelf. Therefore, to evaluate AC progression, inertial sensors systems can be applied during the execution of functional tasks.
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Affiliation(s)
- Liesbet De Baets
- REVAL Rehabilitation Research, Hasselt University, 3590 Diepenbeek, Belgium
- Correspondence: ; Tel.: +32-11-286-939
| | - Stefanie Vanbrabant
- Rehabilitation Sciences and Physiotherapy, Faculty of Rehabilitation Sciences, Hasselt University, 3590 Diepenbeek, Belgium
- Department of Physical Medicine and Rehabilitation, Jessa Hospital, 3500 Hasselt, Belgium
| | - Carl Dierickx
- Medicine, Faculty of Medicine and Life Sciences, Hasselt University, 3590 Diepenbeek, Belgium
| | | | - Annick Timmermans
- REVAL Rehabilitation Research, Hasselt University, 3590 Diepenbeek, Belgium
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Carnevale A, Longo UG, Schena E, Massaroni C, Lo Presti D, Berton A, Candela V, Denaro V. Wearable systems for shoulder kinematics assessment: a systematic review. BMC Musculoskelet Disord 2019; 20:546. [PMID: 31731893 PMCID: PMC6858749 DOI: 10.1186/s12891-019-2930-4] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Accepted: 10/31/2019] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Wearable sensors are acquiring more and more influence in diagnostic and rehabilitation field to assess motor abilities of people with neurological or musculoskeletal impairments. The aim of this systematic literature review is to analyze the wearable systems for monitoring shoulder kinematics and their applicability in clinical settings and rehabilitation. METHODS A comprehensive search of PubMed, Medline, Google Scholar and IEEE Xplore was performed and results were included up to July 2019. All studies concerning wearable sensors to assess shoulder kinematics were retrieved. RESULTS Seventy-three studies were included because they have fulfilled the inclusion criteria. The results showed that magneto and/or inertial sensors are the most used. Wearable sensors measuring upper limb and/or shoulder kinematics have been proposed to be applied in patients with different pathological conditions such as stroke, multiple sclerosis, osteoarthritis, rotator cuff tear. Sensors placement and method of attachment were broadly heterogeneous among the examined studies. CONCLUSIONS Wearable systems are a promising solution to provide quantitative and meaningful clinical information about progress in a rehabilitation pathway and to extrapolate meaningful parameters in the diagnosis of shoulder pathologies. There is a strong need for development of this novel technologies which undeniably serves in shoulder evaluation and therapy.
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Affiliation(s)
- Arianna Carnevale
- Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University, Via Álvaro del Portillo, 200, 00128 Rome, Italy
| | - Umile Giuseppe Longo
- Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University, Via Álvaro del Portillo, 200, 00128 Rome, Italy
| | - Emiliano Schena
- Unit of Measurements and Biomedical Instrumentation, Campus Bio-Medico University, Via Álvaro del Portillo, 21, 00128 Rome, Italy
| | - Carlo Massaroni
- Unit of Measurements and Biomedical Instrumentation, Campus Bio-Medico University, Via Álvaro del Portillo, 21, 00128 Rome, Italy
| | - Daniela Lo Presti
- Unit of Measurements and Biomedical Instrumentation, Campus Bio-Medico University, Via Álvaro del Portillo, 21, 00128 Rome, Italy
| | - Alessandra Berton
- Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University, Via Álvaro del Portillo, 200, 00128 Rome, Italy
| | - Vincenzo Candela
- Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University, Via Álvaro del Portillo, 200, 00128 Rome, Italy
| | - Vincenzo Denaro
- Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University, Via Álvaro del Portillo, 200, 00128 Rome, Italy
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Upper limb joint kinematics using wearable magnetic and inertial measurement units: an anatomical calibration procedure based on bony landmark identification. Sci Rep 2019; 9:14449. [PMID: 31594964 PMCID: PMC6783441 DOI: 10.1038/s41598-019-50759-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Accepted: 09/17/2019] [Indexed: 11/08/2022] Open
Abstract
The estimate of a consistent and clinically meaningful joint kinematics using wearable inertial and magnetic sensors requires a sensor-to-segment coordinate system calibration. State-of-the-art calibration procedures for the upper limb are based on functional movements and/or pre-determined postures, which are difficult to implement in subjects that have impaired mobility or are bedridden in acute units. The aim of this study was to develop and validate an alternative calibration procedure based on the direct identification of palpable anatomical landmarks (ALs) for an inertial and magnetic sensor-based upper limb movement analysis protocol. The proposed calibration procedure provides an estimate of three-dimensional shoulder/elbow angular kinematics and the linear trajectory of the wrist according to the standards proposed by the International Society of Biomechanics. The validity of the method was assessed against a camera-based optoelectronic system during uniaxial joint rotations and a reach-to-grasp task. Joint angular kinematics was found as characterised by a low-biased range of motion (<-2.6°), a low root mean square deviation (RMSD) (<4.4°) and a high waveform similarity coefficient (R2 > 0.995) with respect to the gold standard. Except for the cranio-caudal direction, the linear trajectory of the wrist was characterised by a low-biased range of motion (<11 mm) together with a low RMSD (8 mm) and high waveform similarity (R2 > 0.968). The proposed method enabled the estimation of reliable joint kinematics without requiring any active involvement of the patient during the calibration procedure, complying with the metrological standards and requirements of clinical movement analysis.
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Konda S, Sahara W, Sugamoto K. Directional bias of soft-tissue artifacts on the acromion during recording of 3D scapular kinematics. J Biomech 2018; 73:217-222. [PMID: 29576312 DOI: 10.1016/j.jbiomech.2018.03.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Revised: 02/28/2018] [Accepted: 03/03/2018] [Indexed: 11/30/2022]
Abstract
Scapular kinematics during sports performances can be recorded using skin-mounted trackers attached to the skin overlying the acromion for continuous data collection without restricting natural motions of the subject relative to medical imaging analyses limiting its use for wide-range or high-speed motions. This study aimed to describe the existence of a directional bias in the translational and rotational errors of skin-mounted trackers using a 3D magnetic resonance imaging (3D-MRI) protocol. 3D-MRI scans of the healthy right shoulders of 19 males were acquired in 12 arm positions. The relative transformation of the scapular configuration determined to be the measurement error, as recorded by the configuration of the small cuboid imitating a skin-mounted tracker relative to the actual scapular configuration measured by the voxel-based registration. These measurement errors were expressed with either positive or negative values to describe the bias. Overall translational errors in the lateral, anterior, and superior directions were 3.7 ± 8.4 mm, 9.5 ± 6.4 mm, and 6.2 ± 4.6 mm, respectively. Overall rotational errors in protraction, upward rotation, and posterior tilt were 7.8 ± 8.4°, 0.2 ± 7.4°, and - 4.0 ± 7.5°, respectively. The skin-mounted tracker displayed a high probability of displacement in antero-superior (93% and 91%) directions and rotates in a protracting manner (82%) relative to the position of the underlying bone with the gradual nature of its change. The existence of the directional bias with its gradual change suggests a statistical predictability in measurement errors, which can be used to predict accurate scapular translation and rotation.
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Affiliation(s)
- Shoji Konda
- Department of Orthopaedic Biomaterial Science, Osaka University Graduate School of Medicine, Suita, Osaka, Japan; Japan Society for the Promotion of Science, Chiyoda-ku, Tokyo, Japan; Department of Health and Sport Sciences, Osaka University Graduate School of Medicine, Toyonaka, Osaka, Japan.
| | - Wataru Sahara
- Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Kazuomi Sugamoto
- Department of Orthopaedic Biomaterial Science, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
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Bekker MJ, Vegter RJK, van der Scheer JW, Hartog J, de Groot S, de Vries W, Arnet U, van der Woude LHV, Veeger DHEJ. Scapular kinematics during manual wheelchair propulsion in able-bodied participants. Clin Biomech (Bristol, Avon) 2018; 54:54-61. [PMID: 29554550 DOI: 10.1016/j.clinbiomech.2018.03.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2016] [Revised: 01/26/2018] [Accepted: 03/13/2018] [Indexed: 02/07/2023]
Abstract
BACKGROUND Altered scapular kinematics have been associated with shoulder pain and functional limitations. To understand kinematics in persons with spinal cord injury during manual handrim wheelchair propulsion, a description of normal scapular behaviour in able-bodied persons during this specific task is a prerequisite for accurate interpretation. The primary aim of this study is to describe scapular kinematics in able-bodied persons during manual wheelchair propulsion. METHODS Sixteen able-bodied, novice wheelchair users without shoulder complaints participated in the study. Kinematic and kinetic data were collected during a standardized pose in the anatomic posture, frontal-plane arm elevation and low-intensity steady-state handrim wheelchair propulsion and upper-body Euler angles were calculated. FINDINGS Scapulothoracic joint orientations in a static position were 36.7° (SD 5.4°), 6.4° (SD 9.1°) and 9.1° (SD 5.7°) for respectively protraction, lateral rotation and anterior tilt. At 80° of arm elevation in the frontal plane, the respective values of 33.4° (SD 8.0°), 23.9° (SD 5.4°) and 4.1° (SD 11.3°) were found. During the push phase of manual wheelchair propulsion, the mean scapular rotations were respectively 32.7° (SD 7.1°), 7.1° (SD 9.2°) and 9.8° (SD 8.3°). INTERPRETATION The orientation of the scapula in a static pose, during arm elevation and in manual wheelchair propulsion in able-bodied participants showed similar patterns to a previous study in persons with para- and tetraplegia. These values provide a reference for the investigation of the scapular movement pattern in wheelchair-dependent persons and its relation to shoulder complex abnormalities.
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Affiliation(s)
- Michel J Bekker
- Swiss Paraplegic Research, Guido A. Zächstrasse 4, CH, 6207 Nottwil, Switzerland; Research Institute MOVE, Department of Human Movement Sciences, Free University Amsterdam, Van der Boechorststraat 7, NL, 1081BT Amsterdam, The Netherlands; Center for Human Movement Sciences, University Medical Center Groningen, University of Groningen, Antonius Deusinglaan 1, NL-9713AV Groningen, The Netherlands.
| | - Riemer J K Vegter
- Center for Human Movement Sciences, University Medical Center Groningen, University of Groningen, Antonius Deusinglaan 1, NL-9713AV Groningen, The Netherlands.
| | - Jan W van der Scheer
- Center for Human Movement Sciences, University Medical Center Groningen, University of Groningen, Antonius Deusinglaan 1, NL-9713AV Groningen, The Netherlands
| | - Johanneke Hartog
- Center for Human Movement Sciences, University Medical Center Groningen, University of Groningen, Antonius Deusinglaan 1, NL-9713AV Groningen, The Netherlands; Department of Cardiology and Thoracic Surgery, University Medical Center Groningen, University of Groningen, Hanzeplein 1, NL-9713GZ Groningen, The Netherlands.
| | - Sonja de Groot
- Center for Human Movement Sciences, University Medical Center Groningen, University of Groningen, Antonius Deusinglaan 1, NL-9713AV Groningen, The Netherlands; Amsterdam Rehabilitation Research Center Reade, Dr. Jan van Breemenstraat 2, NL, 1056AB Amsterdam, The Netherlands.
| | - Wiebe de Vries
- Swiss Paraplegic Research, Guido A. Zächstrasse 4, CH, 6207 Nottwil, Switzerland.
| | - Ursina Arnet
- Swiss Paraplegic Research, Guido A. Zächstrasse 4, CH, 6207 Nottwil, Switzerland; University of Lucerne, Department of Health Sciences, Frohburgstrasse 3, CH, 6002 Lucerne, Switzerland.
| | - Lucas H V van der Woude
- Center for Human Movement Sciences, University Medical Center Groningen, University of Groningen, Antonius Deusinglaan 1, NL-9713AV Groningen, The Netherlands; Center for Rehabilitation, University Medical Center Groningen, University of Groningen, Antonius Deusinglaan 1, NL-9713AV Groningen, The Netherlands.
| | - Dirkjan H E J Veeger
- Research Institute MOVE, Department of Human Movement Sciences, Free University Amsterdam, Van der Boechorststraat 7, NL, 1081BT Amsterdam, The Netherlands; Department of Biomechanical Engineering, Delft University of Technology, Mekelweg 2, NL, 2628CD Delft, The Netherlands.
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De Baets L, van der Straaten R, Matheve T, Timmermans A. Shoulder assessment according to the international classification of functioning by means of inertial sensor technologies: A systematic review. Gait Posture 2017; 57:278-294. [PMID: 28683420 DOI: 10.1016/j.gaitpost.2017.06.025] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2017] [Revised: 05/12/2017] [Accepted: 06/23/2017] [Indexed: 02/02/2023]
Abstract
This review investigates current protocols using Inertial Measurement Units (IMUs) in shoulder research, and outlines future paths regarding IMU use for shoulder research. Different databases were searched for relevant articles. Criteria for study selection were (1) research in healthy persons or persons with shoulder problems, (2) IMUs applied as assessment tool for the shoulder (in healthy subjects and shoulder patients) or upper limb (in shoulder patients), (3) peer-reviewed, full-text papers in English or Dutch. Studies with less than five participants and without ethical approval were excluded. Data extraction included (1) study design, (2) participant characteristics, (3) type/brand of IMU, (4) tasks included in the assessment protocol, and (5) outcomes. Risk of bias was assessed using the Downs and Black checklist. Scapulothoracic/glenohumeral and humerothoracic kinematics were reported in respectively 10 and 27 of the 37 included papers. Only one paper in healthy persons assessed, next to scapulothoracic/glenohumeral kinematics, other upper limb joints. IMUs' validity and reliability to capture shoulder function was limited. Considering applied protocols, 39% of the protocols was located on the International-Classification-of-Functioning (ICF) function level, while 38% and 23% were on the 'capacity' and 'actual performance'-sublevel, of the ICF-activity level. Most available IMU-research regarding the shoulder is clinically less relevant, given the widely reported humerothoracic kinematics which do not add to clinical-decision-making, and the absence of protocols assessing the complete upper limb chain. Apart from knowledge on methodological pitfalls and opportunities regarding the use of IMUs, this review provides future research paths.
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Affiliation(s)
- Liesbet De Baets
- REVAL Rehabilitation Research Center - BIOMED Biomedical Research Institute, Faculty of Medicine and Life Sciences, Hasselt University, Diepenbeek, Belgium.
| | - Rob van der Straaten
- REVAL Rehabilitation Research Center - BIOMED Biomedical Research Institute, Faculty of Medicine and Life Sciences, Hasselt University, Diepenbeek, Belgium.
| | - Thomas Matheve
- REVAL Rehabilitation Research Center - BIOMED Biomedical Research Institute, Faculty of Medicine and Life Sciences, Hasselt University, Diepenbeek, Belgium.
| | - Annick Timmermans
- REVAL Rehabilitation Research Center - BIOMED Biomedical Research Institute, Faculty of Medicine and Life Sciences, Hasselt University, Diepenbeek, Belgium.
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Sun T, Li H, Liu Q, Duan L, Li M, Wang C, Liu Q, Li W, Shang W, Wu Z, Wang Y. Inertial Sensor-Based Motion Analysis of Lower Limbs for Rehabilitation Treatments. JOURNAL OF HEALTHCARE ENGINEERING 2017; 2017:1949170. [PMID: 29065575 PMCID: PMC5516720 DOI: 10.1155/2017/1949170] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Accepted: 05/09/2017] [Indexed: 11/18/2022]
Abstract
The hemiplegic rehabilitation state diagnosing performed by therapists can be biased due to their subjective experience, which may deteriorate the rehabilitation effect. In order to improve this situation, a quantitative evaluation is proposed. Though many motion analysis systems are available, they are too complicated for practical application by therapists. In this paper, a method for detecting the motion of human lower limbs including all degrees of freedom (DOFs) via the inertial sensors is proposed, which permits analyzing the patient's motion ability. This method is applicable to arbitrary walking directions and tracks of persons under study, and its results are unbiased, as compared to therapist qualitative estimations. Using the simplified mathematical model of a human body, the rotation angles for each lower limb joint are calculated from the input signals acquired by the inertial sensors. Finally, the rotation angle versus joint displacement curves are constructed, and the estimated values of joint motion angle and motion ability are obtained. The experimental verification of the proposed motion detection and analysis method was performed, which proved that it can efficiently detect the differences between motion behaviors of disabled and healthy persons and provide a reliable quantitative evaluation of the rehabilitation state.
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Affiliation(s)
- Tongyang Sun
- School of Mechanical & Automative Engineering, South China University of Technology, Guangzhou, Guangdong, China
| | - Hua Li
- The Second People's Hospital of Shenzhen, Shenzhen, Guangdong, China
| | - Quanquan Liu
- School of Mechanical & Automative Engineering, South China University of Technology, Guangzhou, Guangdong, China
- Shenzhen Institute of Geriatrics, Shenzhen, Guangdong, China
| | - Lihong Duan
- Shenzhen Institute of Geriatrics, Shenzhen, Guangdong, China
| | - Meng Li
- Shenzhen Institute of Geriatrics, Shenzhen, Guangdong, China
| | - Chunbao Wang
- School of Mechanical & Automative Engineering, South China University of Technology, Guangzhou, Guangdong, China
- Shenzhen Institute of Geriatrics, Shenzhen, Guangdong, China
- School of Mechanical Engineering, Guangxi University of Science and Technology, Liuzhou, Guangxi, China
| | - Qihong Liu
- School of Mechanical & Automative Engineering, South China University of Technology, Guangzhou, Guangdong, China
| | - Weiguang Li
- School of Mechanical & Automative Engineering, South China University of Technology, Guangzhou, Guangdong, China
| | - Wanfeng Shang
- Shenzhen Institute of Geriatrics, Shenzhen, Guangdong, China
| | - Zhengzhi Wu
- Shenzhen Institute of Geriatrics, Shenzhen, Guangdong, China
| | - Yulong Wang
- The Second People's Hospital of Shenzhen, Shenzhen, Guangdong, China
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Robert-Lachaine X, Mecheri H, Larue C, Plamondon A. Accuracy and repeatability of single-pose calibration of inertial measurement units for whole-body motion analysis. Gait Posture 2017; 54:80-86. [PMID: 28279850 DOI: 10.1016/j.gaitpost.2017.02.029] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2016] [Revised: 02/27/2017] [Accepted: 02/28/2017] [Indexed: 02/02/2023]
Abstract
Portable inertial measurement units (IMUs) are suitable for motion analysis outside the laboratory. However, IMUs depend on the calibration of each body segment to measure human movement. Different calibration approaches have been developed for simplicity of use or similarity to laboratory motion analysis, but they have not been extensively examined. The main objective of the study was to determine the accuracy and repeatability of two common single-pose calibrations (N-pose and T-pose) under different conditions of placement (self-placement and passive placement), as well as their similarity to laboratory analysis based on anatomical landmarks. A further aim of the study was to develop two additional single-pose calibrations (chair-pose and stool-pose) and determine their accuracy and repeatability. Postures and movements of 12 healthy participants were recorded simultaneously with a full-body IMU suit and an optoelectronic system as the criterion measure. Three repetitions of the T-pose and the N-pose were executed by self-placement and passive placement, and three repetitions of the chair-pose and stool-pose were also performed. Repeatability for each single-pose calibration showed an average intraclass correlation coefficient for all axes and joints between 0.90 and 0.94 and a standard error of measurement between 1.5° and 2.1°. The T-pose with passive placement is recommended to reduce longitudinal axis offset error and to increase similarity to laboratory motion analysis. Finally, the chair-pose obtained the least longitudinal axis offset error amongst the tested poses, which shows potential for IMU calibration.
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Affiliation(s)
- Xavier Robert-Lachaine
- Institut de Recherche Robert-Sauvé en Santé et en Sécurité du Travail, 505 Boul. Maisonneuve Ouest, H3A 3C2, Montréal, QC, Canada.
| | - Hakim Mecheri
- Institut de Recherche Robert-Sauvé en Santé et en Sécurité du Travail, 505 Boul. Maisonneuve Ouest, H3A 3C2, Montréal, QC, Canada
| | - Christian Larue
- Institut de Recherche Robert-Sauvé en Santé et en Sécurité du Travail, 505 Boul. Maisonneuve Ouest, H3A 3C2, Montréal, QC, Canada
| | - André Plamondon
- Institut de Recherche Robert-Sauvé en Santé et en Sécurité du Travail, 505 Boul. Maisonneuve Ouest, H3A 3C2, Montréal, QC, Canada
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17
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Crabolu M, Pani D, Raffo L, Conti M, Crivelli P, Cereatti A. In vivo estimation of the shoulder joint center of rotation using magneto-inertial sensors: MRI-based accuracy and repeatability assessment. Biomed Eng Online 2017; 16:34. [PMID: 28320423 PMCID: PMC5359843 DOI: 10.1186/s12938-017-0324-0] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2016] [Accepted: 03/11/2017] [Indexed: 11/13/2022] Open
Abstract
Background The human gleno-humeral joint is normally represented as a spherical hinge and its center of rotation is used to construct humerus anatomical axes and as reduction point for the computation of the internal joint moments. The position of the gleno-humeral joint center (GHJC) can be estimated by recording ad hoc shoulder joint movement following a functional approach. In the last years, extensive research has been conducted to improve GHJC estimate as obtained from positioning systems such as stereo-photogrammetry or electromagnetic tracking. Conversely, despite the growing interest for wearable technologies in the field of human movement analysis, no studies investigated the problem of GHJC estimation using miniaturized magneto-inertial measurement units (MIMUs). The aim of this study was to evaluate both accuracy and precision of the GHJC estimation as obtained using a MIMU-based methodology and a functional approach. Methods Five different functional methods were implemented and comparatively assessed under different experimental conditions (two types of shoulder motions: cross and star type motion; two joint velocities: ωmax = 90°/s, 180°/s; two ranges of motion: Ɵ = 45°, 90°). Validation was conducted on five healthy subjects and true GHJC locations were obtained using magnetic resonance imaging. Results The best performing methods (NAP and SAC) showed an accuracy in the estimate of the GHJC between 20.6 and 21.9 mm and repeatability values between 9.4 and 10.4 mm. Methods performance did not show significant differences for the type of arm motion analyzed or a reduction of the arm angular velocity (180°/s and 90°/s). In addition, a reduction of the joint range of motion (90° and 45°) did not seem to influence significantly the GHJC position estimate except in a few subject-method combinations. Conclusions MIMU-based functional methods can be used to estimate the GHJC position in vivo with errors of the same order of magnitude than those obtained using traditionally stereo-photogrammetric techniques. The methodology proposed seemed to be robust under different experimental conditions. The present paper was awarded as “SIAMOC Best Methodological Paper 2016”.
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Affiliation(s)
- M Crabolu
- Department of Electrical and Electronic Engineering, University of Cagliari, Piazza d'Armi, 09123, Cagliari, Italy.
| | - D Pani
- Department of Electrical and Electronic Engineering, University of Cagliari, Piazza d'Armi, 09123, Cagliari, Italy
| | - L Raffo
- Department of Electrical and Electronic Engineering, University of Cagliari, Piazza d'Armi, 09123, Cagliari, Italy
| | - M Conti
- Department POLCOMING, University of Sassari, Sassari, Italy
| | - P Crivelli
- Department POLCOMING, University of Sassari, Sassari, Italy
| | - A Cereatti
- Department POLCOMING, University of Sassari, Sassari, Italy.,Interuniversity Centre of Bioengineering of the Human Neuromusculoskeletal System, Sassari, Italy.,Department of Electronics and Telecommunications, Politecnico di Torino, Turin, Italy
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18
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Deng S, Chen K, Ma Y, Chen J, Huang M. The Influence of Test Positions on Clinical Assessment for Scapular Dyskinesis. PM R 2016; 9:761-766. [PMID: 27916706 DOI: 10.1016/j.pmrj.2016.11.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2016] [Revised: 11/14/2016] [Accepted: 11/17/2016] [Indexed: 11/30/2022]
Abstract
BACKGROUND Appropriate evaluation of scapular dyskinesis is essential for therapeutic strategies. Although the current visual-based assessment is rapid and practical, the reliability of this method is unsatisfactory. It is necessary to adequately understand the conditions of assessment to maximize the benefit of therapeutic interventions. OBJECTIVE To explore the influence of different test positions on clinical assessment for scapular dyskinesis. DESIGN Observational study. SETTING University rehabilitation department. PATIENTS A total of 102 subjects diagnosed with unilateral shoulder disorder were recruited from among rehabilitation outpatients from November 2015 to February 2016. METHODS Two experienced raters categorized the subjects' scapular movement pattern according to Kibler et al classification by the vision-palpation method at 4 test positions (at rest, and the end range of elevation in the sagittal, scapular, and coronal planes). MAIN OUTCOME MEASUREMENTS The overall prevalence of scapular dyskinesis, the distribution of types, and the reproducibility of types at the 4 test positions were analyzed. RESULTS The overall prevalence of scapular dyskinesis was 90.08%, and the highest frequency was found at the resting position. Type III was the most common type in our sample. In reproducibility analysis, 21.57% of subjects presented with the same type at any position, and 75.49% of subjects presented with 2 types. CONCLUSIONS Scapular dyskinesis in individuals with shoulder disorder showed a high prevalence, especially at the resting position. More than 1 type of scapular pattern would be present if assessed at different positions. This study indicates that test positions can affect the results of scapular dyskinesis assessment, and that the resting position should primarily be applied. LEVEL OF EVIDENCE III.
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Affiliation(s)
- Simin Deng
- Department of Rehabilitation Medicine, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China(∗)
| | - Kang Chen
- Department of Rehabilitation Medicine, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China(†)
| | - Yanhong Ma
- Department of Rehabilitation Medicine, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600 Yishan Road, Shanghai 200233, China(‡).
| | - Juan Chen
- Department of Rehabilitation Medicine, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China(§)
| | - Mi Huang
- Department of Rehabilitation Medicine, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China(‖)
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